I recently returned from visiting family in Norway and traveling in several other European countries. A common question I was asked is why a wealthy nation like the United States does not provide universal health insurance for all its citizens. As I was departing in early June, the health crisis created by the high cost of insulin was fresh in my mind. A bill in the Minnesota Legislature to provide emergency insulin to those in need had just failed to pass.
Not surprisingly, news of the insulin crisis was covered by European media, including the case of Alex Smith, the 26-year-old Minnesotan who died in 2017 as a result of rationing insulin after he was no longer covered by his parent’s plan. As most Minnesotans know from media coverage, the legislation was named in Smith’s memory.
France24, a major French television station, reported on a diabetic in Kentucky who had gone to purchase insulin in Canada, where a vial costs $22, while the same retail pharmacy in the U.S. charged over $300. The headline read: “The price of insulin is killing Americans.” A sad commentary on our nation. Successive U.S. governments — from George W. Bush’s Medicare D plan to Obamacare to the Trump administration — bet on the marketplace to lower costs. Yet costs continue to rise and U.S. health care outcomes have declined to nearly last among our peer nations.
Not an isolated problem
The insulin crisis is not an isolated problem, but a result of our relying on an ineffective, bureaucratic, private, for-profit health insurance system. Public systems in Canada and Europe keep drug costs in check because pharmaceutical firms and pharmacy distributors are prevented from gouging the public. Competition from generic producers is encouraged, and negotiations on prices provide for accountability and transparency.
If we followed the best practices of our Canadian and European friends and created a single-payer health insurance system – improved Medicare for all – we could end the insulin crisis and deliver effective, quality and timely health care to all Americans. No worries, no health care bills and with less cost to the nation.
As presidential candidate Sen. Bernie Sanders often says, if Canada and European nations do it, so can we. He rightly asserts that private insurers and for-profit medical and administrative firms are simply transfer entities that siphon off premium and tax dollars to reward shareholders and fund lobbyists, CEO salaries, political campaigns and advertising firms. These are the other reasons our health costs are nearly twice that of comparable European nations.
Next time you see a TV ad, billboard or online ad for drugs, hospital care, health insurance or the lobbying arms of these industries, ask: Are these dollars providing health care? Do any of these activities add value? These dollars are simply a revenue stream of federal and state taxes, and premiums, co-insurance premiums and co-payments paid by companies and individuals. With single payer almost all these resources could be spent on delivering health care. Advertising makes sense for most products, but health care is not a product, it’s a necessity. Our doctors know where the hospitals are; they know what drugs to prescribe and what diagnostic procedures a patient may need.
Lies at worst, exaggerations at best
Critics who disparage national health insurance as a socialist idea are correct. It is. So is Medicare. So is Social Security. Decades ago, workers in Europe and the U.S., through their trade unions, and indeed socialist parties, fought for and won public health insurance and other benefits. These same critics spread rumors of long wait times and other shortcomings of “socialist health care” in Europe or Canada. Such rumors are lies at worst, and exaggerations at best. In short, they are scare tactics designed to distract our attention from the real problem.
Another distraction is the allegation that single-payer would damage the economy. On the contrary, public health insurance would be an economic boost. Several million Americans could retire early, opening jobs for young people. Single-payer would create a more flexible, higher-paid workforce because employees could more securely switch jobs, consequently putting pressure on employers to compete more vigorously on wages. Yet, employers would also benefit. With the volatility of health care costs in check, they could forecast and plan future investments with more confidence.
One fear that is understandable is that of the million-plus people working for health insurers whose livelihoods would be threatened as private insurers are phased out. This too is a scare tactic. Each single-payer legislative proposal in congress addresses job displacement and provides for a just transition through retraining and employment with no loss of income. The only way we can use our resources more effectively is to streamline administration, which is possible with a single-payer financing system. Medicare is a good example of this, as its administrative costs are far less than private insurers.
Resist the negative propaganda
If we as a nation continue to believe the negative propaganda, as repeated by the corporate media, Trump and far too many Democratic politicians, our families and nation will continue to experience health care insecurities, mounting bills and worries.
A majority of Americans, including many GOP voters, now support an improved Medicare for all that would cover dental and eye care and mental health and lifesaving drugs like insulin. Health studies, and a bit of common sense, tell us that improving our nation’s overall health outcomes would bring about a more prosperous, more competitive and safer society. Would the transition be challenging? Of course, but we are known as a “can do” nation and people. It is time to think bigger and inclusively. All in and all covered, so we have no more tragic deaths like that of Alec Smith.
Wayne Nealis is a writer and longtime peace and labor activist living in Minneapolis.
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