The time for playing games on Medicare For All is over

Abdul El-Sayed said something yesterday that brings into focus the essential dysfunction which is the US health-care system:

Millions of Americans need insulin to survive. The researchers (Frederick Banting, Charles Best and James Collip) who developed insulin in the 1920s knew this and wanted to ensure the medication would remain affordable and safe. They assigned the patent to the University of Toronto for a nominal amount. When asked why they’d done that, Dr. Banting reportedly said “Insulin belongs to the world, not to me.”

On January 23, 1923, an American patent on both insulin and Toronto’s method of making it was awarded to Banting, Collip, and Best. For $1.00 to each, the three discoverers assigned their patent rights to the Board of Governors of the University of Toronto. The application had stressed that none of the other researchers in the past had been able to produce a nontoxic antidiabetic extract. A patent was necessary to restrict manufacture of insulin to reputable pharmaceutical houses who could guarantee the purity and potency of their products. It would also prevent unscrupulous drug manufacturers from making or patenting an impotent or weakened version of this potentially dangerous drug and calling it insulin. —…

Which brings us back to our system. It has clearly failed patients in this and many other respects. It has also failed the vision and intention of the researchers whose humanitarian intentions are being undone as pharmaceutical companies try to extract profits out of insulin sales, using every trick in the book.

As we head towards 2020, we know that healthcare will again be a major part of the conversation. Republicans have failed miserably in outlining any alternative approach beyond reactionary slogans like “repeal and replace”. They have made it clear they do not plan to do anything in the approach to 2020, and will not detail any plans past 2020 either.

This is a good thing, because it allows Democrats to set the terms of the debate. A huge majority of Americans supports Medicare For All. This includes 85% of Democrats and a slim majority of Republicans.

The Republican response is, in Trump’s case to call private insurance “beloved” in a tweet that launched a hundred comedy routines:

I don’t know anyone apart from health-insurance executives who “loves” our current exploitative system. Most Americans know they’re being scammed. Republicans have underscored that by literally putting a fraudster in charge of their health-care proposals. There is no compromising with this party which wants to defraud the American people on a massive scale to line the pockets of its donors:

But this is no laughing matter. It is a matter of life and death.

It is a serious political enterprise and if Medicare For All is to be instituted, it will require an enormous push. Over the past three years, public support for the idea has snowballed. To turn this support into a reality we have to:

  • solidify the public support
  • win an election by campaigning on it
  • push Medicare For All through Congress
  • close the door on Republican attempts to undermine it

The wide field of Democratic candidates offer a variety of positions on health-care and the problem of pharmaceutical prices. Jeff Stein over at the Washington Post has done us a favor by synthesizing all the candidates’ positions on healthcare.  He asks seven important questions, and places all the candidates on a scale for each of them.

  1. What should happen to private insurance?
  2. Do you support creating a public option to expand health care, such as allowing people to buy into a state Medicaid program regardless of income?
  3. Do you believe all undocumented immigrants should be covered under a government-run health plan?
  4. Do you support partially expanding Medicare by allowing people ages 50 to 64 to buy into Medicare?
  5. Do you support giving the federal government the ability to negotiate drug prices for Medicare
  6. Do you support importing drugs from other countries?
  7. Do you support having the federal government produce and sell generic drugs to lower drug prices? —…

In all the responses, one pattern is clear across all the candidates, Warren and Sanders are the major candidates who are clearest on the challenge, and on the solutions. Most of the other candidates waffle on details, or hem and haw instinctively wary of upsetting the health insurance industry.

This is not the path we should follow. We’ve already gone down that road with the ACA. Republicans amplified every single negative aspect of a plan based on their own Heritage Foundation’s proposal. They called Obama socialist for instituting a market based plan. Insurers have continued to raise premiums, recalcitrant Republican governors have tried to kill the ACA with a thousand cuts, the complexity of the system has made it prone to misrepresentations

That should have taught us a lesson. Complex, half-measures will not do in our current environment. We need to create simple, universal programs and implement them in the way Medicare and Social Security were. We need to do this once, demonstrate the value to the people, and put the fear of god into any politician who tries to undo them. 

We need to convince people that they should jealously protect these programs from any right-wing hack who might try to undermine them.

There are two major candidates who understand this. Elizabeth Warren and Bernie Sanders. The rest seem to be playing around. The time for games has ended.

— @subirgrewal