Health and Human Services Secretary Tom Price and House Speaker Paul Ryan, the Dr. Jekyll and Mr. Hyde of Donald Trump’s Washington, keep cobbling together new schemes for repealing and replacing the Affordable Care Act—with huge tax cuts for the rich and a lot less care for everyone else. But even with the White House and Congress under Republican control, shredding what remains of the health-care safety net has no appeal beyond the counting rooms of Wall Street.
So Price, Ryan, and their minions are—we should certainly hope—on a fool’s mission. But so are Democrats who imagine that the ACA is popular as anything other than an alternative to the crony-capitalist corruption that makes Price, Ryan, and their campaign donors drool with delight.
The ACA is just OK. It provides some protections, and they are important. But Americans are still stuck with a health-care system that makes them put off routine care because of exorbitant deductibles, that makes major illness not just a physical catastrophe but a financial nightmare, and that rations care in order to boost corporate profits. As the National Nurses United union notes, “Despite ACA restrictions on insurance abuses, insurers continue to find ways to discriminate against the sick, for example, tailoring benefit packages and provider networks to discourage high cost patients from choosing or remaining in their plans, and limiting network choices to exclude providers that specialize in critical services such as cancer care.”
Americans recognize what’s wrong—even if most politicians in Washington do not. “According to a Gallup poll last year (and a similar Kaiser survey), more than half of Americans wanted to repeal the ACA, and most Americans still have a dim view of the law. They know it is not working. They know the deductibles are too high and they can’t afford the co-payments. (Curiously, on the eve of its repeal, a growing number of Americans say they support the law.)” explains Dr. Claudia Fegan, who serves as the national coordinator of Physicians for a National Health Program. “But the Gallup poll also showed that 58 percent of Americans—including 41 percent of Republicans and 53 percent of those who favored repeal—wanted the ACA replaced with ‘a federally funded health care program providing insurance for all Americans,’ in other words, single-payer reform. They want a plan that covers the care they need and lets them see the providers they choose with no out-of-pocket costs.”
Bernie Sanders has the right response. Arguing that “our job is to improve the Affordable Care Act, not repeal it. Our job is to guarantee health care to all people as a right, not a privilege,” Sanders says, “We have got to have the guts to take on the insurance companies and the drug companies and move forward to a Medicare for All single-payer program.”