Now that ‘Obamacare’ is Constitutional, the next step is Medicare for all

Whew…I feel as if we, as a country, have dodged a huge bullet today.

As predicted yesterday by former Treasury Secretary Robert Reich, the Chief Justice John Roberts crossed party lines and sided with Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan to uphold the constutionality of the Affordable Care Act (AKA Obamacare or ACA).  

The main sticking point that Republicans thought would bring the whole bill down– individual mandate to buy health insurance (or be penalized)– was upheld. 

In its coverage this morning, National Public Radio said that although most Americans like parts of the ACA, the law’s overall popularity is not high. This is not surprising at all, given the millions of dollars that have been spent and the lies that have been spread by groups like the American Enterprise Institute to discredit the ACA and push for the Ryan Plan or just plain “free market” capitalism.

Republican leaders, including Congressman John Boehner and Senator Mitch McConnell have vowed to keep fighting to repeal the ACA. It is predicted that Presidential candidate Mitt Romney will continue to campaign on the repeal of Romneycare… er… Obamacare. (You’ll remember: Obamacare was built upon Romneycare, the Massachusetts healthcare plan passed while Romney was governor.)

What about progressives? Will they be satisfied with Obamacare? Hell no. Earlier this week, progressives in the House of Representatives said they would fight for universal healthcare if Obamacare was found unconstitutional. Just as Boehner and Mitchel vowed to continue to fight for insurance companies, big pharm, and the profits of the 1%, progressives will continue to fight for universal coverage– Medicare for all.

Why?

Obamacare includes many good provisions: elimination of pre-existing conditions as a reason to deny coverage; mandate for a minimum benefits package (which includes coverage for many preventive services… duh, finally); and a massave expansion of coverage. Unfortunately, the Achillies’ heel of Obamacare and Romneycare is the mandate to buy insurance. Yes– like the Republicans– I am against the invidual mandate but for different reasons. It doesn’t work.

Yes, Romneycare has expanded coverage to nearly all Massachusetts residents. The individual mandate works in a sense because it does expand coverage to nearly 100%. Where it breaks down is in the area of medical bankruptcy. More US citizens file for bankruptcy because they can’t pay their medical bills than for any other reason. This is a national disgrace. Analyzing the Massachusetts program, Harvard researchers found that the medical bankruptcy rate did not improve under Romneycare. The curx of the problem is that people bought the insurance they could afford. In many cases, the insurance they purchased was not enough to cover expenses, and, therefore, the bankruptcy rate was not significantly different from the national rate. From The American Journal of Medicine…

Although high medical bills per se often lead to financial disaster, lost income due to illness or caregiving responsibilities also plays an important role. Many families experience multiple simultaneous blows; some lose their jobs when they get sick, and others get sick after they have lost jobs. Either way, medical bills arrive just as the paycheck stops. In recent years, these problems have been compounded by increasing unemployment and decreasing home values that have made borrowing more difficult…

The recently enacted national health reform law closely mirrors Massachusetts’ reform. That reform expanded the number of people with insurance but did little to upgrade existing coverage or reduce costs, leaving many of the insured with inadequate financial protection. Our data do not suggest that health care reform cannot sharply reduce the number of medical bankruptcies. Indeed, medical bankruptcy rates appear lower in Canada,19 where national health insurance provides universal, first dollar coverage. Instead, these data suggest that reducing medical bankruptcy rates in the United States will require substantially improved—not just expanded—insurance, as well as better disability insurance programs to provide income support to ill individuals and family caregivers. [Emphasis added.]

So, forces on the right and the left will continue to struggle. The right will fight for the 1%, and we will fight for Medicare for all. Let’s join the rest of the world in caring for our citizens. As Michael Moore said at the end of Sicko: When will we stop thinking about “me” and start thinking about “we”?

 [This post was published originally on Blog for Arizona on June 28, 2012.]