Down by about 300 delegates, Bernie Sanders has an admittedly narrow path to victory in the race for the Democratic Party presidential nomination. An essential element of the argument against Bernie and thus for Joe Biden is that Bernie is simply “not electable,” while Biden, who had never won a state primary in three campaigns until this year, will beat an overall unpopular incumbent in Donald Trump.
As a counterpoint to this prevailing narrative of electability perpetuated by professional pundits and corporate hacks, everyone is electable if you vote for them. Moreover, with roughly half of states yet to vote, it’s not too late to vote for Bernie Sanders. Amid a global pandemic which has seen over a million cases worldwide, has killed more than 50,000 people, and is responsible for sickness, death, and surging unemployment claims here in the United States, he is unquestionably the leader for this moment.
Keeanga-Yamahtta Taylor, assistant professor of African-American studies at Princeton University and author, expresses this sentiment beautifully in a recent piece for The New Yorker titled “Reality Has Endorsed Bernie Sanders”. As she finds, Sanders’s “policy proposals are especially apt now, when the coronavirus crisis is revealing an economy organized around production for the sake of profit, not need.”
In meditating on the alacrity with which the U.S. and the world at large has found itself in an existential crisis, Taylor underscores the reality that the state of America’s welfare state, precarious to begin with, has been steadily worsened by the marginalization of the individuals and families who rely on it. The poor, despite numbering in the tens of millions, are mostly ignored except to be demonized as fundamentally lacking in effort, intelligence, and social graces. All the while, rent goes up and salaries/wages don’t, leading to a national housing crisis, and as a function of racial injustice, black and brown Americans feel the pinch worst of all, including having reduced access to affordable, high-quality healthcare.
Throw in a highly infectious and deadly novel coronavirus and the byproduct is brutal, if unsurprising. People of color, particularly those who live in poverty, are at greater risk for contracting and for suffering severe complications from COVID-19 because they are unable to afford the kind of social isolation “flattening the curve” merits, whether as a function of their living arrangements, jobs/professions which pay little and expose them to the public (e.g. home healthcare, retail, service industry), or both. The greater the economic and racial inequality, the more pronounced the racial disparities are liable to be.
As Taylor makes the connection, looking back at U.S. politics of recent decades, it is no wonder why both major political parties’ responses to the spread of coronavirus have been lacking. During Richard Nixon’s presidency, conservatives did their part to undermine the welfare state by depicting entitlement programs as rewards for laziness or a form of privilege, while at the same time pushing for corporate tax cuts and profits. In response, Democrats followed suit, echoing concerns about Americans “taking advantage” of welfare and advocating for criminal justice “reform” in the form of harsher attitudes and penalties for violators, predominantly those from communities of color. Today, Democrats and Republicans alike elevate profligate spending on the military and the perpetuation of a cruel and unjust criminal justice system above investment in and protection of an adequate social safety net. They have done little to change course since the start of the crisis in the United States because they don’t know how, a slave to the ideologies they have elaborated for more than a generation.
This is where Bernie Sanders and his campaign come in. Previously derided by his political rivals, their supporters, and armchair political theorists, Sanders and his policy goals sound more than plausible in the current climate, political or otherwise. It is this global crisis which has brought clarity to the notion that Bernie’s active bid for the White House isn’t just the one that best elaborates the antidote to what’s happening now, but to the underlying conditions that preceded it too. In theory, the idealized “free market” should have an answer to the present economic crunch and health care emergency. Instead, free testing and treatment for COVID-19 is a “debate;” PPE, tests, and ventilators (not to mention the essential personnel to tend to the sick and dying) are in dire supply, overpriced or overtaxed; the cruise industry is asking for a bailout despite not paying U.S. income tax; and others are actively seeking ways to profit from this disaster. Does that sound acceptable to you?
Consequently, any set of solutions going forward must rethink our paradigm, embracing collectivity, connectivity, and personal responsibility over illusory top-down solutions. It is in this sense in which Bernie’s emphasis on big-picture thinking and grassroots organizing is thankfully distinct from that of Joe Biden’s and Donald Trump’s hyperpartisan rhetoric. Taylor closes her column thusly:
The class-driven hierarchy of our society will encourage the spread of this virus unless dramatic and previously unthinkable solutions are immediately put on the table. As Sanders has counselled, we must think in unprecedented ways. This includes universal health care, an indefinite moratorium on evictions and foreclosures, the cancellation of student-loan debt, a universal basic income, and the reversal of all cuts to food stamps. These are the basic measures that can staunch the immediate crisis of deprivation—of millions of layoffs and millions more to come.
The Sanders campaign was an entry point to this discussion. It has shown public appetite, even desire, for vast spending and new programs. These desires did not translate into votes because they seemed like a risky endeavor when the consequence was four more years of Trump. But the mushrooming crisis of COVID-19 is changing the calculus. As federal officials announce new trillion-dollar aid packages daily, we can never go back to banal discussions of “How will we pay for it?” How can we not? Now is a moment to remake our society anew.
A mere two election cycles after Barack Obama’s tenure in the White House, the promise of “Yes, we can!” has given way to the notion we not only can work together for a better future, but must do so if we’re to have a future at all. Bernie Sanders’s movement, of which the slogan is “Not Me. Us,” is the human-powered political force that best articulates the paramount importance of putting people and the planet over profit. The rest is just noise at this point.
Touching again upon the insufficiency of both parties’ responses to the coronavirus pandemic gripping the nation, unless you are a steadfast party supporter or backer of the president, you probably don’t need an explanation as to how poorly the Trump administration has handled this situation. I mean, Jared Kushner has a functional role in the response. That’s a red flag right there.
Reports of Donald Trump showing favoritism to red states in the availability of supplies. Press conferences that are more likely to feature the creator of MyPillow than usable information. Considering 200,000 deaths due to COVID-19 a “very good” result of the virus’s spread. The Trump White House is showing its lack of preparedness for an emergency of this magnitude atop its standard incapacity for empathy for people unlike the president. That Mitch McConnell and his ilk would try to blame the “distraction” of impeachment for Trump not doing his job or to create their own distraction by pivoting to talk of Hunter Biden merely adds insult to injury. We’ve seen him at his rallies. We know about the golf. This isn’t fooling anyone except the gullible members of his base.
Unfortunately, establishment Democrats haven’t really seized the advantage. As usual, rather than offering a substantive vision for how to move forward in this time of crisis, they’re hoping and waiting for Trump to self-destruct, all the while coalescing behind a man in Joe Biden who seems patently incapable of making a media appearance without glitching or lying. In the face of millions of Americans losing health insurance as a result of being newly unemployed or having to pay through the nose for testing/treatment for COVID-19, Biden appears unmoved on the subject of single-payer healthcare. When appearing in an MSNBC interview with Yasmin Vossoughian on the matter, here was his response:
Single-payer will not solve that at all. The thing that is needed is, for example, we have a whole number of hospitals that are being stretched, including rural hospitals, they are going to need more financing. That doesn’t come from a single-payer system. That comes from the federal government stepping up and dealing with concerns that they have. The reimbursement they are going to get, how they’re going to be able to move forward.
At one point, Biden also referenced the way Italy has been impacted by the pandemic, saying that single-payer couldn’t prevent coronavirus from spreading. Right, Mr. Biden, but you’re missing the point. Meagan Day, staff writer at Jacobin, details what the former vice president either doesn’t get about single-payer or doesn’t want to admit owing to his fealty to the health insurance industry.
Addressing Biden’s comments re Italy, Day points out, citing responses from Italians across the political spectrum, that the death toll would’ve been much worse had it not been for universal healthcare. Here in the United States, the number of tragic stories grows seemingly day by day of individuals who are dying because they can’t afford treatment/testing or are otherwise reluctant to seek it out because of the cost. A system like Medicare for All would ensure nobody is denied the care they need because they can’t afford insurance. Bernie’s critics have lashed out at him for continuing to champion M4A amid this catastrophe, but this isn’t just politics as usual for millions of Americans. It quite literally could mean the difference between life and death.
In fairness to Biden, he isn’t the only Dem offering weak sauce to a divided electorate desperately seeking a direction forward. Days after the passage of coronavirus stimulus legislation that saw, among other things, Senate Democrats largely capitulate to the GOP on a one-time $1,200 payment and give Treasury Secretary Steven Mnuchin largely unchecked powers over a $500 billion bailout “slush fund,” Nancy Pelosi’s big idea evidently is to…revisit a repeal of the SALT deduction cap that would largely benefit wealthy earners? What?
As un-presidential as Trump proves with every briefing, he’s speaking directly to the public, controlling the narrative on COVID-19 in the United States. What’s worse, it seems to be working for his popularity, which is on the rise as of this writing. He’s also gaining nationally in polling on Biden, the presumptive Democratic Party presidential nominee who has been invisible at times during this crisis and even when making remarks is a gaffe machine. That Democrats would even casually float New York governor Andrew Cuomo’s name as someone they might rather support in the lead-up to November (another leader who has a sizable audience these days) should be deeply concerning to party leadership. Biden’s campaign doesn’t inspire nearly as much confidence or excitement among Democratic supporters as Trump’s does for his base, which could spell disaster close to six months from now.
Meanwhile, Bernie Sanders has been front and center during this crisis, doing regular livestreams answering questions about our coronavirus response and featuring legislators and experts in various fields as part of the broadcasts. He also memorably stood up to Senate Republicans in the stimulus bill negotiations, threatening to hold up its passage unless a handful of them backtracked on stripping unemployment insurance expansion for millions of workers. That’s the kind of real leadership hiding in plain sight that the Dems have been looking for.
Alas, down by about 300 delegates, Bernie Sanders has an admittedly narrow path to victory in the race for the Democratic Party presidential nomination. Win or lose, though, his candidacy matters. For those who have yet to cast their ballots in 2020, it’s not too late to vote for Bernie Sanders. He’s the only candidate left who has the mindset and the wherewithal to steer the country as it should be steered in these perilous waters.
On the U.S. version of The Office, tasked with picking a health care plan for Dunder Mifflin Paper Company, Dwight Schrute, assistant to the regional manager, prided himself on slashing benefits “to the bone” in an effort to save the company money. He rationalized his decision-making with the following thought: “In the wild, there is no health care. In the wild, health care is, ‘Ow, I hurt my leg. I can’t run. A lion eats me and I’m dead’.”
Dwight Schrute is, of course, a fictional character, and his attitude is an extreme one. Nevertheless, his mentality reflecting the notion that health care is no guarantee and the idea he needs to select a plan for his Scranton office at all are indicative of a very real issue facing Americans to this day. If health care is a right, why does it feel more like a jungle out here?
To this point, the Declaration speaks against discrimination based on any identifying characteristic. It opposes slavery, torture, and unfair treatment at the hands of law enforcement and the courts. It asserts that all persons have the right to a nationality and to seek asylum from persecution. They also possess the right to marry, the right to their property, freedom of expression/thought and religion, and freedom to peaceably assemble and participate in government. Other stated liberties include the right to work for equal pay, the right to leisure, the right to health, the right to education, and the right to appreciate culture.
What is striking to Gjelten and others is how the UDHR is designed to be applicable across cultures, political systems, and religions. It is truly meant as a universal set of standards, one with secular appeal. That is, it is a human document, not a God-given list of commandments.
Then again, in some contexts, this last point might be a bone of contention. As Gjelten explains, Saudi Arabia abstained from the original unanimous United Nations Assembly vote because of issues with the Declaration’s views on family, marriage, and religious freedom, in particular the idea that one can freely change religions, which can be considered a crime. In general, some of the strongest objections to the language of the UDHR have come from the Islamic world, though this does not imply that Islamic law and these rights are incompatible.
There were others who abstained from the vote in 1948 as well, though. The Soviet Union and its bloc states were part of the eight abstentions, presumably because of the stipulation about people’s right to freely expatriate. South Africa, a country then predicated on racial segregation, was also part of the eight. Even some American conservatives at the time had their qualms about the UDHR’s wording, convinced the sentiments about economic rights sounded too socialist. Actually, that probably hasn’t changed all that much. In certain circles, socialism is indeed a dirty word.
The thrust of Gjelten’s piece is more than just admiration for the Declaration’s principles and the work of Eleanor Roosevelt as chair of the UN commission responsible for drafting the document, though, deserved as that admiration is. 70 years after the fact, America’s commitment to upholding its articles is not above reproach. Furthermore, in an era when a growing sense of nationalism and resistance to “globalism” pervades politics here and abroad, the UDHR’s spirit of universality and international fraternity is seriously put to the test.
Gjelten cites two areas in which the country “still falls short” as a subset of the “struggles for civil and political rights that were yet to come” subsequent to the UDHR’s approval vote. One is equal pay for equal work, a topic which deserves its own separate analysis and, as such, I’m not about to litigate it at length here. Suffice it to say, however, that I—alongside many others—believe the gender gap is very real. It also disproportionately affects women of color, occurs across occupations and industries, and is frequently mediated by employer practices that rely on prior salary history as well as policies enforced in individual states designed to specifically disenfranchise female earners. Do with these thoughts as you will.
The other area in which the U.S. has fallen short, as alluded to earlier, is universal health care. Article 25 of the Declaration states that “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services.”
As a fact sheet on the right to health from the Office of the UN High Commissioner for Human Rights and the World Health Organization elaborates, the right to health includes access to health care and hospitals, but it’s more than that. It includes safe drinking water, food, and adequate sanitation. It includes adequate housing and nutrition. It includes gender equality, healthy environmental and working conditions, and health-related education and information.
But yes—it does include the “right to a system of health protection providing equality of opportunity for everyone to enjoy the highest attainable level of health.” It doesn’t say this is a privilege only for those who can afford it.
This is an essential point in the health care “debate.” Should health care be a right for all? While you’re entitled to your opinion, Mr. or Ms. Schrute, if you say no, it’s hard to know how to continue the conversation beyond that. This applies both for naysayers on the left and on the right. Don’t hide behind the idea “we can’t afford it.” Don’t hide behind the Affordable Care Act, which is no guarantee to survive given repeated attempts to sabotage it. If you believe health care is a human right, let’s work backward from there. I mean, all these other countries have some form of single-payer health care. Why shouldn’t we—and don’t tell me it’s because we spend too much on our iPhones.
Tom Gjelten’s piece is more concerned with the history behind the Universal Declaration of Human Rights and its formation. Like any good historian, though, he’s got a mind for the Declaration’s larger implications and its potential impact in the years and decades to come. Getting back to that whole growing nationalism thing, Gjelten notes how playing identity politics often draws strength from ethnic or religious conflict.
To be clear, this trend in increasing strife between different groups isn’t just an American phenomenon. Around the world, political leaders have risen to power by aggressively promoting division and/or appealing to a sense of national pride through brutality and curtailing human rights. Rodrigo Duterte. Xi Jinping. Narendra Modi. Viktor Orban. Vladimir Putin. Mohammed bin Salman. The list goes on. There will be more to come, too. Jair Bolsonaro was recently elected president in Brazil. His mindset carries with it a promise for a regressive shift in his country’s politics.
Still, even if we’re not the only ones coping with societal change, if America is truly the greatest country in the world, we should be setting the best example in terms of adherence to the UDHR’s principles. Meanwhile, even before Trump, our country’s commitment to “life, liberty, and the pursuit of happiness” has been uneven.
Criminal sentencing/policing disparities and states’ insistence on use of the death penalty. The lack of a universal health care infrastructure. Failure to protect the rights of vulnerable populations, including women/girls, people with disabilities, and the LGBT+ community. War crimes overseas and at the U.S. prison at Guantanamo Bay. Surveillance of global communications. And since Trump has taken office, our performance on these fronts has only gotten worse, notably in categories like foreign policy, the rights of non-citizens, and safeguarding First Amendment rights. If this is “America First” and “making America great again,” there’s a piece of the puzzle missing.
A lot of this may sound a bit too SJW for some. We should all respect one another’s rights. Everyone should be afforded the same opportunities to succeed. Let’s all hold hands and sing songs together around the campfire. I get it. There are practical considerations which complicate implementing solutions to global ills as well. Agencies and nations have to be willing to work together to achieve common goals, and who pays what is always a bother. On the latter note, I tend to think some cases are overstated or represented in a misleading way by politicians and the media. Cue the myriad “Bernie/AOC doesn’t know what he’s/she’s talking about” articles. Let’s all move closer to the center because it has worked so well for us until now.
The thing is that many of the principles covered by the UDHR reflect policy directions voters want and can agree on. When Republicans came to repeal and replace the Affordable Care Act, they were unsuccessful in part because of the public outcry in support of the ACA. Turns out people like being able to afford health care—who knew? Regarding equal pay for equal work, that shortfall for working women is one that whole families could use if given a fairer salary or wage. Not to mention it’s, you know, the morally right thing to do.
Though we may be susceptible to the words of political figures that would keep us at odds with each other (and secretly may even like it that way), we must continually put the onus on our elected officials to authentically represent all the people within their jurisdiction. The Universal Declaration of Human Rights is a good place to start. As suggested before, let’s consider the change we hope to see before capitulating or saying “no” outright. A more equal America is one which will benefit all its inhabitants—from top to bottom and over the long term.
That’s the story we get from our beloved president, Donald J. Trump, at least. As many of us can attest to, though, what he says may not be (or is rarely) the gospel truth.
In an August 13 post in his nascent online newsletter, Popular Information, journalist Jedd Legum discusses how, indeed, GDP growth is strong and unemployment is low. Sounds great, right? While not to discount these trends, the issue is that wages aren’t rising to accompany them. Legum writes:
There is something fundamentally broken about the United States economy and no one is doing anything about it.
Unemployment is low. GDP growth is strong. But official government data released on Friday show that real wages for American workers have gone down over the last year.
Nominal wages, the dollar amount workers see in their paychecks, have slowly crept up, increasing 2.7% between July 2017 and July 2018. But that has not kept up with inflation, which rose 2.9% over the same period.
The economy is growing. Workers, however, are falling further behind.
This sounds awfully doom-and-gloom coming from Legum, but as he indicates, he has the data provided by the Bureau of Labor Statistics to back him up. What’s more, he identifies key reasons why workers aren’t reaping the benefits of a robust economy through their take-home pay.
First of all, before we get to why wages are stagnant or declining, there’s the matter of the Trump tax cuts. After the Tax Cuts and Jobs Act was signed into law, the White House promised that “the median U.S. household would get a $4,000 real income raise.” That hasn’t happened, though.
To make matters worse, Trump and his advisers are apparently not interested in revisiting their policies to assess their potential flaws. Instead, Trump has—in characteristic fashion—doubled down on his assertions. He has ignored any evidence to the contrary, boasting that our paychecks are bigger and America is booming like never before. That’s especially not true in the case of our “booming” nation, but why let facts get in the way of a good story?
As Legum is keen to point out, however, trends in wage stagnation relative to inflation are bigger than Donald Trump. (But shh—don’t tell Trump that. In his mind, he is the sun around which we revolve.) Regardless of who is president or which party is in power, wages have been effectively stagnant for decades.
Based on this phenomenon, Legum insists that if people are complaining of an economy “rigged” against them, they are, well, right. Despite America’s status as one of the richest countries in the world and in an era of increasing profits, fewer people are enjoying those additional rewards. Cue the conversation about the 99% versus the 1%.
Accordingly, as Legum asks in his introduction, what gives? The answer is a complicated one, though there are some major culprits in the eyes of economic analysts. The first is employer-based health insurance, of which costs are on the rise. Because of escalating health care expenses, employers are less likely to raise wages. Because they are concerned about coverage and costs, employees are less likely to seek employment elsewhere. Consequently, employers are less inclined to negotiate on wages for fear of a departure. It shouldn’t surprise you to know that lower-wage workers also are disproportionately affected by these rising health care costs.
Speaking of negotiating for higher wages, a decline in union membership mediated by deliberate attempts to undermine organized labor has weakened the bargaining power and wages of union and non-union workers alike. Without significant union membership, there is insufficient reason for non-union employers to raise wages to compete with those of union firms. This is to say that it is not a zero-sum game involving the wages of union and non-union workers.
Compounding the problem of wages in America is that productivity is lagging despite advancements in technology. Legum speaks to the theory that American companies are simply not investing enough for the long term, instead opting to turn revenues into dividends or stock buybacks that inflate stock prices. Meanwhile, as he also indicates, wages have increased more slowly than productivity, so this is “only a piece of the puzzle.”
All of these factors lead up to Legum’s central point. While wage stagnation is obviously complex, there are yet remedies which can be effected. On the health care front, Medicare-for-all and other single-payer models at the state level have been suggested as ways to make employer costs more manageable. For unions, there are possible interventions like majority sign-up or multi-employer bargaining. For productivity’s sake, where private organizations fail, public investments in infrastructure can help pick up the slack.
The problem with these remedies is that they aren’t being implemented, or as Legum puts it, “no one is working to fix the problem.” Re the Trump administration, in many cases, these solutions aren’t just being ignored—they are forsaken for policies that deliberately move us backward.
We all remember the attempts by the president and a Republican-led Congress to kill the Affordable Care Act. They haven’t yet proven wholly successful, though this doesn’t mean the GOP will stop trying. Trump also celebrated the ruling in Janus v. AFSCME, characterized by many as a major blow to public-sector unions. As for infrastructure, Trump promised it would be a priority of his tenure in office. Heretofore, like most of Trump’s promises, it has yet to come to fruition.
In closing, Legum writes, “Politicians of all stripes speak incessantly about the American worker. But until they tackle the wage crisis head-on, it’s hard to take them seriously.” The absence of references to a specific political party here implies that both Republicans and Democrats should be taken to task for their role in subverting the wage growth of the labor force in the United States.
For the GOP, which has long kept the interests of big business close to heart, this is no big surprise. On the other hand, for the Democrats, the putative party of the people, the charge is that they have failed workers by not more vigorously defending organized labor, not to mention too eagerly embracing corporate lobbies/wealthy donors and their influence. This is the sort of inaction from lawmakers that the average voter is arguably justified in raging against. With the criticism from the left, there is an added sense of disappointment that a party which traditionally has embraced working-class Americans appears to have so readily abandoned them.
As Judd Legum underscores, these trends which have contributed to wage stagnation amid a growing economy were in motion before the rise of Donald Trump. His ascendancy is perhaps an all-too-logical consequence of their elaboration. As numerous publications and pundits observed, working-class whites, who came out in force for the business tycoon in 2016, were a key source of his support.
Before the election, the voting bloc of whites without a college degree was reportedly shrinking, and polling data had Hillary Clinton with one foot in the White House. Meanwhile, a group of individuals who disdain professionals because they perceive themselves to be disdained, while holding fast to the aspirational model embodied by Trump, was instrumental in swinging the election to the Republican presidential nominee. If Democratic strategists were convinced they could all but ignore this subset of the electorate (and key segments of the Rust Belt), it turned out they were wrong.
It’s political realities like this which make the recent decision by Tom Perez and the Democratic National Committee to reverse a ban on donations from fossil fuel companies rather alarming. Ostensibly, this was a move made because input from labor suggested a ban on fossil fuel money was an “attack” on workers. In reality, and as the activist community has observed, this 180 is designed to allow fossil fuel executives to keep donating to (and buying influence within) the Democratic Party.
The DNC’s about-face is particularly galling given that the prohibition on fossil fuel contributions—which specifically targeted corporate PAC donations—only came about this past June. Defenders of Perez’s proposal might be wont to point out that the Republican Party accepts substantially higher amounts of cash from the fossil fuel industry than the Dems do. There’s also the aspect that Democrats in contested districts/states feel they need to take a more moderate stance when it comes to energy production.
Still, as Kate Aronoff, contributor to The Intercept, quipped, “There are no jobs on a dead planet.” The DNC’s recommitment to an “all-of-the-above” energy strategy is a regressive turn of events at a time when more urgent action on climate change is needed, and when the Trump administration is doing its part to reverse as many regulations designed to safeguard the environment as possible (see also Scott Pruitt as the original pick for the EP-freaking-A).
Moreover, the rationalization of taking fossil fuel PAC money as a defense of organized labor is an altogether cynical one. Apparently, being a rank-and-file worker/Democratic Party supporter and having enthusiasm for an energy plan based on renewable sources are mutually exclusive. If you care about your job, evidently you give f**k-all about the planet.
To reiterate, the problem of stagnant and declining wages in America is a complex one mediated by a number of factors. At the same time, a little leadership from our elected representatives could go a long way in convincing us we are on the right track in trying to ameliorate the situation. Unfortunately, legislative gridlock and intentional concessions to corporate interests inspire little confidence we’re moving in the right direction on this issue.
What if I told you there were a way for the United States of America to save, up front, tens of billions of dollars? Access to health care would drastically improve. Individuals, families, and businesses alike would experience less of a financial and logistical burden, and doctors and patients would be empowered regarding the decisions made in the interest of the latter. Other areas tied to health care would also stand to benefit from the reduced complexity of the new system and the relief over who is and who isn’t insured or otherwise cannot afford critical procedures. On top of all this, such a framework is already being used to great success elsewhere in the world. Sounds great, right? We should be jumping at the chance as a nation to implement such a system, no?
In case it were not already apparent, I’m referring to a single-payer health insurance system, which, in this country, would take the form of a Medicare-for-all paradigm. Hmm, are you still as enthusiastic?
I’m guessing there are those of who you aren’t, whether you’re a staunch Republican, a Democratic loyalist, or none of the above. Advocacy for a single-payer public insurance system was one of the cornerstones of Bernie Sanders’ presidential campaign, but it was one of the most commonly assailed elements of his platform alongside the notion of free college tuition for public schools. As was the running theme from his detractors, the idea sounded great, but practically speaking, it had no chance of becoming reality. On some level, I tend to think the plausibility of Bernie’s proposed policies got and still does get conflated with the likelihood of him becoming a finalist, if you will, in a presidential race. However you slice it, Sanders was fighting an uphill battle in capturing the Democratic Party nomination ahead of Clinton. Still, for all those convinced a Medicare-for-all system in the U.S. would be a disaster in the making, might there be more to the story than even these self-professed experts realize? That is, could the concept of a single-payer insurance plan not only have merit, but also be exactly what this country needs?
First things first, let’s discuss what a single-payer health insurance system involves at its most elemental, and then we can better explore the case for implementing such a system nationwide. To do that, we’ll consult Physicians for a National Health Program (PNHP), an organization devoted explicitly to advocacy for a universal, single-payer national healthcare program. PNHP, as part of its work, strives to furnish a more informed debate on how to address health care in the United States, and it offers a wealth of information and resources to this point. According to the organization, single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private. For those of you who hear “public agency” and start frothing at the mouth, yes, the government would be involved in the administration of a Medicare-for-all program. Before you get carried away, however, let’s directly and immediately address what this entails, and what it does not.
1. Single-payer health insurance does not require steep tax hikes.
As Physicians for a National Health Program explains, indeed, an additional tax will be needed to cover the costs of a national single-payer system, one described as “modest” and based on ability to pay. Now, I see you breaking out your pitchforks and torches there, but hold on a minute, would you? An estimated 95% of households—what I consider to be a significant majority—would ultimately save owing to not having to pay premiums (including co-pays and deductibles), as they do under private insurance plans. In other words, you’d give a little, but get a lot in return.
2. Single-payer is not socialized medicine.
Republican politicians often like to dangle the specter of socialism and vague notions of government overreach to scare voters away from a superior policy option. In this instance, arguments against Medicare-for-all or even the Affordable Care Act are designed to distract from scrutiny of the American Health Care Act, the intended GOP replacement for the ACA and a piece of legislation so flawed no Republican—not even Donald Trump—wants to be associated with by name. Which is, ahem, exactly why it should be referred to as TrumpCare or RyanCare.
With specific regard to a single-payer program, the association with socialized medicine is one that is used to obscure and deflect. Socialized medicine is when facilities are owned by the government, and health professionals are on the public payroll. This is how it works in England, or even with the VA in the States. A Medicare-for-all, national health insurance system only socializes the administration of this insurance, not the care itself. Patients would be able to choose their doctor and hospital, and doctors would be afforded greater autonomy in their own right.
3. Medicare-for-all is not unaffordable.
Double negative, apologies, but I’m most concerned with the underlying concept here. I noted earlier how individuals and companies would benefit by no longer having to fuss around with co-pays and the like, but the American economy stands to gain at large from a single-payer framework. Nearly a third of current health spending in the United States today belongs to administrative expenses. As President Trump has learned the hard way, health care is complicated, and the price tag for billing, marketing, underwriting and other overhead activities is estimated to cost us some $400 billion. A year. Recouping that money alone would be sufficient to cover a Medicare-for-all health care system. So much waste—and so much of it preventable, too.
4. Single-payer insurance does not result in rationed care.
One of the biggest points of the hit piece regularly levied against universal health care is that it rations care. Unbearable wait times! You’ll die before you get to see a doctor! You mean as opposed to the current system in the United States, where you basically have insurance only if you can afford it? That’s rationing too, bruh! Some 30,000 Americans die every year because they can’t afford health insurance, and still more forgo procedures and treatments because of refusals of insurers to cover them. The extent to which delays are experienced in any single-payer system is a function of that system’s capacity and the ability of the associated government to manage the patient load, and as such, long waits are not an inherent condition of universal health care. Besides, and I don’t know about you, but I would rather wait a little longer to be seen by a doctor than, um, die.
5. Approval for a national health care system is not a minority opinion.
Establishment politicians on both sides of the aisle would try to convince you that a national health program isn’t desirable, or in the case of the more conservative ones, bad for business. Poppycock and hogwash, I say! For starters, on the dimension of business, a single-payer system would actually be a boon, as employers would no longer be burdened by administrative tasks related to health care and health insurance, and would thus be better able to focus on their core functions. Irrespective of what a Medicare-for-all program would stand to do for companies and their management, though, doctors and their patients alike see the writing on the wall when it comes to the merits of universal health care. Nearly 60% of Americans support a single-payer health insurance program in the United States, and four in ten Republicans also favor such an approach. This complements a similar percentage of doctors who have been, for close to a decade now, calling for a national health insurance system. This polling data begs the question: if Medicare-for-all/single-payer is so bad, why do so many of us want it?
In trumpeting the support of a majority of Americans who favor a single-payer health insurance format in the United States, it should be duly noted that a good portion of the constituency does not. For some, notably on the Democratic Party side of things and ever mindful of the legacy of Barack Obama, upholding the Affordable Care Act seems to be sufficient. To be sure, in the short term, resisting attempts by Donald Trump and Co. to eviscerate the ACA and elements of the social safety net is important—bigly important, at that. Still, a side-by-side comparison of a proposed Medicare-for-all plan and the current legislation in place regarding health care/health insurance makes the flaws in ObamaCare stand out, and arguably gives Republicans more fodder in trying to convince the public to get behind repealing and replacing it. Once again, Physicians for a National Health Program has a handy guide as to why the Affordable Care Act, though leaps and bounds ahead of the AHCA, yet falls short of being, ahem, what the doctor ordered when it comes to what is ailing health care in the U.S. Here are the salient points from this study of contrasts:
1. The Affordable Care Act still leaves millions of Americans without coverage.
An estimated 30 million Americans will go without health insurance by 2022 if current projections and trends hold. For a nation as affluent as the United States, that’s appalling, and this figure doesn’t even begin to consider the tens of millions who remain underinsured, and as alluded to earlier, intentionally bypass recommended medically necessary procedures because they can’t afford them, or otherwise believe they can’t. Medicare-for-all, meanwhile, offers health care for everyone, as the name implies.
2. Under the ACA, patients are not offered a full range of benefits.
In a seemingly very backward state of affairs, employers and other insurers tend to offer fewer health benefits and yet require higher co-pays and deductibles as we go along. That’s borderline insane. Under Medicare-for-all, all medical necessary services would be covered.
3. In a single-payer system, the country would save money. With what is currently in place, costs would only skyrocket.
To reiterate, with Medicare-for-all, we’d be saving about $400 billion with no net increase in health spending. Over the next ten years, if health care in America remains unchanged, costs would increase by more than $1 trillion. Trillion. Again, craziness, especially if plans offered by insurers are getting more draconian with each passing year.
4. In a single-payer system, patients would be allowed free choice of doctor and hospital. In the current system, denials and limitations of service abound, and networks continue to be restricted.
How often have you heard or experienced situations in which an individual wants to see a specialist or undergo a procedure, but that function or professional is not covered by his or her health insurance plan? Or worse, what about a situation in which a patient, unbeknownst to him or her, is attended by a doctor not included in his or insurer’s network, and is hit with a disproportionate charge on his or her bill as a consequence of this care, the likes of which may be nominal attention at best? These are all-too-common scenarios under the current health care framework, which disempowers both doctor and patient. Within a Medicare-for-all paradigm, patients would be afforded their choice of facility and physician.
5. The Affordable Care Act does not rectify inequality in costs between the wealthy and lower-to-middle classes.
Because funding for a Medicare-for-all system would be based on a progressive tax system that draws revenue from income and wealth taxes, and because premiums and out-of-pocket costs are replaced by these taxes, not only would 19 out of 20 Americans pay less than they do now, but health care administration would run more smoothly and fairly. Currently, health care costs are disproportionately paid by poorer Americans, especially those facing or suffering from acute and chronic illness. Which, honestly, if you’re surprised about, you perhaps suffer from some form of break with reality or a particular condition that yields delusions.
So, single-payer health insurance would save Americans time, money, energy, and grief. It is loads better than the American Health Care Act, and it surpasses the Affordable Care Act, a well-intentioned but structurally flawed bit of policy. Moreover, internationally, there are plenty of successful models from which to choose, including those of Australia, Canada, France, Spain, and Taiwan. A majority of Americans supports it. Why aren’t we progressing faster and further on this issue even at the state level? Well, the potential answers are manifold, but as is so frequently the case, it helps to follow the money. Indeed, understanding resistance becomes that much easier when we consider who stands to lose from the implementation of a Medicare-for-all system, or better yet, who has been profiting handsomely from today’s confusing and fragmented market. The following are some of the key players in the opposition of universal health care:
When you stop to think about it, it’s kind of a shitty thing for insurance companies to make such heavy profits on something that could very well mean life or death for the health care seeker. And yet they do, and where this revenue stream exists, you’ll usually find a voice against single-payer. Take AARP. You might think an organization devoted to the well-being and empowerment of retirees would support a program that would stand to help a population worth the advocacy and extra protection. You’d be wrong. AARP makes about a quarter of its money via UnitedHealthcare, the largest for-profit insurance company in the nation, and so its support for the Affordable Care Act is about all the Association can muster. Public insurance would almost certainly rein in the health insurance industry to a considerable extent, and to this end, the private insurance lobby has devoted a commensurately large amount of resources to try to keep it down.
Not our pharmaceutical companies, forever motivated by the highest ethical and moral standards! That’s right, kids: Big Pharma doesn’t like the idea of Americans importing prescription drugs from Canada at reduced rates, and they certainly do not like the idea of the government negotiating drug prices on behalf of the consumer and buying in bulk so as to make their products more affordable. The entrenchment of the pharmaceutical industry in our everyday lives is apparent from anyone who has watched television for, like, an hour. “Moderate to severe” illnesses. “Possible side effects” include. Shit, that you probably know what to do in case of a four-hour erection just speaks to the tight grip Big Pharma has on this country, as does your likely familiarity with who Martin Shkreli is and the absurd practice of jacking up prices of drugs like EpiPen at a moment’s notice. In the Wild West of the prescription drug market, drug makers see a no-nonsense sheriff looming in Medicare-for-all—and make no mistake, they ain’t fixin’ to stand by and let it try to restore order. No siree.
Conservatives in business and government who bank on “free-market” economics
Conservative Republicans love the theory behind the power of the free market, and hate what they perceive to be government interference in the due course of business. What has aided the GOP in their electoral aspirations and their attempts to dismantle the ACA is the American people’s own distrust of government and pursuit of wealth. As you might expect, there are serious problems with simply allowing health care to take care of itself under the premise that allowing people to make choices without the federal government interceding always leaves consumers better off. Critical to understanding this debate is realizing visions of a “free” market in health care are all but illusions. The peculiarities of this industry are such that consumers rarely possess the sort of content knowledge adequate enough to participate in an informed negotiation with the seller, be that the facility performing the requested service, the pharmaceutical company selling the drugs, the medical equipment company selling the paraphernalia, the private insurance company selling the plan, or some combination therein.
Even assuming end users can reasonably close this knowledge gap, however, there is still the matter of prices being less than transparent and subject to change, not to mention subject to variance across states and dependent on whether people/families can afford to pay. On top of all this, and perhaps most importantly, so much of health care is not based on want, but need. If you need a reasonably complicated form of treatment, or a prescription drug that is fairly expensive to manufacture, you need health insurance, or else you are paying exorbitant amounts out of pocket—and even then you might be out of luck if supply is on the short side and prices shoot up with demand. Breaking this whole situation down to its essential point, we, the consumers, have little bargaining power when it comes to trying to negotiate a fair deal, and as costs get shifted to out-of-pocket expenses, those who genuine lack the ability to pay are more frequently disadvantaged, and the companies and wealthy individuals that have a vested interest in generating profit from health care and health insurance tend to benefit. In other words, free-market principles applied to health care in the United States are fundamentally about redistribution of costs—and in a way that is pretty much guaranteed not to be in your favor.
So far, a number of states have tried to pass some form of single-payer legislation, and in the case of the state of Vermont, it actually went into effect before being repealed a few short years later. In terms of current attempts to enact a public health insurance system on a state level, perhaps the most notable examples are those of California and New York, if for no other reason than they are big states, electorally speaking. As you might expect, though, these initiatives have been targeted by more than their fair share of hit pieces and smear campaigns. In the Golden State, there are scare-tactic specials such as a piece in the Sacramento Bee entitled “The price tag on universal health care is in, and it’s bigger than California’s budget.” Which, technically, is true, but still lower than the current price tag, as author, radio host, and one-time Green Party vice presidential candidate Pat LaMarche explains. In the Empire State, meanwhile, you have the likes of Bill Hammond, director of health policy at the conservative think tank Empire Center, being given a platform by the New York Post to deride New York Democrats’ push for single-payer health care as a “lunatic” endeavor. Well, Gerald Friedman, economics professor and department chair at UMass – Amherst says the Dems’ proposed plan would not only save lives and money over time, but create some 200,000 jobs. Dude’s got a PhD, too, so suck on that, Hammond!
Noting the hurdles faced in individual states to get single-payer plans approved and sustained, maybe it’s just as well that we think bigger as a country and fully get behind Medicare-for-all health care. After all, the legislation is ready and waiting. In the House of Representatives, H.R. 676, the Expanded & Improved Medicare for All Act, was introduced by Rep. John Conyers of Michigan’s 13th District (the Fightin’ 13th!) and referred to the House Committee on Energy and Commerce back in January. Since that time, it has also been referred to the House Ways and Means and House Natural Resources Committees, and 112 representatives have signed on as co-sponsors, a record-breaking number. As for the Senate, three guesses as to who plans to introduce a version of this bill. If you aren’t thinking about a certain senator and unabashed democratic socialist from Vermont, well, you very well may not know your ass from a hole in the ground.
Granted, in the very short term, this means little without Republican support, and to be clear, not one GOP legislator has signed on as a co-sponsor of H.R. 676. We would expect similar treatment in the Senate; if Tom Price’s confirmation as Secretary of Health and Human Services is any indication, Republican legislators will actively try to rig health care to the benefit of moneyed interests. This does not mean that the effort is an unworthy one, however. The more that GOP leaders push a more deeply flawed replacement (AHCA) for an already-flawed health care system (ACA), the more that people understand that single-payer national insurance exists and is effective the world over, and the more single-payer legislation is advanced on a state-by-state basis, the more momentum builds for a credible solution to our health care crisis and politicians who will rise to the challenge of meeting the needs of their constituents. Because it is a crisis. Try telling the families of the people who have died as a result of not having health insurance it’s not.
So, seriously—it’s time for Medicare-for-all/single-payer health insurance in this country. We’ve waited long enough, and in truth, we the people can’t afford to wait any longer.
After a Democratic Party primary season which saw nine debates and 13 candidate forums held, and a Republican Party campaign season which saw 12 debates and nine forums held, many Americans may be justifiably and understandably “debated out.” Half-truths and outright lies. Pandering to prospective voters along demographic lines. Constant interruptions. The rambling attempts to answer questions from the person of Dr. Ben Carson. For these reasons and more, it is no wonder people may not only become disengaged from political discourse in the weeks and months following any presidential election and into the inauguration, but may actively distance themselves from anything of a political nature. Especially if you find yourself on the liberal end of the political spectrum, the executive actions taken by President Trump and the partisan rancor which has marked the confirmation process for a number of his Cabinet nominees has made tuning in to the news these days almost somewhat of an act of masochism. Either that or you want to take out your frustrations on the nearest object. In the latter case, make sure the consistency of said object is closer to that of a pillow than, say, a brick wall.
While the nature of politics today and President Trump’s victory have helped alienate scores of Americans, others have taken recent events as a call to action and a reason to stay informed and involved. Though the workings of Congress may remain arcane to many of us, a notion buttressed by the crushing boredom of House and Senate proceedings, through News Feeds and trending topics on social media, as well as dedicated accounts whereby average citizens can interact with their elected representatives, political figures have never been more accessible than they are today. Why, I interact every day with President Trump via Twitter! OK, so maybe it’s a bit one-sided, and it consists of me Tweeting to his preferred account each time that he lost the popular vote, according to the most recent count, by 2,868,519 votes—but hey, I get to speak to him directly! (He seems very concerned with the results of the popular vote, so I figured he should be apprised of the status of the count, you know, just in case anything were to change.) It’s an exciting time in American history to be so close to those with our best interests in mind!
It is with this dichotomy that I offer the news, in the event you were unaware, that CNN aired a televised debate on the subject of health care recently, with periodic updates on social media featuring snippets of the proceedings. Wait—you’re saying—this is February 2017. We just had an election, and the 2018 mid-terms aren’t until November of next year. Why are we having a debate at this very early point in the campaign? Well, for starters, both of the participants are, in fact, running for re-election in 2018, and as a matter of fact, made it pretty darn far in the presidential race before conceding to the eventual party nominees. Besides this possible means to an end, though, the topic of conversation is an important one for Americans across income level, age level and other identifying characteristics. The subject of health care in the United States is a pressing one for individuals and businesses alike, and yet more so in the wake of the GOP’s announced plans to dismantle the Affordable Care Act. Based on what our leaders and policymakers decide in the near future, large swaths of the population stand to be impacted one way or another, and noting the costs involved, generations to come may likewise be affected by the actions of the present. So, yeah, while we’re a way’s away from November 2018, it makes sense to have a debate now when so much is at stake.
Have I sufficiently set the scene? Even if I haven’t, let us press onward, for we have much to discuss, grasshopper.
UNITED STATES OF JOE RECAPS THE CNN HEALTH CARE DEBATE
For a weeknight debate in the campaign off-season, CNN and the powers-that-be for each “side” of the affair could have trotted out your run-of-the-mill, rank-and-file members of Congress. As it turned out, though, this debate brought the heat in the form of two heavyweight contenders in the political scene. Your, ahem, “fighters” in this bout:
In the red corner, the U.S. Senator everyone loves to hate, the Tea Partier from Texas, the Canadian-born, half-Cuban aficionado of the government shutdown, ladies and gentlemen—give it up for Rafael “The Zodiac Killer” Cruz!
Annnnnd in the blue corner, he’s an independent senator but he caucuses with the Democrats, he lives in Vermont but he’s Brooklyn through and through, he’s a fan of democratic socialism and he’s not afraid to show it—”let me be clear” who I am talking about: the one, the only, Bernard “It’s Not about Me, It’s About Our Revolution” Sanders!
Round One: The Opening Statements
Bernie Sanders was first to go in the opening segment, and per the boxing metaphor, he came out swinging. According to Sanders, the Republicans’ intended repeal of the Affordable Care Act would mean 20 million Americans finally able to have health insurance would lose it, the 10 million seniors struggling to pay for prescription drugs would see their costs go up by an average of $2,000, and people with serious diseases/illnesses could be refused insurance for having pre-existing conditions. In making these arguments, Bernie acknowledged the ACA isn’t perfect, but indicated a majority of Americans want better than a repeal without an improved replacement. Then, he dusted off his old line from the campaign trail: that the United States is the only major country on Earth not to offer health care as a fundamental right. It doesn’t make it any less true, of course, but ahem, we’ve heard this before.
Ted Cruz, when he was on for his two minutes, talked about how his colleague in the Senate and the Democrats want government to control health care, and therefore want to wrest control away from you and your family. Cruz then proceeded to engage in the GOP’s new favorite tradition—dragging the legacy of Barack Obama—specifically by alleging Obama made promises about Americans being able to keep their own plans and that families’ premiums wouldn’t rise, and didn’t keep them, and capped these arguments off by saying the election was a referendum on ObamaCare. Actually, it seemed like the election was a referendum on establishment politics in general and/or Barack Obama and “Crooked” Hillary Clinton, but sure, go nuts with that story, Ted.
Round Two: So When Exactly Do We Repeal, Again?
To start off the actual debate portion of the debate, Jake “Please Don’t Put Me on with Kellyanne Conway Again” Tapper, co-moderator of CNN’s prime-time event alongside Dana “Admit It, You’re Glad I’m Not Don Lemon, Aren’t You?” Bash, engaged Ted Cruz about a timeline for a repeal of ObamaCare. After all, Paul Ryan had said a full repeal would get done by the end of 2017, but President Trump recently suggested a repeal and replacement might not come to pass until 2018. So, wouldn’t anything less than a substantive change by the end of this year be tantamount to a broken promise? Cruz was quick to reject this assertion, though, returning to his line about recent elections between a referendum on ObamaCare, saying “the people” wanted lower deductibles and premiums and more choices, not less, when it comes to their health care providers. Don’t we all, Ted. Don’t we all. Cruz closed his thoughts on this particular question by saying we need “common-sense” reform on health care and health insurance in America (“common-sense Republican reform”—bit of an oxymoron, no?), and attacked Democrats for resisting all changes to the Affordable Care Act. It’s not necessarily true, mind you, but it plays well in sound bites and video clips.
Given the opportunity to respond, Bernie Sanders replied by saying the Republicans don’t have a credible substitute for the ACA, and accordingly, are in a state of “panic.” He was all, like, oh, you want a choice under the GOP’s plan? How about if you have cancer, then you either have affordable health care, or if you are refused coverage because you have a “pre-existing condition,” you—wait for it—die? What kind of a choice is that? OK, so he didn’t say it exactly like that per se, but he may as well have. As Sanders views things, it is the nature of private insurance that drives these no-win situations for the consumer, and in a rebuttal to the notion ObamaCare has driven up premiums, remarked that it was under the Bush administration that rates really began to soar. So chew on that for a while, you whipper-snapper!
In a rebuttal to the rebuttal, Ted Cruz pointed out that insurance companies’ profits increased during Obama’s tenure, which doesn’t really prove anything, but the correlation is there. Bernie made a counter-offer that we should just bypass the insurance companies altogether and institute a Medicare-for-all system. Cruz then pivoted to a verbal assault on Big Pharma and the cost of prescription drugs, which Sanders admittedly got baited into joining because he loves him some Big Pharma bashing. Sheesh—one question in, and this thing was already threatening to go off the rails.
Round Three: Ponder This
Round Three marked the introduction of audience member questions into the fray. The first of these came from a woman named Neosho Ponder, someone diagnosed with breast cancer and currently undergoing treatment because of ObamaCare. She wanted to know of Ted Cruz: if the Affordable Care Act is repealed, what guarantee will I have that I’ll be able to afford health insurance given my “pre-existing condition” of cancer? To which Cruz essentially was all, like, um, well, we can pray for you? Bernie Sanders first asked for Jake Tapper to “cut him a switch.” Then he proceeded to lambaste his political rival for wanting to repeal every word of the ACA without maintaining the ability to protect those with pre-existing conditions from the machinations of the insurance industry. Cruz responded by saying what about the 6 million people who lost their coverage as a result of ObamaCare? (By the way, not really close to being accurate.) Dana Bash interceded to ask him when, exactly, he planned on answering Ponder’s question. And Ted Cruz was all, like, I already did a bunch of times. And Bash was all, like, seriously, though, what about those pre-existing conditions? And Cruz then offered to do everyone in attendance a magic trick to lighten the mood. No—you’re right—he didn’t, but it would’ve been just about as effective. Because he and the Republicans can’t promise Americans like Neosho Ponder will be able to find coverage, and in the spirit of illusions, would only excel at making affordable health insurance disappear.
Round Four: The, Er, Abnormal Pap Smear Round
No one involved in the actual debate had an abnormal pap smear, whether we’re talking about the participants or the moderators. That is, that we know of. I mean, Ted Cruz could secretly be a hermaphrodite or something. Not that I’m alleging he is one, by the way. Just saying you never know. No, that revelation came from audience member Melissa Borkowski, a nurse practitioner from Florida with a husband, four kids, and, oh, just a tiny little insignificant $13,000 deductible. Bernie Sanders was asked, um, what gives, old man? Sen. Sanders replied by saying, well, Pam, we shouldn’t be paying that much, and if this were France, Germany, Scandinavia or the U.K., you wouldn’t. She-He Cruz, meanwhile, contended we pay more because we get better and more frequent care. What happens when the government controls health care is that it rations that care. So there, Bernie. Then he stuck his tongue out and made antlers with his hands to his head.
Piggybacking off Borkowski’s question and her, well, candid medical information, Jake Tapper directed a follow-up at Bernie, asking him about a state like Florida that now has less insurance choices to offer through ObamaCare and through the public exchange. How do we manage affordability for the consumer while still offering a fair number of choices? First, responding to Melissa’s question and Ted Cruz’s comments, because he’ll answer your question when he’s good and ready, Mr. Tapper!, Bernie Sanders noted that when people can’t afford health insurance and proper health care, that is effectively a form of rationing as well. The solution, as Sanders sees it, is to, as an extension of a Medicare-for-all single-payer program, provide a public option in all 50 states and offer the kind of competition needed against the private sector. Ted Cruz, in his reply, brought a visual aid in the form of a map of this insurance coverage—or lack thereof—and criticized the public option as the government controlling your health care, also known as—gasp!—socialism. Besides, as much as Sen. Sanders might extol the public option, what about all those Canadians and Scandinavians who come to the United States for superior health care?
Quick to jump back in, Bernie refuted the notion that the government option was the government telling people what to do. After all, it’s an option, not a mandate. Regardless, you don’t see leaders of these countries that offer the public option, even the conservative ones, choosing to get rid of this avenue for insurance. Mr. Zodiac Killer, in response, threw out some horror stories about rationing and waiting periods for patients as a justification for why there shouldn’t be a public option or even a Medicare-for-all program. Bernie, however, wasn’t having any of it, and threw out not his own horror stories, but rather an estimate that tens of thousands of Americans die each year because they don’t seek medical treatment, or as Big Pharma would refer to it within the context of possible side effects for prescription drugs, there are tens of thousands of “fatal events.” Ooh—Bernie Sanders with the haymaker, right before the commercial break!
Round Five: Help Me, LaRonda!
Actually, it was LaRonda who needs the help, although, unfortunately for her, she probably was never going to a satisfactory answer from either debater. The question, first directed at Sen. Sanders, was posed by LaRonda Hunter, an owner of five Fantastic Sams hair salons who would like to expand and hire more employees, but this would put her over the 50-employee threshold, and under ObamaCare, she would need to start providing health insurance to her employees. So, how could she meet this regulatory requirement and grow her business without raising prices or lowering wages? (Side note: I have never heard of Fantastic Sams, but evidently, they have locations all over the damn place. They also evidently don’t like using apostrophes. I mean, it should be “Fantastic Sam’s,” right? Unless the founder has the last name Sams? Either way, their distinction of being “fantastic” seems suspect.) And Bernie was all, like, well, Ronda. And Ms. Hunter replied, it’s LaRonda. And Sanders was all, like, dammit, you people have to stop changing your names on me! As to your question, though, um, you don’t? That is, if you have that many employees, they should be getting health insurance. Sen. Ted Cruz, given the floor, took the opportunity to portray ObamaCare as the nemesis of small business, and identified two piteous classes of people created by the Affordable Care Act. The first is the 29ers, those forced to work part-time jobs because ObamaCare kicks in at 30 hours a week. The other is the 49ers, who suffer the plight of being a terrible football franchise. Kidding—sort of! The 49ers, in Cruz’s context, are people like LaRonda Hunter that stop short of hiring 50 employees or else be subject to needing to meet the insurance requirement under the ACA. So, thanks, Democrats, thanks, Barack Obama—this is the Hell you’ve wrought in the United States of America.
Bernie Sanders, of course, was not about to take this line of thinking from Sen. Cruz lying down. On the contrary, he made a few key points. First, he acknowledged that premiums are way too high, but again, they’ve been on the incline since the days of Dubya. Second, Sanders explained that there are actually fewer part-time workers now than there were before the passage of the ACA. Third, and reiterating his point from earlier, from the campaign trail, and from much of his adult life, the U.S. should enact a Medicare-for-all program—that is, unless Ted Cruz and the Republicans don’t kill it off first. Ooh—a body blow from the people’s champ! Cruz hadn’t lost his fighting spirit either, however. He asked his competitor, you know, Bernie, President Obama said premiums would go down. Wasn’t he a liar-liar-pants-on-fire? Ouch—a right hook from the challenger of his own!
The older fighter, though, proved he can still take a punch. Bernie conceded it turned out that Obama’s promise turned out not to be true, though he probably thought it was true at the time. (Second side note: if we’re calling Barack Obama a liar on this front, what does that make Donald Trump, who has already unrepentantly broken scores of campaign promises in less than a month on the job? Oh, that’s right—that would make Trump a “fraud.”) At any rate, the only way a scenario like LaRonda Hunter’s would work, he reasoned, is if we cut through the administration and bureaucracy and guarantee health care for all. Cruz, perhaps surprisingly, agreed. There’s too much paperwork. It’s all the government’s fault. Sanders replied, wait a second, Mr. Looks Like the Lead Singer of Stryper—government is part of the reason, but so are insurance companies. Sen. Cruz, once more, agreed, saying they should agree on some sort of alternative. Sen. Sanders, putting his hand to his face and shaking his head back and forth, was all, like, I’ve already said it, like, five times—Medicare-for-all, single-payer. What, do you not believe health care is a right? And Ted Cruz was all, like, I like rights. Religious freedom, that’s a good one. The Second Amendment—I enjoy that one as well. Bernie Sanders was, at this point, growing tired of his rival’s rope-a-dope. The ensuing dialog went a little something like this, and I’m paraphrasing, obviously:
BERNIE: Do you believe health care is a right?
TED CRUZ: I believe access to health care is a right.
BERNIE: WHAT THE HELL GOOD IS “ACCESS” IF YOU CAN’T AFFORD IT? THERE’D BE 20 MILLION MORE PEOPLE WITHOUT INSURANCE IF NOT FOR OBAMACARE! AM I SPEAKING ANOTHER LANGUAGE HERE?
Damn, Bernie! Don’t hurt him! Ted Cruz, in this round, may just have been saved by the bell, er, commercial break.
Round Six: The “Congratulations on Your MS” Round
The next audience question from the debate came from the person of Carol Hardaway, who suffers from multiple sclerosis. Because her state did not expand Medicaid coverage under the ACA (and what state is that? Hint: it rhymes with “Shmexas”!), she was forced to move to one that did in Maryland. So, if the Affordable Care Act is to be repealed, can she still have her coverage or a replacement that is at least on par with it? Ted Cruz, in his response, first said this—and I wish I was making this up:
Well, Carol, thank you for sharing your story. And congratulations on dealing with MS. It’s a terrible disease. And congratulations on your struggles dealing with it.
As I often do with these debates, I follow people’s comments on Twitter as they air live, and after this line from Cruz, the immediate response from most of the users was, “Wait—did this guy just f**king congratulate her on having MS?” Yes, he f**king did. This is the problem Ted Cruz faces when he has to express an actual human emotion: it often comes across as extremely awkward. When he was done applauding Ms. Hardaway for having a debilitating illness, Sen. Cruz then basically said, gee, I’m glad Medicaid is working for you, but it’s a terrible program and should be replaced with private insurance. Bernie Sanders, in rebuttal, once more conceded Medicaid, like the ACA, is not perfect, but for those governors who have refused federal funds on principle, he hopes they can sleep at night knowing some of their constituents probably died as a result of refusing the Medicaid expansion. Cruz fired back by saying Medicaid is rationed care. Sanders replied by saying that slashing funding for Medicaid is only making things worse, and what’s more, this fabled access to quality health care that the Republicans and others tout is lacking in urban and rural areas, begging the expansion of programs like the National Health Service Corps to help meet the needs of the primary care crisis.
Throughout all of this, meanwhile, Carol Hardaway’s question remained unanswered, such that Jake Tapper actually cut in to let her speak again when he noticed her shaking her head because Ted Cruz did not adequately address her concerns. Given the chance to respond, Sen. Cruz professed that there is “widespread agreement” on replacement plans, and cited three hallmarks of something that would theoretically fill the void of ObamaCare if it were repealed: 1) allowing Americans to purchase plans across state lines, 2) expanding health savings accounts (HSAs), and 3) making health insurance portable so it travels with you from job to job. He also cited his home state’s passage of tort reform laws to address lawsuit abuse and medical malpractice suits. Some notes on these “widely agreeable” solutions:
Across-state plans sound good in theory, but the primary obstacle, as this New York Times piece written by Margot Sanger-Katz details, is not regulatory, but financial and of insurer network difficulties. Insurers don’t like them, by and large, and besides, the states like to regulate these matters themselves. Not to mention it takes time to establish relationships between insurance companies and health care providers. In other words, it’s not that simple, Ted.
HSAs offer possible advantages in that plans with lower premiums but higher deductibles may cause people to be more cognizant of what they’re spending. However, a potential drawback is that consumers may not be willing to seek out more expensive procedures—even when they really need them. It’s a disturbing thought, but a reality of these types of accounts.
Portable health insurance is, in theory, a great idea. In practice, though, logistical difficulties often loom herein related to an inability to find comparable plans when changing insurers, or otherwise failure by the insured to adequately suss out whether a plan is truly beneficial to them. At any rate, the big picture issue would seem to be keeping insurance costs low regardless of insurer, and this seems to be at odds with how many health insurance giants operate. As quick as Sen. Cruz and others are to point to “big government,” the insurance industry bears as much, if not more, responsibility.
Ted Cruz touts his state’s commitment to tort reform as a success, but studies suggest that health care costs did not decrease as a result of Prop 12, which passed in Texas in 2003 and was advocated for by Gov. Rick Perry and other GOP members within the state. Often, malpractice suits and the costs of litigation are blamed for the rising cost of medical care, but it is the economics of the health care industry and errors which primarily drive the upward trend. Moreover, capping the possible damages for victims of malpractice risks denying them the monies they need, or otherwise shifting the burden to programs like Medicare and Medicaid. You know, the same programs Republicans are trying to gut. But, go ahead, Senator Cruz—pat yourself on the back.
The “round” concluded with Sanders pointing out that Texas has the highest rate of uninsured residents by far—and in the process, casually dropping the notion his state, Vermont, has the second-lowest rate of insured in the nation—and Cruz defending the Lone Star State as a job producer and drastically more diverse than Vermont. Then Sanders said Cruz was ugly. Then Cruz said Sanders’ accent is stupid. If Jake Tapper didn’t intercede, the two senators might literally have gotten into a slap fight—forget my boxing analogy. Oh, it was so on now!
Round Seven: Womanhood—The Pre-existing Condition
On the debate pressed. Next to pose a query was Maria Shahid Rowe, a nursing student at the Medical University of North Carolina, pregnant with her second child, who wanted to know of Ted Cruz what any plans to repeal the Affordable Care Act would mean for pregnant women, who were at risk of being dropped before ObamaCare passed due to being considered to have a pre-existing condition, or for women in general for that matter, in that they could be charged higher premiums than men. Cruz went on for a while, eventually settling on the issue of mandated coverage for ObamaCare, such as the example of a 101-year-old being forced to have maternity coverage. Sanders was more succinct in his reply, and translating for his colleague in the Senate, explained the Republican Party could make no such guarantees. Cruz, in his follow-up, threw out a lot of stats about how young people, in particular, have been hurt by ObamaCare. They could be true. Then again, they could be misleading or just made up. Suffice it to say, though, that despite the myth-making of Republicans about the ACA, many millennials have actually been able to better afford health insurance as a result of subsidies, or have been protected against unexpected events such as getting laid off by virtue of the provision that allows them to stay on their parents’ plans until the age of 26. If nothing else, this muddies the proverbial waters on Ted Cruz’s “facts.” Man, does that guy love “facts.”
Dana Bash stepped in at this point to redirect the conversation a bit. First, she circled back to the notion of women over the age of 60, and asked Bernie Sanders whether or not he believed they should be paying for maternity coverage. Sanders acknowledged it was a problem, but something that could be looked at going forward, before stressing the idea that pregnancy should not be considered a pre-existing condition. Bash then turned to Ted Cruz, and inquired whether or not a replacement for the Affordable Care Act would maintain the provision that women do not have to pay out-of-pocket for birth control. Uh-oh, Ted—it’s a question with religious undertones! Sen. Cruz stuck to his playbook, assailing government mandates, and making some weird analogy about driving a Lamborghini. Sen. Sanders, in his answer, while questioning the merits of the fancy car metaphor (“I think it’s a bit disingenuous to talk about driving a fancy car with getting access to healthcare when you’re sick”) raised perhaps the most significant point: that the GOP has incentive to repeal the ACA to give the top 2% sizable tax breaks, much as they would abolish the estate tax. Then Cruz started talking about a flat tax, and once more, the debate threatened to go off the rails. Jake Tapper really couldn’t have called for a commercial break any sooner than he did.
Round Eight: Possible Side Effects of Listening to Ted Cruz Include Nausea and Suicidal Thoughts
With the final audience question of the night, Colorado resident Cole Gelrod, whose daughter was diagnosed with a heart defect and who can’t pay for her prescription drugs with his employer-provided insurance, but can do so under the auspices of ObamaCare and his state’s Medicaid expansion, asked Ted Cruz what the plan was to address the rising cost of prescription drugs and how to deal with insurance plans in which companies can choose not to cover life-saving drugs. Sen. Cruz basically said it’s the FDA’s fault, because these drugs are getting approved in other countries. Ted Cruz should just make his motto, “When in doubt, blame the government.” Bernie Sanders, while he agreed with his colleague to the extent that FDA-approved drugs should be affordable and available to Americans to re-import at cheaper rates, and vowed to re-introduce legislation to facilitate this function, also said we as a nation should be negotiating lower prices through Medicare. Cruz once again—wait for it—blamed the government. Sanders—wait for it—blamed pharmaceutical companies and corporate greed, and professed the belief that these corporations and exorbitant executive pay should be reined in. Sen. Cruz was all, like, well, I don’t think the government should dictating who gets paid what. This is America, not some socialist nation. Sen. Sanders was all, like, you know, places like Denmark, Finland and Sweden aren’t that bad. Even if they do put pickled herring in mustard sauce.
Dana Bash then broke out an air horn and pressed it loudly for several seconds before redirecting the two debaters to the subject of taxes, whereupon she asked Bernie, if he is opposed to taxes going up on the middle class, why should those individuals and families who go without some form of health insurance be subject to a tax penalty? Bernie was all, like, well, they shouldn’t. The rich should be paying more, but in the meantime, we have to try to get needed revenue for benefits somehow. Ted Cruz was then all, like, well, if you don’t like the tax penalty, why did you help write ObamaCare? Your health care plan is going to cost us trillions of dollars. And Bernie Sanders was all, like, yeah, well, your tax plan gives the top 1% most of the benefits, as does doing away with the estate tax. Now, if we were to enact the Sanders plan—
And that’s when CNN cut to commercial to fulfill its obligation to its corporate overlords. Buy more cars! And more prescription drugs! WHAT ARE YOU WAITING FOR?!?
Round Nine: Closing Statements
I’m going to breeze through this final section, because I’m sure by now you know where each of the debaters are headed. Sen. Bernie Sanders sees major problems in Congress being beholden to the wants of the insurance, medical equipment, and pharmaceutical industries, and the United States being the wealthiest nation in the world and lagging behind other developed nations with respect to health care. Sen. Ted Cruz sees ObamaCare as a failure as evidenced by high premiums and deductibles, canceled insurance policies, and lies, lies, lies! from Barack Obama, and wonders why we would give yet more power to government to mediate health care. That’s basically all you need to know from this exercise. Oh, and DON’T F**KING CONGRATULATE SOMEONE WITH MS! I’M TALKING TO YOU, TED CRUZ!
And the winner was? CNN? Listen—who you think “won” the debate probably depends on whose point of view most closely resembles your own. To that end, I’m not all that interested. I personally think Bernie Sanders made the more compelling arguments, but as a self-identifying progressive, I naturally would. Others watching or reading the transcript might believe Ted Cruz mopped the floor with the senator from Vermont, and furthermore, that Democrats are bringing down this country. Seemingly more and more these days, Americans, buoyed by the news they absorb through cable news channels and social media echo chambers, hear what they want to hear and believe what they want to believe. Still, that so many people are engaged on these issues and others even after the election signals to me that Americans are understanding the importance of continued involvement with political news, if not the merits of volunteering in campaigns or running for public office themselves. Accordingly, I hope events of this sort are scheduled in the future. Maybe a debate on commercial banking regulation between Elizabeth Warren and Steve Mnuchin, or, say, a debate on education practices between Betsy DeVos, and—I don’t know—a freaking fifth-grader. Average Americans should have a way to be exposed to the major parties’ stances on a variety of issues in a highly accessible, comprehensible way.
It’s the dawning of a new age in U.S. politics. More power to the people, I say! And more debates! You know, provided they don’t involve Don Lemon.