Insurers, not insured, in driver’s seat

When the Supreme Court issues its decision on the Affordable Care Act (ACA), the debate will not stop. The ACA brought about immediate relief from some of the worst outcomes of for-profit healthcare, but it is by no means sufficient to temper the rapacious conduct of insurance companies who are determined to make money by not providing healthcare.

The Affordable Care Act prevented insurance companies from denying care to a patient who had a pre-existing condition like cancer or heart disease. It allowed young adults to remain on their parents’ family plan until age 26. It required that the kind of care that saves lives but is usually not profitable to cover — preventive care — is covered for free. It provided healthcare for tens of millions of Americans. It lowered the cost of prescription drugs for seniors. It gave states more authority to challenge exorbitant rate increases by insurance companies. It showed that the healthcare system can be reformed within the current healthcare model.

However, healthcare reform within the current healthcare model has glaring deficiencies. In the current model, insurance companies increase profits by not providing healthcare.

They avoid paying bills when their customers need healthcare. They compete by trying to invent creative ways to deny care, like providing complicated plans with large loopholes buried in the fine print that are only discovered if a person falls ill.

They also refuse to pay bills after care has been delivered, knowing patients often don’t have the time or strength to fight insurance company practices. For-profit healthcare has produced economic hardship for millions of Americans: it’s estimated 46 percent of all bankruptcies are tied to medical bills piling up due to an illness in the family. Three-quarters of those bankrupted by illness were insured when they first got sick, which shows that the insurance policies did not pay the bills. It defeats the purpose of buying insurance.

People buy health insurance expecting that it will protect them from financial disaster. The for-profit model of “care” is fundamentally and inherently flawed.

The Affordable Care Act represented reform only within the context of a for-profit system. We must change the incentives that drive a healthcare race to the bottom. We must stop insurance companies from making a profit by denying care. We must get the insurance companies out of the doctor-patient relationship, where they influence the practice of medicine by dictating limitations on care. Healthcare must not be out of financial reach for any

There is only one solution: Medicare for All. Embodied in H.R. 676, Medicare for All would cover everyone in the United States for all medically necessary services with no co-payments, premiums or deductibles, for the same amount we currently pay for healthcare. This not-for-profit system would cover all residents, reduce costs, increase the quality of care, lower costs to businesses and families, increase worker pay and relieve state governments of the significant financial burdens that come with our healthcare system.

Guaranteed healthcare systems have repeatedly proven themselves by outperforming alternative healthcare models. That is one reason states are pursuing them. California’s legislature has passed legislation similar to H.R. 676 twice, only to be vetoed by a Republican governor. Pennsylvania’s bill has strong bipartisan interest, and one of its largest advocacy groups has elected a Republican former member of Pennsylvania’s legislature as its president. Most promising is Vermont, where Gov. Peter Shumlin ran on a platform that called for a Medicare for All-type system. The Vermont legislature is currently working through legislation that is predicted to “produce savings of 25.3 percent of total health expenditure between 2015 and 2024.” Most recently, a report by The Lewin Group showed that Minnesota would save $189.5 billion over 10 years if they adopted a similar guaranteed healthcare model, adding to a long list of studies commissioned by states that find similar savings.

Guaranteed healthcare will improve the quality of care, control costs and create jobs. It is only a matter of time until it becomes a reality. It is also the right thing to do.

Kucinich serves on the House Education and the Workforce Committee and the Oversight and Government Reform Committee.

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