Time has come today
* * *
Can't put it off another
day
I don't care what others say
* * *
Time has come today1
The time has come today for the United States of
America to recognize an absolute right to health care. In his 2020 campaign for the U.S. Presidency,
Senator Bernie Sanders has urged America to “join every other major country on
earth and guarantee healthcare to all people as a right.” According to a September 2019 story published
by NBC
news, 27.5 million Americans or 8.5% of the population had no health
insurance in 2018. The article pointed
out that the number of uninsured Americans increased by nearly two million
people from the prior year. One might
wonder why, in one of the richest nations on the planet, do so many people not
have coverage for health care?
The historic framework for healthcare systems was
constructed in the aftermath of the Second World War. America’s closest ally, England, chose to
nationalize the provision of healthcare by establishing the National Health
Service. Though it was a Labour Party
government that first established the NHS, that system has enjoyed wide public
support by both Labour and Conservative led governments. America chose a different path.
In contrast to the devastation wrought by the war in
Europe, the U.S. mainland was barely touched.
As the American industrial machine geared up to respond to Europe’s need
to rebuild, the U.S. labor market tightened.
Mindful of the hyperinflation that crippled Germany after the First
World War, the U.S. government imposed wage and price controls. Unable to bargain for higher wages, unions
and employers turned to benefits as a means to attract and retain workers. The U.S. tax code lent its full support to this
development by allowing employers to deduct the cost of providing healthcare,
while excluding the value of healthcare coverage from an employee’s income.
This system worked well for the veterans of WWII and
their families. Though initially a
benefit of unionized employment, non-unionized companies followed suit to
compete for workers who had come to expect healthcare benefits as an essential
part of their compensation. The main problem
with a healthcare system tied to employment benefits was what happened when a
person was no longer employed or employed in a low-wage job that did not offer
healthcare benefits. In 1965, this
problem was addressed for persons retiring from the labor force by the
enactment of Medicare. Medicare established
government provided healthcare benefits for those 65 and older. The law also provided
government-sponsored healthcare benefits to the poor and disabled through
Medicaid.
But for the rest of Americans, employment continued to
be the key to accessing healthcare. Then, in the 1980s a number of factors caused
America’s employment-based system to begin to unravel. First, medical costs rose rapidly. While this was happening, a wrenching
recession, combined with fierce competition from Japan and Europe, resulted in
American manufacturers closing factories, eliminating jobs and desperately
looking for ways to lower costs. As
unemployment soared, employees reluctantly gave back hard-earned benefits. Where health insurance had been a “free”
benefit for more than 30 years, employees were now required to share its cost. At the same time, as blue collar manufacturing
jobs were lost, job gains in retail and service industries often came without
healthcare benefits.
By
2008, over 44 million Americans had no health insurance. To address this crisis, President Obama and a
Congress controlled by Democrats, enacted the Affordable Care Act. After its provisions went into effect, the
ACA reduced the number of uninsured Americans by roughly half. But the legislation left the American system
of employer-provided health insurance intact.
And that insurance was provided by a host of private insurance
companies.
Even though the ACA’s design borrowed
heavily from health care models proposed by conservative think tanks, the legislation
was passed with virtually no Republican support. Since its passage, Republicans have tried
repeatedly to repeal it. Currently, the
Trump administration is urging the U.S. Supreme Court to declare the law
unconstitutional in its entirety.
Meanwhile, the United States is in the throes of a
national health crisis where over
1.3 million people have been infected with the COVID-19 virus and over 80,000
have died. The crisis is nowhere near
its endpoint. Cases will continue to increase;
the number of deaths will be well over 100,000.
Since there is no cure for this highly contagious
disease or vaccine to stop its spread, experts have recommended measures such
as quarantines and social distancing to slow its expansion. These measures have had some success, but at
a severe economic cost. In the two
months since states in the U.S. began imposing restrictions to contain the
virus, the unemployment rate has gone from 3.4%
to 14.7% - the highest rate since the Great Depression. More than 20 million Americans are out of
work. Along with their jobs, these newly
unemployed Americans have lost their healthcare. That is how employer-based health insurance
works – no job, no healthcare.
This crisis makes clear why the time has come for
America to decouple health insurance from employment. Every American should have healthcare
coverage from cradle to grave, regardless of their employment status.
So, what should that healthcare system look like? It should be comprehensive. It should cover all necessary medical costs
including vision, dental care and prescription drugs. It should be available to all, whether young,
old, rich, poor, working, unemployed or retired.
Bernie Sanders’s Medicare for All plan is a good place
to start, especially if the Trump Administration succeeds in getting the
Supreme Court to kill Obamacare. Wouldn’t
it be amazing if you could get medical treatment if you were sick or injured
and did not have to worry about premiums, deductibles, copays or whether your
insurance company would deny coverage for the treatment your doctor prescribed?
That is what the citizens of most other
developed countries have. The time has
come today for Americans to demand the same.
1“Time has Come Today,”
written by Willie and Joseph Chambers, originally performed by The Chambers
Brothers
Corona, Corona.
Yeah, you’re on my mind. I wake
up in the morning and I feel ya’ – hovering over me like a stifling cloud of
smoke. It’s 5:30 in the morning but
thinking about you is all I can do. Yeah,
you’re with me all the time. 
