The best way to hold them accountable, though, instead of decrying the passage of this bill -- which has almost no chance of passing the Senate into law -- is for Democrats to see it as an opportunity. Rather than try to defend a flawed program such as Obamacare, they should crusade for health care as a basic human right. And there's a simple way to make that happen -- institute "Medicare for all."
Republicans will never go for it, but there is no better banner to carry forward as the party works to build support for a Democratic takeover of Congress in 2018.
The repeal of the Affordable Care Act squeaked through the House, but Republican leaders forced a bad vote on many of its caucus members. The bill is dead on arrival in the Senate because every week since the election, the ACA has become more popular among people, particularly those with existing illnesses who, no matter what their political affiliation, feared being left with no insurance. The pittance thrown into the repeal to pay for high-risk pools won't do much
. The end result: Millions of people will now lose insurance, as the Congressional Budget Office found
in an earlier version of the bill, and, thus, Americans will be sicker -- and many will die.
There is plenty of competition for the award for "Dumbest Policy Debate," but the fight over health care has got to rank close to the top. If politicians of both parties could put ideology aside and choose smart, moral economics, they would embrace the only sane solution: a single-payer system. If we can shift the debate, admittedly a huge hurdle, there is a simple solution that could be done virtually overnight: Establish a single-payer system by just removing Medicare's age requirement.
Underneath the immediate debate lies the unfortunate truth that, when it comes to health care coverag
e that can mean the difference between life or death, Americans face unpalatable options. On the one hand is a Republican Party that doesn't view national health care as a right. The party has always opposed Medicaid and Medicare, seeing them as a sign of weakness in the country's moral fiber. The GOP's basic view is that if you can't summon up the money to pay free-market prices, well, that's your own fault.
That said, the ACA was never a panacea. To be sure, millions of people gained coverage under the ACA, and a wide range of benefits created a framework of protections. But prices are going up and the ACA continued to allow hundreds of billions of dollars to be drained from people's pockets, suck capital from the bottom line of companies and, overall, hobble the economy by letting insurers, along with the drug companies, cost us roughly 17%
of our gross domestic product.
The truth is Democrats have bungled health care for a quarter of a century. Both the Clinton administration in the 1990s and the Obama administration made the same fundamental error: Both presidents tried to erect a system that let insurance companies continue to dictate health care costs.
Ideologically, Barack Obama, and the Clintons before him, believed in the so-called free market with a friendly face. You could see that in their fervent embrace of bad trade deals, deregulation and "responsible" capitalism. Democrats also have fallen in love
with massive corporate campaign contributions, millions of dollars of which have come from insurers and drug companies.
But the truth is Medicare is one of the most successful and efficient government programs ever created in the country's history. It operates at a 2% to 3% administrative cost, which should be the envy of every penny-pinching politician. I argued recently
that every company in the country should be for this approach because of the massive cost savings.
Republicans, pay attention: You don't have to be a left-winger longing for European-style health care "socialism" to embrace "Medicare for all." Australia, currently governed by a center-right government, continues to manage a national, single-payer system. Back in the 1980s, after a vigorous national debate, Australia resolved to join other nations by placing the task of health care in the hands of a single-payer: the government. Australia cut its cost of health care dramatically to about 9%
of GDP. Today, no Australian business would seriously advocate abandoning its system and taking on the cost madness of an onerous American health care scheme.
Some Democrats argue that America is "different" from other countries and that difference -- presumably the resistance to creating broad social safety nets like most advanced countries -- accounts for the health care system we have today, and the need to accept an inferior solution. Similarly, some Democrats also say it's not politically feasible to enact single-payer because there isn't enough public support.
Both arguments fail to be convincing, as seen in the strength of public support out there for "Medicare for all." When framed as a choice between health care as a right versus the rights of insurance companies, single-payer has had
strong majority support.
Moreover, on the heels of many defeats the party has suffered in the past decade, it's worth noting it is a fight for single-payer "Medicare for all" that would distinguish the Democratic Party very clearly from Republicans -- a distinction between the two parties on economic issues that is not evident today to many Americans, including some who voted for Donald Trump.
Posing the choice as the people versus the insurance companies, a true opposition party -- meaning, opposition to an economic system that is bankrupting Americans -- would mass millions of people in the streets and make single-payer the single issue to drive voters to the polls in 2018.
Health care should never be left to the free market (an aside: nor should other parts of the economy, but let's leave that for another day). This is life and death. It should be a right, from cradle to grave, guaranteed by the government. Indeed, in this callous vote, which will cause millions to choose between buying food or staying healthy, we may end up eventually on a better path. People will organize to demand health care from cradle to grave as a right, toss out politicians who do the bidding of powerful economic forces and, most important, reinvigorate the role of government as the guardian of a decent society.