Lucas,
It will take some time to digest the U.S. Supreme Court's decision, but it appears to have averted some terrible jurisprudence that might have very seriously restricted the government's overall ability to regulate the economy and protect citizens.
In upholding most of the Affordable Care Act, the Supreme Court lets stand legislation that offers some important benefits, but only to a portion of those who are uninsured. The Affordable Care Act will predictably fail to fully solve our nation's health care crisis.
However the health reform law ultimately plays out, we know two things for certain. Tens of millions of Americans will remain uncovered, as will tens of millions of under-insured who will remain at risk of financial ruin if a major illness strikes. The private health insurance and pharmaceutical industries will remain in charge of prices and life-and-death treatment decisions.
There is a single solution to the challenges of providing coverage to the 50 million Americans who are uninsured that would curb out-of-control health care costs and provide a humane standard of care to all who enter the medical system.
The solution is single-payer, improved Medicare for all.
Public Citizen has supported a single-payer system since our founding more than four decades ago, and we remain committed to winning improved Medicare for all.
The improved Medicare-for-all approach starts with the premise that health care is a critically-needed right that must be afforded to all, irrespective of any individual's ability to pay.
It solves the problems of 50 million uninsured Americans simply and directly by establishing that everyone is covered by improved Medicare for all.
Everybody in, nobody out.
Improved Medicare for all would prevent the deaths of the 45,000 Americans who die every year from lack of health insurance. It would eliminate the hundreds of thousands of medical bankruptcies -- affecting millions of Americans every year -- that occur because people can't pay their medical bills.
These deaths and economic tragedies are entirely preventable. A system that permits them to continue is morally repugnant and must be replaced.
The improved Medicare-for-all approach would eliminate the greatest waste in the health care system: the needless costs imposed by the private health insurers. These firms impose hundreds of billions of dollars of excess cost on us via their excessive profit-taking and executive compensation, their marketing expenses, their vast bureaucracies devoted to denying care, and their imposition of massive paper-pushing obligations on actual health care providers.
It is not for lack of policy justification or moral force that Americans continue to suffer from a malfunctioning health care system. Our failure to have adopted improved Medicare for all is due entirely to the political power of the health insurance industry.
That political power can be overcome, however, by a grassroots movement that musters enough of its own strength. The country cannot survive the ongoing reign of the private health insurance industry, and it will not.
Public Citizen is going to continue and step up its advocacy for single-payer, improved Medicare for all.
We have no illusions that winning single-payer, improved Medicare for all will be easy.
In the near term, we expect to devote substantial energy to holding off efforts to further privatize and weaken existing Medicare. We anticipate that the early steps forward in winning expanded and improved Medicare will come from state initiatives, which we aim to support directly, and by ensuring that states are able to obtain needed waivers from federal laws and rules.
But we have no doubt about what we must achieve, and no doubt that the improved Medicare-for-all movement will eventually succeed.
We cannot and will not tolerate a system that sacrifices 45,000 Americans a year just for the sake of corporate profits.
We can be our brother's (and sister's) keeper and be cost-effective at the same time. Indeed, it turns out that being cost-effective requires that we take care of each other.
Onward,
Robert Weissman
President, Public Citizen