America's New Single-Payer Majority

By John Conyers, Jr.

Dean of the U.S. House
of Representatives
John Conyers, Jr.

The Republican-led House of Representatives just unsuccessfully attempted to undo the Affordable Care Act for the 56th time.

While it's been well established that repealing Obamacare without a plausible replacement would leave tens of millions of people uninsured and worsen our deficits by accelerating the growth in healthcare costs, it's also important to note that this continued GOP crusade to get government out of health care runs directly counter to the stated will of the majority of Americans.

A new poll shows that more than half of Americans -- including 80 percent of Democrats and a quarter of Republicans -- support expanding health reform to "Medicare for All." While Obamacare has been a step in the right direction, more and more people across the country understand that a single-payer healthcare system is the only way to guarantee quality care and at the same time reduce medical costs.

The United States spends almost twice as much per person on health care as any other country, yet our key outcomes -- life expectancy, infant mortality and preventable deaths -- too often lag behind our peers. A recent Commonwealth Fund study ranked the U.S. healthcare system dead last among 11 highly developed countries in terms of quality, efficiency and access to health care.

What are we doing wrong?

One major problem is that billing and insurance-related administrative costs -- in other words, bureaucratic red tape -- cost the American people $471 billion in 2012. That's enough money to pay for our country's whole interstate highway system. At least 80 percent of that extraordinary cost was, according to a respected study, due to inefficiencies in our for-profit, multipayer healthcare system.

By adopting a "Medicare for All" model -- which, by the way, is the standard for health care throughout the industrialized world -- we can achieve hundreds of billions of dollars in cost savings that can be used to cover the nation's remaining uninsured and upgrade coverage for millions of underinsured citizens. While the ACA has brought insurance to 19 million Americans, 13 percent still lack health insurance, including one out of every five young adults. Notwithstanding the fact that the ACA has significantly reduced out-of-pocket costs, 21 percent of insured Americans are still spending 5 percent or more of their income on out-of-pocket costs.

This week I was joined by 44 members of Congress in reintroducing the only healthcare legislation that will overcome these persistent challenges to our healthcare system: H.R. 676, or "The Expanded and Improved Medicare for All Act." This bill has been introduced in every Congress since 2003 and has a broad base of support among healthcare activists, organized labor, physicians, nurses, and social-justice organizations across the nation. The bill has been endorsed by 26 international unions, Physicians for a National Health Program, two former editors of the New England Journal of Medicine, National Nurses United, the American Medical Students Association, Progressive Democrats of America, the NAACP, and countless others.

This isn't just good ethics; it's also good economics. H.R. 676 will boost the economy by enabling America's small businesses to focus on building their companies rather than on dealing with the cost and complexity of providing healthcare for their employees. H.R. 676 keeps the delivery of health care a private matter, enabling health providers to engage in market-based competition and innovation.

Half a century ago, addressing the convention of the Medical Committee for Human Rights, Martin Luther King Jr. declared, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." It's time to adopt a serious comprehensive plan to address it.

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