Trump’s campaign and victory in the 2016 presidential election highlighted deep divisions in our “united” states. One such division is over our country’s healthcare system. Should we follow the examples of countries like the UK, France, Canada, and Switzerland and push for a universal healthcare system? Or should we return to the “good old days” of privatized healthcare systems with little-to-no government interference? It’s a dilemma our country has faced for at least a century, with no clear resolution in sight.
Past Injuries: How Did We Get Here?
It is a long, winding road, but my goal here is to give brief context, not a history lesson. America’s healthcare system spans as far back as the late 1800’s, with the industrial revolution causing greater amounts of injuries on the job and louder calls for sickness protection. Several groups attempted to establish some form of universal healthcare in the U.S including the American Association of Labor Legislation (AALL), Blue Cross, Blue Shield, and the Committee on the Cost of Medical Care (CCMC) and presidents such as FDR, Truman, JFK, Johnson, Nixon, Reagan, and Clinton. These attempts, however, faced serious backlash from interest groups such as the American Medical Association (AMA), insurance companies, and even labor unions. Despite the ups and downs of pushes for affordable, universal healthcare, America entered the 21st century with government programs such as Medicaid, Medicare, the Social Security Act.
Now at this point, some may be wondering: why are so many Americans against universal healthcare, a system that many other developed countries have established? The reason is as simple and complex as American history itself: capitalism and individualism. Groups such as the AMA have their own interest, rather than that of the whole country in mind. It is important to note that such a group does not represent the interest of all doctors, just as these groups do not represent the interest of all (or even most) Americans. They are simply voicing their agendas the loudest. They’re merely a symptom of the culture this country promotes – rugged individualism and a push for self/group profit – profits such as those stated below:
- Keeping healthcare expensive leads to larger profit margins for doctors.
- Privatizing healthcare keeps money in the hands of individual insurance companies.
- Preventing healthcare from becoming universal allows unions to continue incentivizing workers with competitive healthcare packages.
Keeping the middle class in agreement? No problem, scare them away from ideas of universal healthcare with words like “socialism,” “communism,” “big government,” and “loss of freedoms.” If this aspect of history is not understood, similar attempts at universal healthcare will be met with similar defeats.
Signs of Life: Obamacare
The Patient Protection and Affordable Care Act (ACA) was signed into law through the Obama Administration in 2010. Since its conception, the bill has been highly contentious – an unsurprising fact given the context of America’s history with healthcare. Regardless of what side people stand on regarding this bill, opinions should be distinguished from facts. An overview of the ACA holds that:
- Lifetime and annual benefits cannot be limited.
- All insurance plans must include essential benefits including outpatient, maternity, and mental health care.
- Citizens with pre-existing conditions cannot be denied coverage, except when fraud was used.
- Those not on a plan are subject to relevant taxes.
The benefits of such mandates are apparent. The contention comes from a handful of sources: the millions of Americans who lost company-sponsored health care plans (when those companies found it more cost-effective to pay the ensuing penalty and let employees purchase their own plans); the higher cost of private plans that included the mandated essential health benefits of the ACA; the overall, short-term increase in healthcare costs due to treating illnesses that had long been ignored; and pharmaceutical companies being forced to pay fees estimated at $85 billion between 2013 and 2023.
Flatlining Again: Repeal & Replace
One of Trump’s major campaign points was the promise to repeal and replace Obamacare. This has proven extremely difficult to accomplish. So instead, Republicans have pushed for a “skinny” bill that would repeal several ACA mandates including:
- Requiring that every individual buy insurance
- Requiring that companies with 50+ employees provide insurance benefits
- Defunding Planned Parenthood
- Defunding the Prevention and Public Health Fund
- Defunding the Community Health Center Fund
However, despite complaints on the cost of Obamacare, the Congressional Budget Office found that the “skinny” bill and its various iterations would actually increase premiums by 20% due to the millions of Americans who would be left uninsured (many of whom were healthy) and no longer paying premiums. With Republicans lacking the 60-vote majority needed, such bills have not passed. Still, Trump is working hard to undermine Obamacare, even if he can’t sign off on a bill to replace it. Trump has threatened to stop reimbursing insurers who offer waivers on deductibles and copayments to low-income customers, directed the IRS to let people slide if they leave the portion of their tax return that indicates whether or not they have insurance blank, and weakened the essential benefits required by the ACA.
Handle With Care: Where Do We Go From Here?
Several developed nations have recognized the economic strength of insuring the health of their citizens. For too long, America has prioritized the good of the rich rather than the people as a whole. Our culture of capitalistic competition and rugged individualism is important for growth and innovation, but so too are socialist aspects that ensure all of our citizens be provided for. Fear-mongering has been used since the turn of the 20th century to steer this country away from universal health insurance. Goals of national health insurance have frequently been labeled communistic. Even Truman’s proposed plans had his administration criticized as “followers of the Moscow party line.” Universal healthcare needs to be seen for what it is: not “handouts” from the government to be derided, but worthwhile investments to strengthen our country. We have accepted that truth for public education, and it is time we do the same for mandated national health insurance.
None of this is to say that Obamacare is perfect. It still leaves some of our most vulnerable citizens uninsured, it can be difficult to understand and enroll for, and (in the short term) it is costing our country billions of dollars. That being said, the answer is not to repeal and replace; the answer is to better adjust it and adjust to it. Most of our federal budget goes toward military expenses. While we are handling matters of defense abroad, we must not forget to address the threats within our own country – one of which is our workforce being diminished by preventable and treatable illnesses that go untreated due to healthcare complexities.
Ebony Cadet is an Animal Care Technician at her local humane society, and a recent graduate of Cornell University with a Bachelors in Animal Science and a minor in education. She was born and raised in Brooklyn, New York, and is now living in Greeley, Colorado. During her free time, she enjoys reading, creative writing, gaming online, and loving on the feral cats that come into the shelter.