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Amy Goldstein
Reporter covering health policy and other social policy issues
Jim McGovern (D-Mass.), Chair of the House of Representatives' Regulatory Committee, has long said that "health care is a right for all, not a privilege for the lucky ones". little."
The mantra of rights and other staff on Tuesday morning are political ammunition for the Progressive Crusade to convert the US health care system into a single payer model. The language proposes an overhaul aimed at guaranteeing all Americans access to care by expanding the role of government as a moral imperative.
"Every family is finally facing a serious illness or accident," said Ady Barkan, a dying health activist from ALS, a neurological disease with no known cure, who testified to the disease. help from a computer because his diaphragm did not allow him to talk anymore. "The day of our birth and death, and so many days in between, we all need medical care. And yet, in this country, the richest in the history of human civilization, we do not have an effective, just or rational system to provide this care. "
But while the rights discourse reinforces the progressives' health agenda, it also polarizes politicians, policy experts and voters elsewhere on the ideological spectrum. This disagreement makes the United States a special case among developed countries, which have almost all long since embraced the value of health care as a human right.
According to a survey conducted by the Pew Research Center last September, 60% of those surveyed said it was the responsibility of the government to ensure that all Americans receive health insurance, which is a clear more than a decade ago when the country was more evenly divided. But the differences of supporters are striking, with 49% of Democrats but only 12% of Republicans subscribing to this idea. Overall, just under a third of respondents believe that the government should run a single national insurance program.
The rules representative, Rep. Tom Cole (R-Oklahoma), described the Medicare for All by Pramila Jayapal (D-Wash.) As "a radical bill" and said the Democrats did not tell us how much a new massive program would cost, who would pay for it and how much taxes should go up. .. to pay for this program. "
Nurses hold a banner outside the public facility in Montpellier, Vermont, at a 2009 rally for single payer health care. (Jeb Wallace-Brodeur / The Times Argus / AP Photo)
This dispute is part of the debate being played Tuesday in a small House hearing room, while the Medicare-for-all supporters of Congress present the moral, political and economic arguments in favor of a idea advocated by the most liberal Democrats vying for the nomination of their party to the presidency. .
The hearing, as well as the one scheduled by the House Budget Committee, offers single-payer proposers unforgettable moments in Congress without the legislation necessarily becoming closer to the law.. The Speaker of the House of Representatives, Nancy Pelosi (D-Calif.), Skeptical Single Payer, did not commit to other steps in the process that would lead to a vote in the House of Commons. Medicare for all. And even if the measure were to be put to a vote in the House, such a law would have virtually no chance of winning the Senate under Republican control.
Even among the supporters of Medicare-for-all, there is a disagreement about the role of private insurance companies. Some, such as Jayapal and Sen. Bernie Sanders (I-Vermont), argue that private insurance should be eliminated, while others suggest that public and private insurance could coexist.
According to Jayapal, consumers would not contribute to their medical costs, and even expensive long-term care would be covered. Its legislation does not provide for the cost of the new system, leaving it to the secretary of the Department of Health and Social Services to submit an annual budget.
The Congressional Budget Office is expected to release a report on the costs of single payer coverage on Wednesday.
Among advocates with different perspectives on how Medicare-for-all should be designed, the idea of health care as a right is a common thread.
The idea has a lineage that goes back almost a century and has not always been associated with a single payer. system. In his 1944 speech on the state of the Union, President Franklin Roosevelt called on Congress to adopt a second bill of rights guaranteeing American economic security, including "the right to adequate medical care and the possibility of enjoying a good state of health ".
Roosevelt died the following year, but his goal, his widow Eleanor Roosevelt, was at the origin of the adoption by the United Nations of the 1948 Universal Declaration of Human Rights, which states that everyone has the right to adequate health care. This declaration is the basis of the International Covenant on Civil and Political Rights of 1966, which states that citizens must be assured of "a medical service and medical assistance in the event of illness".
More than a decade later, President Jimmy Carter signed the agreement, but the United States has never joined the more than 170 countries that have ratified it, including most democracies.
In the presidential election of 2008, then Sen. Barack Obama of Illinois and his Republican opponent, the late Senator John McCain (Arizona) were questioned during an election campaign debate over whether health care was a privilege, a right or liability.
McCain said that it was a responsibility. Obama said it should be "a right for every American".
Obama was not thinking about Medicare for all. He advocated federal grants to help workers and the middle class to offer private health plans – a central idea of the Affordable Care Act, passed by the Democratic Congress in 2010, which helped millions Americans to take out insurance without however evading universal coverage.
But the idea of expanding Medicare, the federal insurance popular with older Americans, to everyone in the country goes back at least four decades.
As McGovern, the chair of the regulatory committee, pointed out, Tuesday's hearing is the first in Congress on legislation called Medicare-for-all, which he described as historic. The late Senator Edward M. Kennedy (D-Mass.) Convened hearings across the country in 1971 to explore a single payer payroll plan.
Conservative health policy experts say that if the government were responsible for providing universal health care – tit implication if health care and health were defined as a right – it would be difficult to draw the line about where this should stop. Should he be responsible for providing housing, nutritious food, clean air and other factors known to improve health?
For his part, Don Berwick, former acting director of the Federal Centers for Medicare and Medicaid Services, who ran unsuccessfully for the governor of Massachusetts, said that the United States "is a unicorn," compared to D & # 39; 39, other developed countries, where the right to health care "is not even a question anymore."
Read more
Why Vermont's Single Pay Stress Failed and What Democrats Can Learn
The 2020 Democrats' position on Medicare-for-all
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