Nobody Counts the US Health Care System Dead Anymore

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Nobody Counts the US Health Care System Dead Anymore

The author (foreground) stands with other nurses from the National Nurses United (NNU) in front of the US Supreme Court building. (Photo: Courtesy of Donna Smith)

It has been a while since I updated any counts of the dead and broke due to the deeper corporatization of the U.S. health care system. I knew that some of the tallies of the uninsured were based on estimates of the dead flowing from pre-Affordable Care Act/Obamacare days. I just don't like monkeying around with the numbers of dead. The people who die unnecessarily because they cannot afford the care or coverage that might have saved their lives deserve to have the truth told about their lives and their deaths. I expect we'll have some updates on that calculation soon enough. Meanwhile, just know the suffering has not stopped.

Corporations count lots of things, but counting the number of dead due to their greed and their denials of needed care are not among those things. And those who hate the ACA/Obamacare don't count those still dying due to a lack of care because they either believe the free market, corporate model should play a larger role in the U.S. health system or they think our political system will somehow morph overnight into one that advances a social insurance model and counting any less dead might delay their revolution. Those who support the ACA/Obamacare are busy trying to fend off attacks to the law even while some of the implementation glitches continue, so calculating deaths due to a lack of access to care just hasn't been high on anybody's to-do list.

I see lots of game-playing with health care numbers now -- perhaps more than ever before as the political agendas ramp up. Last week, I listened to the discussions around the Supreme Court's consideration of insurance subsidies granted to those who signed up for insurance through the Federal ACA exchange, and I just got sick. I imagine the mom or dad or the cancer patient or the heart patient waiting and worrying about whether they'll be able to access on-going care, treatments and medications. I get nauseous reading and listening to all those who proselytize about the political implications of millions of people being priced out of coverage because most of the talking and writing heads will never have to worry about that situation no matter what the Supreme Court does. It's the working class that will take the hit -- again.

Many of my fellow supporters of a social insurance model -- a single-payer system -- are even among those who often think anything that hastens the demise of the ACA/Obamacare will create the political space for the better solution that single-payer certainly is for the U.S. What they ignore is that in the long run that might be true but the long run isn't what troubles me. It's the here and now of injuries and illness, the pain of watching someone you care about suffer when care is available, and the guilt of not being able to legally or financially provide the care that someone needs that makes me sick. Talk about terror...

There is no political space for a single-payer solution just yet. Neither the Republicans nor the Democrats are willing to take that sort of political risk. Just look at how they behaved around the whole U.S. Congress v.Iran v. Netanyahu v. Obama dance. Political liberals may want the ACA/Obamacare to collapse because they want something better and more comprehensive while political conservatives want the ACA/Obamacare to fall because they think returning to a more market-based system is the better direction.

Both major political parties ought to be diving in right now to make sure they mitigate the damage that might be done -- the damage that is being done -- by the deeper corporate control of our health system and the potential for human suffering if millions of people are forced to go without access to coverage again. Among those millions will be those who are getting life saving care who will lose that care and who will die while the 2016 campaign waltzes play. And who will be counting them?

The answers aren't easy right now. Single-payer, improved and expanded Medicare for all for life supporters need to be speaking up. I do not doubt that for a moment, and I am there too. But those of us who believe in providing care to those who need that care when they need it without financial barrier better have ready a wiser solution than expecting this Congress or this President to advance a full system overhaul and transformation. And what's our plan? To count the dead and wave more signs? The corporations are counting on that. The politicians are too. Protest and political pressure are great. Organizing the grassroots is necessary. But we, too, need to be offering next, best steps so we don't have to see more widespread suffering and death as our path to success.

Very wise people I have known along my advocacy path have said that this nation will get to a truly universal, publicly administered, improved and expanded Medicare for all for life system within a few years as crushing costs increase and fewer options remain. In the meantime, I just do not believe that we have to support a surge in the suffering and death as any sort of catalyst to that change. We're smarter and better than that, so let's get to it. We have to sell that improved and expanded Medicare for all for life is a centrist, compromise position -- a good idea from the right in private and public delivery of care and a good idea from the left in public financing. Not so hard, eh?

Donna Smith

Donna Smith
Donna Smith is the executive director of Progressive Democrats of America.  PDA's mission is to strengthen the voice of progressive ideas inside and outside the Democratic Party by using "inside/outside" and "grassroots fusion" models of working both in the Democratic Party as well as working with other progressive organizations both inside and outside the Party.

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