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medicaid
It's Obvious the US Healthcare System Isn't Working, So Why Not Try Medicare for All?
In a moment when the boundaries of what is “reasonable” or “possible” have been completely blown open, universal healthcare no longer seems so unrealistic.
Dec 18, 2025
Between the (likely) expiration of the Affordable Care Act enhanced subsidies, cuts to Medicaid and Medicare, and the decade-long efforts to undermine and dismantle the ACA, the casualties and costs of our current healthcare system continue to grow as Americans continue to wait for a better option. Nearly 45,000 Americans aged 17-65 die each year due to lack of insurance, a number that could rise to over 51,000 preventable deaths in the coming years.
Yet, the Senate has failed to pass either healthcare plan proposed to keep health insurance premiums from skyrocketing in the New Year and the Medicare for All bill introduced by Sen. Bernie Sanders (I-Vt.) and US Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.) in April 2025 has not advanced in Congress. Ideas like Medicare for All or universal healthcare often make eyes roll. “That’s unrealistic,” we’re told.
But is it? Universal healthcare is, after all, the reality for most other high-income countries. And yes, it might be disruptive, but Americans have lived through unprecedented changes and significant events in the past five years: the Covid-19 pandemic, the January 6 insurrection, and the rapid development of generative AI. Throughout history, major healthcare reforms have been born from disruption; Medicare is rooted in the civil rights movement, and the ACA passed in the wake of the 2008 financial crisis.
Now, as the United States prepares to celebrate its 250th anniversary, our foundational rights and institutions are being tested in ways that once would have been unthinkable. In a moment when the boundaries of what is “reasonable” or “possible” have been completely blown open, universal healthcare no longer seems so unrealistic.
Do we accept being the only high-income country where getting sick can cost you your home, your job, or your life?
We certainly can’t continue as we’ve been going. As a nurse scientist and postdoctoral fellow, I have a front-row seat to the healthcare crises we are facing: unaffordable medical bills, growing healthcare costs, long waits for specialty and even primary care appointments, and the growing burden of chronic illness and mental health crises. Employers are now shifting employees into high-deductible plans with high out-of-pocket costs. People are effectively locked into jobs they cannot leave because losing coverage, even temporarily, can be a significant financial risk—especially for those covering spouses and children.
We have extensive evidence, both internationally and within the US, showing what strategies produce better results. Any meaningful reform should include:
- Universal population coverage: Federal requirements must guarantee that every person living in the US has insurance that covers necessary healthcare services, including primary care, specialty care, mental health, reproductive health, preventive care, and hospitalizations.
- Care that is free or affordable: A largely single-payer financing model like Canada, Australia, and most high-income countries (as proposed in the “Medicare For All” bill) or a hybrid public-private system, where private insurance is still available but federally regulated to ensure cost containment, limit out-of-pocket costs, and eliminate catastrophic medical expenses, protecting families from significant medical debt.
- A focus on prevention and primary care: Meaningful investment in preventive services, primary care, and care coordination to reduce costs, prevent unnecessary emergency room visits and hospitalizations, and improve long-term health.
But people remain skeptical that we can achieve these goals in the US—largely because of public opinion and political will, both of which are significantly influenced by private health corporations, including insurance companies, large hospital systems, pharmaceutical companies, and other obscure middlemen that profit from the status quo.
For decades these corporations have spent hundreds of millions of dollars lobbying Congress and advertising to the public to protect their revenue and discourage solutions that most of us agree with and would benefit from. President Donald Trump himself criticized health insurers as “money-sucking,” calling them “BIG BAD insurance companies.” If policymakers on both sides of the aisle agree that corporate interests are getting in the way of healthcare reform, why do we continue to defer to them?
Opponents of single-payer, universal healthcare cite the costs, but the US already spends more on healthcare than other high-income countries with universal healthcare—and better health outcomes. It is expensive to maintain a broken system.
Major change is challenging but not impossible. Most Americans are dissatisfied with the costs, shortcomings, and complexities of our current healthcare system and support the idea of universal healthcare. We have the resources, expertise, and innovation to create a healthcare system that works for everyone. What we have not yet shown is the courage to do it.
As the country approaches its 250th anniversary, we should be asking what kind of nation we want to be. Do we accept being the only high-income country where getting sick can cost you your home, your job, or your life? Or do we finally build a system that treats healthcare as a public good rather than a commodity?
If the president really wants to “make America Healthy Again,” he can—through real healthcare reform. And for the rest of us, instead of just waiting to see what happens with the ACA subsidies, we can all work to build broad coalitions and support politicians who have a bold vision for healthcare and the courage to actually make a change.
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Beware Rick Scott's Brave New Healthcare Fix
The hospital CEO turned US senator is a fraud superstar at working the system.
Dec 08, 2025
When Rick Scott came to town, every one of us who worked at Columbia Hospital Corporation’s Victoria Hospital in Miami, Florida stood at attention. The young, dashing CEO had come to make sure staff bloat was reduced and profits were maximized. After leaving my position in Denver and moving my whole family to Florida just five months prior to being the hospital’s billing manager, I was just learning how to do my job within all the rules and regulations. And Rick Scott in our facility meant I needed to at least be pleasant to the big boss. And, indeed, I was.
As the day of Scott’s visit wore on, staff members who were about to be laid off just six weeks before the holiday season in 1989 were called to the admin offices via the hospital’s public announcement system. The extension named “3200” was the call to ride the elevator up several floors to be dismissed by the hospital CEO and his CFO. The day never left my memory as one during which good, kind, and dedicated colleagues, including the boss who brought me to the position, were riffed. On her way out the door, she reminded me to stay alert and be careful. I didn’t know what to do. I cried a lot that night at home, yet I didn’t know what was still to come in Scott’s new vision of profitability.
Within weeks, I noticed a change in our workflow. I was pushed hard to generate collection letters for all the Medicare patients who had been admitted to Columbia’s Victoria Hospital who had not paid their Medicare deductibles before discharge. But then I was instructed to put those generated collection letters in the patient files but never to mail them to the patients. That, I was told, would create a paper trail for due diligence in collection efforts as required before the hospital could submit to have those unpaid (and now unbilled) deductibles reimbursed by the federal Medicare program.
Filing letters in patient files without sending them out seemed wrong and it seemed fraudulent to me, and since I was new to it all I thought maybe if this was standard practice for the hospital, it could have been some loophole I didn’t know about. I dove into the Medicare rules, and I found this troubling line, “If you knew or should have known,” a certain action was fraud, you are complicit and could be charged with a crime. When I questioned the CFO about it, he snapped at me and said that if I wouldn’t do my job, I might need to rethink working there.
Universal coverage via improved and expanded Medicare for all of us would end Rick Scott’s grift.
In mid-December 1989, with my husband suffering heart problems and desperately in need of insurance coverage, I loaded all my personal items in a box and left the hospital. I quit my job. I wrote a letter to my former US Sen. Tim Wirth of Colorado about the situation, and I never heard directly back about what happened to that letter as I asked him to be cautious about disclosing my name or location. I was already terrified of these people. They collected hundreds of thousands of dollars quarterly from the scheme I was asked to be part of, and Rick Scott’s Columbia Hospital Corporation was building a portfolio that included an awful lot of hospitals. Scott was a rising star, after all, and making the first few hospitals he owned profitable was critical to keep that star on its trajectory.
After the Department of Justice started investigating Columbia’s hospitals in the mid to late 1990s, the hospital industry giant paid a record $1.7 billion settlement around defrauding the US government programs, Medicare, Medicaid, and TriCare. It turns out the schemes to enrich profits were widespread and involved much more than patient collection letters. Yet, even after Rick Scott was forced to resign and take responsibility for the fraud committed, he took a severance package of $10 million and stock options totaling nearly $300 million. Wow, that was a generous, golden, gilded, and glorious send off, eh? Up next for Scott?
To see this man ascend the political ranks to be thought of as an appropriate US Senate architect of a new health industry scheme to replace the Affordable Care Act-Obamacare subsidies is a tragic turn of events. We will not get anything close to a humane system under a Rick Scott plan.
The health industry is likely celebrating a return to laissez-faire, anything-goes-if-it’s-profitable model Rick Scott was an expert at designing and operating for Columbia Hospital Corporation. Patients will be the revenue stream upon which his fortune grows larger, and until we wake up and finally move to a model that puts patient health and well-being at the forefront of the design, we will see the health industry enrich itself beyond its wildest dreams while the architect of Medicare and Medicaid fraud, Sen. Rick Scott, takes yet another victory lap on taxpayer money. He and his health industry allies really love being on the dole, despite any claims to the contrary. They just call it profit.
Universal coverage via improved and expanded Medicare for all of us would end Rick Scott’s grift. Perhaps now the truth becomes even more clear. Ending the stranglehold of hospital corporations like the behemoth HCA Healthcare that also includes all of the hospitals previously owned by Columbia Hospital Corporation. On the corporate website, HCA Healthcare writes, “HCA Healthcare, Inc. owns and operates 186 hospitals and approximately 2,400 ambulatory sites of care, including surgery centers, free standing emergency rooms, urgent care centers, and physician clinics in 20 states and the United Kingdom.”
The profits are dear—not the patients, my friends.
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Mike Johnson Touts $901 Billion Military Budget Plan After Gutting Medicaid, SNAP
"At such a time, bipartisan agreement to provide additional funds to the Pentagon would deliver a cruel message to the American public," advocacy groups warned.
Dec 08, 2025
Republican congressional leaders unveiled a sprawling military policy bill late Sunday that would authorize $901 billion in US military spending for the coming fiscal year, just months after GOP lawmakers and President Donald Trump pushed through the largest-ever cuts to Medicaid and federal nutrition assistance.
House Speaker Mike Johnson (R-La.), who aggressively pushed cuts to Medicaid by peddling false claims of large-scale fraud, touted the 3,086-page National Defense Authorization Act (NDAA) as legislation that would "ensure our military forces remain the most lethal in the world."
The bill, a compromise between House and Senate versions of the annual legislation, would authorize $8 billion more in US military spending than Trump asked for in his 2026 budget request.
If passed, the 2026 NDAA would pump billions of dollars more into the Pentagon, a cesspool of the kinds of waste, fraud, and abuse that Johnson and other Republicans claim to be targeting when they cut safety net programs, stripping health insurance and food aid from millions. The Pentagon has never passed an independent audit and continues to have "significant fraud exposure," the Government Accountability Office said earlier this year.
"The surge in Pentagon spending stands in sharp contrast to the drastic cuts in healthcare and food assistance programs imposed by the reconciliation package."
Final passage of the NDAA would push total military spending authorized by Congress this year above $1 trillion, including the $150 billion in Pentagon funds included in the Trump-GOP budget law enacted over the summer.
Last month, as Common Dreams reported, a coalition of watchdog and anti-war groups implored Congress not to approve any funding above the originally requested $892.6 billion, warning that additional money for the Pentagon would enable the Trump administration's lawless use of the military in US streets and overseas.
The groups also noted that "the surge in Pentagon spending stands in sharp contrast to the drastic cuts in healthcare and food assistance programs imposed by the reconciliation package."
"At such a time," they wrote in a letter to lawmakers, "bipartisan agreement to provide additional funds to the Pentagon would deliver a cruel message to the American public, one out of step with Democratic messaging over healthcare, reconciliation, and the shutdown."
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