Abel is a Co-chair of the Medicare for All Working Group of the Metro DC Democratic Socialists of America. An abridged version of this essay was presented as a speech at a March 17 rally organized by Our Revolution DC to celebrate the reintroduction of the Medicare for All Act.
Our current health care system is racist. To see that this is true, you only have to look at the rate of COVID infections and deaths in Black and Brown communities. This beautiful city we live in, Chocolate City as they used to call it, has some of the nation's highest racial disparities in health care. Vaccine distribution in this city, because it is tied so closely with the for-profit health care industry, has seen some of the worst racial disparities in the country. The communities that are the most affected by COVID-19 are simply not the same communities that have received the most vaccine distribution.
This city is offering the vast majority of its vaccine shots through for-profit hospital systems which, with the exception of Howard University, have access limited to only those that are enrolled in their system; essentially those that have health insurance. While the vaccine is technically free, access to it is certainly not. Those with health insurance found an easy pipeline to vaccination while the uninsured are left to fend for themselves. The excuse for this is obvious: the only system available for immediate distribution of vaccines was the exclusionary for-profit health care system already in existence. We lack the basic infrastructure, the basic administrative services, needed to distribute treatment to millions — in this pandemic and any future pandemic that is sure to come.
Let’s be honest: Medicare for All is not a fix-all solution. But it is a foundation, a cornerstone, upon which we can build an equitable and just health care system. We need additional targeted anti-racism policies and legislation to overcome the racial disparities in health care, and a federally administered single-payer system could act as a starting point. The Medicare for All Act of 2021 includes in its newest provisions the creation of an Office of Health Equity which, among other things, would be responsible for gathering data on health inequity in the US and generating an annual report. These annual reports could serve as the basis for instituting more robust legislation and policies to address the many disparities that exist in our health care system.
The current for-profit health care system, however, is unsustainable; COVID-19 proved this for all to see. In the course of a year, nearly 15 million people lost their health care coverage due to unemployment, demonstrating how tying health care to employment is dangerous and just plain stupid. Swelled uninsured rolls add to the approximately 87 million people that were uninsured or underinsured prior to the pandemic.
More than half a million people in the US died because of this pandemic. That is more than any other country in the world and about double the amount in Brazil, the country with the second highest number of deaths. The richest country in the history of the world could not deal with a viral disease better than some of the poorest nations. So this bears repeating: our current health care system in the US is unsustainable; COVID-19 proved this for all to see.
This for-profit health care system simply cannot be allowed to continue, and there is no better time than now to fight for Medicare for All, for a single-payer health care system with zero cost-sharing for patients.
I have been a proponent of universal single-payer health care for some time, but it is only recently that I realized why this struggle is so personal to me. In the mid-2000s, I began having sporadic excruciating pain in my stomach. I did not have — and still do not have — health coverage, so I withstood the pain for a long time. Eventually, I went to a doctor. They could not find a diagnosis for my pain but they suspected that I had developed an ulcer and that my diet was a contributing factor. They referred me to a hospital to get imaging and additional testing. The antacid medication I was given worked temporarily, and I knew going to a hospital could cost me hundreds or thousands of dollars.
This continued for several years. The pain would return, I would go to a doctor, they would prescribe over-the-counter medication and refer me to a hospital for additional testing, but I would still not go. I know, and knew even back then, that this was a bad decision. While the pain has not returned for several years, to this day, I do not know what was and may be still wrong with me.
I work as a freelancer in the online gig economy and make just enough money to afford my rent and other needs. I cannot afford to pay for health insurance. I cannot tell you how excited I was when Obamacare passed. This was after my chronic issue had passed, but I feared it would return and believed that I should prepare to carry my treatment to its conclusion. I went on the health exchange website the first day it was offered, only to find out that I still could not afford the rate. Here I am today, on the eleventh anniversary of the enactment of the Affordable Care Act, still without health coverage.
I know there are worse health insurance stories than mine, and that many people have similar experiences. Too often, people like me delay seeking help due to a lack of health care coverage. I also know that delayed care leads to worse outcomes and that people of color have faced the brunt of this evil, draconian health care system. Yet Congress refuses to take action, to do the work that is perfectly within their power, to remedy these awful circumstances in which millions find themselves.
Medicare for All is an overwhelmingly popular legislation across the political spectrum. The public is already convinced! The only people standing in our way are some of the legislators working in the Capitol building and the profiteers funding their reelection. For many of us, anger over federal inaction has prompted grassroots campaigns to push political leaders to move forward with bold change. As a result, many cities and counties have passed resolutions urging Congress to pass Medicare for All, not just in left-leaning states but in cities like New Orleans and Knoxville.
On March 16, a day before the introduction of the Medicare for All Act of 2021, Delegate Deni Taveras, vice chair of the Prince George’s County Council, introduced a resolution endorsing Medicare for All. Already, seven out of the eleven PG County councilmembers are cosponsors of the bill — a majority! This is something that health care advocates in PG County have been fighting toward for some time, including several of our comrades in Metro DC DSA. But we are not stopping there. We are close to introducing a similar resolution in the DC Council. We already have cosponsors lined up and a lead councilmember to introduce it.
Medicare for All resolutions are part of a nationwide strategy to build local support for Medicare for All. Here in the DMV, there are several coalitions working towards this goal. The Maryland Progressive Healthcare Coalition, which several Metro DC DSA members are part of, is going county by county and they need your help. In DC, our Medicare for All Working Group has helped form a coalition led by SPACEs In Action, a Black-led organization focused on health and economic justice. Currently, our DC coalition includes the local National Nurses United and also Public Citizen.
These resolutions are very important, as they demonstrate clearly that politicians at the federal level are the only obstacle to transforming our country’s awful health care system. I urge all of you to help in demanding their passage in every surrounding county. By year’s end, we want every county and every suburb in the DMV to have passed a similar resolution.