Single-Payer Health Care System Now

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It is a windy day in New Haven, and a gust shakes the offices of Fair Haven Community Health Center. The executive director, Dr. Suzanne Lagarde, is in an upstairs meeting room, and she looks around quickly.

“I don’t have a generator—another one of my nightmares,” she said. Downstairs is a full waiting room. A loss of power would be disastrous.

But that is not the only nightmare that haunts the sick and those who provide for them these days. Without enough support, the American Health Care Act—the benighted Republican attempt to replace the Affordable Care Act—was eventually pulled by House Speaker Paul Ryan. Earlier, the Congressional Budget Office said the bill would result in the loss of insurance for 24 million people over the next 10 years. Ryan says his party will continue to push for reform, and prior to this week’s break for Congress, he and other GOP leaders announced that some tweaking had strengthened the failed bill.

But tweaking won’t be enough.

Lagarde said roughly a quarter of her center’s clients are uninsured. The AHCA would have pushed that figure to closer to 40 percent, she said.

But the battle isn’t over. And defending Obamacare is not the country’s only option.

Trump says he will move on to tax reform, but look at his proposed budget, which the press is calling a “skinny budget” for its lack of specifics. A better characterization would be “inhumane” for its potential effect on people such as the ones being treated at Fair Haven, a mid-sized community health care provider that serves a large immigrant population. The battle is not over.

If a budget is a moral document, then President Trump has some explaining to do.

To provide a $54 billion boost to military spending, Trump’s budget cuts funding for services that provide food and health care for the most vulnerable, including children, women, and the elderly. Many of the programs provide preventive care, which is known to provide better (and less expensive) health outcomes.

This all feels like we are arguing about something that was already settled—health care is a human right—so maybe it’s time to settle this once and for all.

With the Republicans’ defeat still stinging, now is the time for Democrats and Republicans to vote for a single-payer health care system. Medicare and Medicaid are basically universal health care lite for particular populations, but it’s time to think about some serious expansion. Organizations such as the Physicians for a National Health Program have long been pushing for a program reflected in a bill proposed every year since 2003, and dubbed “Medicare for All.” As a recent article from The Nation said, Americans have a choice between Obamacare, where “insurance companies made out like bandits,” or Trumpcare, where they could have expected the same.

Many developed countries, including Canada and the U.K., and some of the United States’ historic allies, have a single-payer health care system. In March, America’s Health Insurance Plans, the trade group for health insurance companies, published a chart that showed where money spent on premiums go. Nearly 18 percent of every dollar spent on premiums goes to operating costs. In 2015, administrative costs for traditional Medicare insurance plans for seniors and people with severe disabilities was closer to 1.5 percent.

The bill, which is sponsored by Rep. John Conyers (D-Mich.), is a step in the right direction. Even some of Trump’s trusted advisors agree. Some states have taken it upon themselves to move toward single-payer, including Connecticut in 2007. Two years ago, New York’s state assembly, in a largely symbolic vote, approved a single-payer health care bill. California voters, too, have been discussing something similar.

But the time for symbolism is over. The time for hanging someone’s health on the whims of the marketplace—or the largesse of whatever party is in power—is over. Single payer, and single payer now.

Susan Campbell is a distinguished lecturer at the University of New Haven. She can be reached at


One thought on “Single-Payer Health Care System Now

  1. I think the best thing that can be done right now to advance Single Payer is to pressure John Conyers and the cosponsors to HR 676 to request a CBO/JCT score on the funding proposals for the bill (executive summary pdf). All Conyers has to do, as a formally recognized Congressional Leader, is ask.

    The public has a right to know where the funding comes from and how much money we can save by implementing an expanded and improved Medicare-For-All.