102 Think Piece: “Why We Must Fight for Medicare for All”

Cody Cantu

Lia Schuermann

ENG 1023.17

13 February 2021

Why We Must Fight for Medicare for All

     Like many Americans living today, I battle with depressive episodes and anxiety-driven panic attacks. They have, at their worst, rendered me unfit to drive and unable to function at work. Mental health issues, although sometimes undiagnosed professionally, have been a part of much of my family life growing up – whether it be serious substance abuse, suicide attempts, or routine self-harming behaviors. I don’t mean to go too deep into the chasms of my life story, as I imagine and know that many peoples’ stories are not unlike my own. That is, in fact, the exact reason I mention it with any detail at all. There is a ubiquity of poor mental health in this country that necessitates a national conversation on the issue.

I don’t believe I am unlike many Americans who have found themselves finally accepting the fact that they need professional help but have had either no idea where to look or ended up having to choose between paying for therapy and medicine or essential groceries. Fees for doctor’s visits, therapists, and medicine rack up faster than a lot of people are reasonably able to pay, even with health insurance. In my time as a community organizer speaking with neighbors and organizers alike, I’ve been told so often that searching for mental health resources was ultimately more frustrating and emotionally taxing than coping with it in the ways they knew how. These same folks have told me it felt like they were wasting time they could have spent trying to unwind from a terrible day, taking care of important chores around the house, or perhaps searching for a job that didn’t treat them with contempt. “Fake it ‘til you make it” is the unfortunate turn of phrase coined by Dr. Phil that illustrates what understandably comes next. Unhappy and unhealthy people manage to make it, one moment at a time, through the daily motions of their life. These same people know that they must keep their job in order to keep what health benefits their employer does provide for them, even if their wage cannot cover the fees associated with the mental healthcare they seek to receive. They have also resisted the urge to go to the doctor whenever they have felt extraordinarily ill, for the costs incurred were usually more than they were able to spend that month. The condition is summed up pretty well in one simple sentence I heard once while on the job: the best healthcare is not getting sick. Whether it’s mental or physical health, our common treatment is to just deal with it. In my eyes, and in the eyes of many people I know and love, this reflects an even more profound reality – the evermore common inability to find access to or afford medicine and health care at large. Healthcare reform in America is long overdue, and there is no other policy proposition more unequivocally prepared to provide substantial and affordable healthcare, mental health and substance abuse treatment than a single-payer, national health insurance program – better known as Medicare for All.

The need for this substantial kind of healthcare reform is more than just the dire need for mental health services guaranteed for all citizens. According to Woolhandler and Himmelstein’s article in the Annals of Internal Medicine, if nothing is done about the state of our healthcare system (and since costs for these essential services are expected to continually rise in tandem) over 36 million Americans will be uninsured by the year 2027 (793). This presents us with a desperate need for any kind of healthcare reform, whether it be Medicare for All or an expansion of the Affordable Care Act to ensure that more Americans are insured.

So, why Medicare for All? In the past year, millions of people have lost their jobs in the wake of the COVID-19 pandemic. Woolhandler and Himmelstein’s research, while insightful, could not even begin to account for the millions who have lost health insurance coverage that was tied to their employment. The sudden precarity in employment, and ultimately income, has had an inordinate effect on the mental health of many people living in the United States. More recent peer-reviewed research, such as Xiong et al’s study of Covid-19 impacts, has concluded that the pandemic is associated with psychological distress of “clinical relevance” in the United States and elsewhere in the world – with a common cause being unemployment concerns (“Abstract”). Despite the enormity of the crisis we are facing, some still believe that such efforts to guarantee access to healthcare for everyone would be “too costly” to American taxpayers. This argument fails to understand or even address the bigger picture with regard to human rights or the implementation of the single-payer national health plan, but first I’ll address the fiscal question: An ambitious research effort published in the Public Library of Science insists that single-payer forms of national health insurance, like those implemented in Canada and Australia, have efficiency savings that would greatly outweigh the cost of implementing the system itself (Cai et al 11). Through simplification of health insurance administration and the ability for the United States as a whole to bargain for low drug prices, the study projects net savings within the first year of implementation of a system like Medicare for All, despite the mass expansion of coverage.

However, the potential benefits don’t end there. Not only would guaranteeing healthcare for all Americans be cost effective in the short and long term, but the clinical research that continually improves our standards of care could be greatly improved with a national system. Centralization of data, according to findings published in Circulation, would have a profound impact on how medical research is conducted, namely in trial recruitments (Thomson et al.). With a cost-benefit analysis and research infrastructure that sees a single-payer system like Medicare for All as the best outcome for citizens and future medical developments, logic would see that such a policy be met with great enthusiasm and optimism. However, politics do not always operate in tandem with the logic of science. The problem, ultimately, is political. Because this is such a common-sense policy that would profoundly improve the declining standard of living for Americans, understanding why there has been such a concerted push-back against it is vitally important in this moment. Just a quick glance into the campaign finance reports of congressmen and women of both the GOP and the Democratic party reveal high sums dealt by private health insurance lobbies and pharmaceutical companies. Although a large majority of all voters support Medicare for All, representatives on both sides of the aisle tend to feel more beholden to the interests of their donors on this matter, as the financial support allows these representatives to maintain office with greater ease. One could say that these politicians are preserving their own livelihood, even if it prevents masses of Americans from receiving potentially life-saving health care.

So, what are masses of Americans who desperately need healthcare to do? The answer is to organize. The battles for women’s suffrage, the Civil Rights movement, and many other political struggles have been battles that were organized in affected communities about their goals, tactics, and means of achieving those goals. Citizens may need to think outside of the voting booth when it comes to implementing a system that so many are desperately trying to keep from existing. Direct action campaigns like labor strikes, sit-ins, and massive public protests disrupting the flow of business-as-usual are but a few tactics used over the years by community activists seeking progressive, society-wide change. In addition to direct action, educating fellow neighbors, friends, family members, and co-workers about the absurd opposition to Medicare for All is one of the best things we can do to advance the cause and get people life-saving healthcare who desperately need it. Because of the strength of narratives put forward by political-pundits (who often have investments in the private health insurance industry), it is vital that we push back on these narratives whenever we hear them and point to the truth of the matter – that healthcare is a human right and a national healthcare system is the best way to ensure that right. Too many of us have seen loved ones forgo medical treatment to save money, neglect their mental health entirely, fall into the throes of substance abuse, and suffer unnecessarily. Too many of us have waited long enough to not consider something as elemental to life as healthcare “a luxury.” Too many people have died attempting to raise money for insulin, and too many have had to rely on a crowdfunding site like GoFundMe to pay for medical emergencies. It’s time to put an end to this absurd and deadly floundering on a policy that will save people’s lives. It’s time to stop the suffering.

Cody Cantu is a student at Texas Woman’s University pursuing a Bachelor’s of Science in Political Science, where he also served as an organizer for Denton Autonomous Tenants’ Union. He can be reached via email at ccantu16@twu.edu.

Works Cited

Cai, Christopher, et al. “Projected Costs of Single-Payer Healthcare Financing in the United States: A Systematic Review of Economic Analyses.” PLoS Medicine, vol. 17, no. 1, Jan. 2020, pp. 1–18. EBSCOhost, doi:10.1371/journal.pmed.1003013.

Thomson, Blake, et al. “What ‘Medicare for All’ Could Mean for US Medical Research: Lessons From the United Kingdom.” Circulation, vol. 140, no. 19, Nov. 2019, pp. 1527–1529. EBSCOhost, doi:10.1161/CIRCULATIONAHA.119.042211.

Woolhandler, Steffie, and David U. Himmelstein. “Medicare for All and Its Rivals: New Offshoots of Old Health Policy Roots.” Annals of Internal Medicine, vol. 170, no. 11, June 2019, pp. 793–795. EBSCOhost, doi:10.7326/M19-0780.

Xiong, Jiaqi, et al. “Impact of COVID-19 Pandemic on Mental Health in the General Population: A Systematic Review.” Journal of Affective Disorders, vol. 277, Dec. 2020, pp. 55–64. EBSCOhost, doi:10.1016/j.jad.2020.08.001.