The Real Cure for "Obamacare": Medicare for All

Posted on 02 March 2012

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By Rose Ann DeMoro
National Nurses United

With the approaching Supreme Court showdown on the President Obama’s 2010 health care law (the Affordable Care Act, modeled on Mitt Romney’s law in Massachusetts), the U.S. healthcare system remains a dysfunctional mess, as nurses bear witness to every day.

In late March, the Court will devote six hours over three days to oral arguments on the legal challenges to the law – the most time the Court has given a case in 56 years – accompanied by a possible record 100 “friend of the court” briefs, Kaiser Health News reported February 16.

While the ACA had some undeniable positive elements, including permitting young adults up to age 26 remain on their parents health plan, and several limitations on insurance industry abuses, such as barring them from denying coverage due to pre-existing conditions, our health care nightmare is far from over.

As nurses have observed the past year, the economic crisis has accelerated broad declines in health linked to job loss, high medical bills, and families having to choose between paying for food, housing, clothing or healthcare.

As to the law itself, despite its name the ACA has done little to actually make healthcare affordable. Out of pocket health costs for families continue to soar largely unabated. Nurses now routinely see patients who have postponed needed care, sometimes even life-saving or life-prolonging care, because of the high co-pays and deductibles.

A Commonwealth Fund study last November, found that the U.S. stands out among high income countries for sick adults having cost and access problems with 27 percent unable to pay medical bills in the past year, compared to from 1 to 14 percent in other countries, and 42 percent skipping doctors visits, recommended care, or not filling prescriptions.

Dental care is a prime case study. A Pew Center report February 27 cited a 16 percent jump in the number of Americans heading to emergency rooms for routine dental problems, at a cost of 10 times more than preventive care with fewer treatment options than a dentist's office.

Nationally, premiums have jumped 50 percent on average the past seven years with more than six in 10 Americans now living in states where their premiums consume a fifth or more of median earnings.

Fifty million Americans still have no health coverage. Another 29 million are under insured with massive holes in their health plans, an increase of 80 percent since 2003, according to the journal Health Affairs.

The percentage of adults with no health insurance at 17.3 percent in the third quarter of 2011 was the highest on record, up from 14.4 percent just three years earlier, Gallup reported.

On quality, the U.S. continues to fall far behind other nations.

What should have been a shocking, under reported study from the University of Washington last June found more than 80 percent of U.S. counties badly trailing on life expectancy compared to nations with the best life expectancies. Some U.S. counties are more than 50 years behind their international counterparts, meaning they have the life expectancy that those nations had in 1957.

One reason for this disturbing news is the regression in death rates for child bearing women. The U.S. ranks just 41st in the world, and it has been getting worse, according to the World Health Organization. The average mortality rate within 42 days of childbirth has doubled in two decades, from 6.6 deaths per 100,000 live births in 1987 to 13 deaths per 100,000 in 2007, partly due to a 10 percent cut in federal spending for maternal and child health programs the past seven years.

Those who think more handouts to the private insurers and other healthcare corporations will improve these dreadful statistics should think again. The wholesale domination of our health by the same Wall Street types who tanked our economy is exactly what has caused the falling health barometers on access, quality, and cost.

Most of the rest of the world has discovered a more humane, cost effective alternative, a national or single payer system, such as expanding and adequately funding Medicare to cover everyone. Even in countries where politicians have proposed privatization or sweeping health cuts they are being met with an aroused public unwilling to trade their health systems for the broken model we have here.

Whether the 2010 law is fully or partially thrown out by the courts, repealed in Congress, or fully implemented, the need for real reform, single payer/Medicare for all, will continue to grow. For now, the fight for single payer is being taken up state by state, a movement that America’s nurses will continue to promote.


Rose Ann DeMoro is executive director of the 160,000-member National Nurses United, the nation’s largest union and professional association of nurses, and a national vice president of the AFL-CIO. Follow Rose Ann DeMoro on Twitter:

The Obamacare was a political accomplishment. It is a first step in the right direction. The Affordable Care Act was achieved and can transitioned into a Single Payer System.

Although imperfect, it is a "start". What follows in the right direction, IS it is already happening. The plan to transition is already rolling even as the debate continues.

The first step is developing an infrastructure so that any doctors and patient is able to access necessary medical records, anywhere, anytime, in order to have it available to get the proper health care for a patient from any doctors in any State within USA.

Kaiser is one health-care facility that I know of; that has this on-line capabilities. However, there needs to be alot more work done to secure patient medical record privacy.

However, for the purpose of medical privacy, a psuedo-name should be applied to every patient. Every patient should be given a membership card that can be used as a ACCESS to the medical records using a system similar to a credit card swipe-system or perhaps better yet using the finger print system like what many banks are using today. If this can be achieved that would be great. The latter is probably the most secured system.

The next step is accounting for every access in order to detect and tract where medical records transaction has evolved. Patient can detect if mistake or fraudulent activity has occured. Patient should also be able to interact with the system with regards to medical service billings. Patients are best to be able to identify billing mistakes or billings for services for which the patient has not received.

For example, if my orginal medical care insurance is in California, and I traveled to New York for a specialized medical care, that should be recorded and be able to retract. If there is a medical transaction in South Carolina and the patient notice it in the tracking system, this mistake can be tracked for fraudulent use of ones medical care.

The medical record in its entirety can be verified and tract to the natural person that the medical record belongs to, or can tract a suspicious billing and fraudulent activity has occurred.

Any suspicious activity can be affirm to the true owner of the medical record. Because it (medical illness and all pertinent information) is "unique" to the individual.

Until all this (infrastructure) is worked in and accomplished in a medical system, the goal of "affordability care" will remain just a myth. I do however am optimistic with the technology today and it's ability to make this happen.

With this in mind, I have no doubt that California may lead its way to a single payer medical care system for USA, with no problem.

Rose Ann

Judging from your avatar photo, you are probably too young to know why Medicare for All is a terrible idea. Medicare is absolutely awful insurance with no catastrophic coverage, no dental/vision/annual-physical/drug coverage, high co-pays and deductibles, and geographic restrictions. Medicare is so bad that only about 8% of Medicare beneficiaries depend on it (and I can't for the life of me figure out why). The rest of us Medicare beneficiaries depend on employer-retiree insurance (around 50%); what Medicare calls the private Medicare option, Medicare Part C (25%-27%); private supplemental insurance called Medigap (around 15%), or Medicaid (around 28%). In some cases Medicaid pays for seniors to choose Medigap or Part C so the numbers add up to more than 100%.

Also, when you way 50,000,000 people are uninsured, I'm sure you meant to say that only 6,000,000 of them are uninsured because they can't afford it. Surely there is a better way to help that 2% of our population than to change things for the other 98% of us.


The only logical plan is to dump Obamacare and begin a single-payer system. The average person would save thousands a year--now many pay $20,00 + for insurance premiunms. With single-payer, this person would no longer have to pay that. Of course, taxes would have to go up (maybe $1,000 a year) a bit to cover all citizens.

Obama's health plan failed in the sense that it didn't go near far enough (and the individual mandate)...but why in the world would we "dump" all the new consumer protections that are already paying some dividends and so needed and beneficial?

No need to do that to move to the FAR SUPERIOR single payer fact, as we move to that there are numerous improvements to his legislation that should be immediately pursued (as single payer is a long way off due to lack of votes and power of health insurance/big pharma) the government's ability to negotiate drug prices, regulatory over-site (and veto power) of health insurance premium increases (like what we're trying to do in California through AB 52 - Feuer), the ability to import cheaper drugs from Canada and Mexico, a STRONG public option that let's anyone who chooses to buy into it, stripping the health insurance industry of its protection from antitrust suits (break up the monopolies), and lower the Medicare age to 55.

These are, some more than others, achievable goals over the next coming years that would vastly improve what is an admittedly modest bill while moving us towards single will be necessary due to industry power, right wing/GOP allegiance to profits over lives and savings (and a growing wing of corporate Democrats), and public ignorance (like the man commenting here)...

I agree. We always start with turning the key to open the door. Once that door is open, we can clean it up and fix it the way WE the people know how it should be.

There is no sense to dump the whole house after years of trying to figure out how to open this door of opportunity without a key.

Now that President Obama had relatively opened it up (the door of opportunity) with a clever political "KEY", it would be unwise to abandon it just because the room we find ourselves is less than perfect than what we expect it to be. We can NOW work on driving this opportunity to design a more perfect health care system, than what we intended to work on.

The point that people forget is that for several decades we have desentisized to the fact that cost of medical care is unsustainable. We got too comfortable at the fact that as long as we can afford "medical premium for a health insurance" we expect to get the care without considering the "REAL and ACTUAL "price" of medical care and prescription. If we are truly want to make health care a " human-right" then we also must be real and consider the real cost to manufacture the drugs for all diseases and the cost for medical treatment that is sustainable for all. A perfect union does not come immediately. It took many many generation to bring us to where we are today. WE are still evolving and will continue until get it right.