Perhaps the strongest argument against enacting Medicare for All has been that most Americans were happy with their job-based insurance and didn't want it taken away. But the coronavirus war is driving unemployment into the stratosphere. Millions of workers who are losing their insurance won't remain so happy.
To their credit, some employers have promised to continue insuring the laid off for a month or two. But not all employers can afford to do this. And if the emergency lasts too long no employers will be able to pay for insurance.
The newly unemployed theoretically can continue their employment-based insurance under COBRA (which can be very expensive) or purchase subsidized insurance privately through the exchanges. But where are the unemployed going to find the cash for replacement insurance?
Since the coronavirus can require hugely expensive hospitalization, lack of insurance could bankrupt many families. Although normal pneumonia hospitalizations cost about $20,000, coronavirus cases might average more like $72,000.
A single-payer, tax-funded insurance system — totally separate from employment or lack thereof — may suddenly look attractive to millions of additional Americans.
Joe Biden, the likely Democratic presidential nominee, has loudly opposed Medicare for All. His economically invalid criticisms were probably just campaign oratory aimed at his principal rival, Sen. Bernie Sanders. Biden needs to reconsider. If he endorses Medicare for All or some other single-payer system, otherwise discouraged Sanders supporters could turn out enthusiastically in November, enhancing Biden's chances of winning.
Republicans could neutralize Democrats' sudden advantage on this issue by coming out themselves for Medicare for All, if voters believe them. But are Republican leaders smart enough to recognize this opportunity?
If such a flip flop sounds unbelievable, remember how single-payer insurance was adopted by Taiwan. In "The Healing of America," T.R. Reid describes what happened: "The liberal Democrats latched onto universal health care as a central issue." The conservatives naturally opposed the idea. (So far, nothing surprising here!) But then, "in Taiwan, the familiar script took an unexpected turn. The conservative party changed its position."
Backing universal health insurance was a brilliant political move. Having stolen the liberals' strongest issue, the conservatives were able to retain power in the 1996 presidential election. With support from both parties, Taiwan enacted an excellent single-payer system.
Some American conservatives already favor single payer. Just google "Republicans for single payer" to get an earful. But most conservatives have not yet realized how much the current crisis increases a political opportunity that has existed all along.
Connecting health insurance with people's jobs poses immense dangers to personal security. The coronavirus war drives this home. It was always unrealistic for workers to assume that their jobs ... and medical insurance ... were secure since large corporations often whack staffing whenever their MBAs think it will save them some money. The dangers of such optimism are now obvious.
Medicare for All would have been helpful when the current crisis arose. People who now lack insurance or cannot afford copays, and therefore don't seek medical treatment when they become ill, endanger the health of the entire community.
Universal coverage will come too late for today's pandemic, but will be invaluable for the next one. And the logic of epidemics requires that insurance coverage be literally universal, covering everyone in the country, citizens, foreign tourists, and resident aliens — legal and illegal — alike. Viruses don't discriminate, and neither should the insurance system.
In 2017 the New York Times reported that a conservative friend of Donald Trump was quietly trying to persuade him to back a single-payer system to replace Obamacare. Even if he was convinced, Trump may have decided it was not politically expedient to push for such a "radical" reform. Thanks to the coronavirus the situation has changed, and the president needs to reconsider.
Paul F. deLespinasse is Professor Emeritus of Political Science and Computer Science at Adrian College. He received his Ph.D. from Johns Hopkins University in 1966, and has been a National Merit Scholar, an NDEA Fellow, a Woodrow Wilson Fellow, and a Fellow in Law and Political Science at the Harvard Law School. His college textbook, "Thinking About Politics: American Government in Associational Perspective," was published in 1981 and his most recent book is "Beyond Capitalism: A Classless Society With (Mostly) Free Markets." His columns have appeared in newspapers in Michigan, Oregon, and a number of other states. To read more of his reports — Click Here Now.
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