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Following up on the Affordable Care Act ruling, Bernie Sanders' state is looking to implement a Medicare for All, single-payer system.

The Vermont Model
By John Nichols

There has been no steadier congressional hand throughout the health care reform debate than Fighting Bob Fest regular and Vermont Senator Bernie Sanders’. Principled in his support for Medicare for All, yet pragmatic in his advocacy for Affordable Care Act provisions that expand public health programs and allow states to experiment with single-payer options, Sanders has been in the thick of every fight over President Obama’s signature reform.

What Sanders says about the recent Supreme Court decision upholding the law provides important insights for progressives.

On the ruling, his line is upbeat: “Today is a good day for millions of Americans who have pre-existing conditions, who can no longer be rejected by insurance companies. It is a good day for families with children under 26, who can keep their children on their health insurance policies. It is a good day for women, who can no longer be charged far higher premiums than men.”

But that does not mean Sanders is satisfied.

“In my view, while the Affordable Care Act is an important step in the right direction and I am glad that the Supreme Court upheld it, we ultimately need to do better,” the independent senator says. “If we are serious about providing high-quality, affordable health care as a right, not a privilege, the real solution to America’s health care crisis is a Medicare for All, single-payer system.”

Sanders’ state of Vermont is taking the lead in seeking to implement a state-level single-payer system — much as Canadian provinces led in the 1940s and ’50s in developing what would became that country’s national health care system. Sanders says, “I hope our state will be a model to show the rest of the nation how to provide better care at less cost to more people.”

Agreed. Amid the celebration of the Supreme Court ruling by those who did not want to go backward, there is a need to focus on going forward.

“Stepping up the fight for Medicare for All is even more critical in the midst of the still persistent economic crisis,” says National Nurses United Co-president Deborah Burger, who noted that nurses have seen declines in health status among patients who have suffered the loss of jobs, homes and insurance.

NNU notes: “The Affordable Care Act still leaves some 27 million people without health coverage, does little to constrain rising out-of-pocket health care costs, or to stop the all-too-routine denials of needed medical care by insurance companies because they don’t want to pay for it.”

NNU co-president Karen Higgins echoes Sanders: “Medicare is far more effective than the broken private system in controlling costs and the waste that goes to insurance paperwork and profits, and it is universally popular, even among those who bitterly opposed the Obama law. Let’s open it up to everyone; no one should have to wait to be 65 to be guaranteed health care.”

That’s correct.

The Supreme Court’s ruling can be celebrated on some levels.

But Sanders and his allies speak a profound truth when they say: “We ultimately need to do better … the real solution to America’s health care crisis is a Medicare for All, single-payer system.”

(A version of this article originally appeared in the opinion section of the Capital Times.)

July 8, 2012


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John Nichols is associate editor for the Capital Times in Madison, Washington correspondent for the Nation magazine, and a FightingBob.com contributing editor. He and Robert McChesney are co-authors of The Death and Life of American Journalism.

 

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