To Pave the Way for Medicare for All, We Need to Overcome “Citizens United”

There’s only one person in this photograph/video of last week’s G7 meeting who represents a country where an illness can destroy an entire family, leaving them bankrupt and homeless, with the repercussions of that sudden fall into poverty echoing down through generations.

Most Americans have no idea that the United States is quite literally the only country in the “developed world” that doesn’t define healthcare as an absolute right for all of its citizens. That’s it. We’re the only one left.

The United States spends more on “healthcare” than any other country in the world: about 17% of GDP.

Switzerland, Germany, France, Sweden and Japan all average around 11%, and Canada, Denmark, Belgium, Austria, Norway, Netherlands, United Kingdom, New Zealand and Australia all come in between 9.3% and 10.5%.

Health insurance premiums right now make up about 22% of all taxable payroll, whereas Medicare For All would run an estimated 10%.

We are literally the only “developed” country in the world with an entire multi-billion-dollar for-profit industry devoted to parasitically extracting money from us to then turn over to healthcare providers on our behalf. The for-profit health insurance industry has attached itself to us like a giant, bloodsucking tick.

And it’s not like we haven’t tried. Presidents Theodore Roosevelt, Franklin Roosevelt, Harry Truman, Jack Kennedy and Lyndon Johnson all proposed and made an effort to bring a national healthcare system to the United States. Here’s one example really worth watching (it’s 2 minutes and gets better as it goes along):

They all failed, and when I did a deep dive into the topic last year for my newest book The Hidden History of American Healthcare I found two major barriers to our removing that tick from our backs.

The early opposition, more than 100 years ago, to a national healthcare system came from southern white congressmen (they were all men) and senators who didn’t want even the possibility that Black people could benefit, health-wise, from white people’s tax dollars. (This thinking apparently still motivates many white Southern politicians.)

The leader of that healthcare-opposition movement in the late 19th and early 20th centuries was a German immigrant named Frederick Hoffman. Hoffman was a senior executive for the Prudential Insurance Company, and wrote several books about the racial inferiority of Black people, a topic he traveled the country lecturing about.

His most well-known book was titled Race Traits and Tendencies of the American Negro. It became a major best-seller across America when it was first published for the American Economic Association by the Macmillan Company in 1896, the same year the Supreme Court’s Plessy v. Ferguson decision legally turned the entire US into an apartheid state.

Hoffman taught that Black people, in the absence of slavery, were so physically and intellectually inferior to whites that if they were simply deprived of healthcare the entire race would die out in a few generations. Denying healthcare to Black people, he said, would solve the “race problem” in America.

Southern politicians quoted Hoffman at length, he was invited to speak before Congress and was hailed as a pioneer in the field of “scientific racism.” Race Traits was one of the most influential books of its era.

By the 1920s, the insurance company he was a vice president of was moving from life insurance into the health insurance field, which brought an added incentive to lobby hard against any sort of a national healthcare plan.

Which brings us to the second reason America has no national healthcare system: profits.

“Dollar” Bill McGuire, a recent CEO of America’s largest health insurer, UnitedHealth, made about $1.5 billion dollars during his time with that company. To avoid prosecution in 2007 he had to cough up $468 million, but still walked away a billionaire. Stephen J Hemsley, his successor, made off with around half a billion.

And that’s just one of multiple giant insurance companies feeding at the trough of your healthcare needs.

Much of that money, and the pay for the multiple senior executives at that and other insurance companies who make over $1 million a year, came from saying “No!” to people who file claims for payment of their healthcare costs.

This became so painful for Cigna Vice President Wendell Potter that he resigned in disgust after a teenager he knew was denied payment for a transplant and died. He then wrote a brilliant book about his experience in the industry: Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.

Companies offering such “primary” health insurance simply don’t exist (or are tiny) in almost every other “developed” country in the world. Mostly, where they do exist, they serve wealthier people looking for “extras” beyond the national system, like luxury hospital suites or air ambulances when overseas. (Switzerland is the outlier with exclusively private insurance, but it’s subsidized, mandatory, and non-profit.)

If Americans don’t know this, they intuit it.

In the 2020 election there were quite a few issues on statewide ballots around the country. Only three of them outpolled Joe Biden’s win, and expanding Medicaid to cover everybody was at the top of that list. (The other two were raising the minimum wage and legalizing pot.)

The last successful effort to provide government funded, single-payer healthcare insurance was when Lyndon Johnson passed Medicare and Medicaid (both single-payer systems) in the 1960s. It was a hell of an effort, but the health insurance industry was then a tiny fraction of its current size.

In 1978, when conservatives on the Supreme Court legalized corporations owning politicians with their Buckley v Belotti decision (written by Justice Louis Powell of “Powell Memo” fame), they made the entire process of replacing a profitable industry with government-funded programs like single-payer vastly more difficult, regardless of how much good they may do for the citizens of the nation.

The Court then doubled-down on that decision in 2010, when the all-conservative vote on Citizens United cemented the power of billionaires and giant corporations to own politicians and even write and influence legislation and the legislative process.

Medicare For All, like Canada has, would save American families thousands every year immediately and do away with the 500,000+ annual bankruptcies in this country that happen only because somebody in the family got sick. But it would kill the billions every week in profits of the half-dozen corporate giants that dominate the health insurance industry.

The Covid crisis — which is producing an explosion in healthcare debt for American families (but not for those in any other “developed” nation) — is starting to create considerable pressure for change, but Americans still must overcome the political corruption the Supreme Court wrote into our system with Citizens United.

It’ll be a big lift: keep it on your radar.