As Court Showdown Nears, Our Healthcare System Still a Mess

By Rose Ann DeMoro

With the approaching Supreme Court showdown on the President Obama’s 2010 health care law (the Affordable Care Act, modeled, of course, 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. The testimony will likely be 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, such as permitting young adults up to age 26 to remain on their parents health plan, and a few 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.

And, as nurses have reported repeatedly the past year, the economic crisis has great aggravated the suffering with broad declines in health status that are directly linked to job loss, unpayable 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 co-pays and deductibles.

A Commonwealth Fund study in November, comparing the U.S. to other high income countries, found that the U.S. stands out 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.

Nationally, premiums have jumped on average 50 percent over 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.

Universal coverage remains a far off dream. Fifty million Americans still have no health coverage. Another 29 million are underinsured, meaning they have 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, underreported study from the University of Washington last June found that more than 80 percent of U.S. counties in free fall on life expectancy compared to nations with the best life expectancies. Some U.S. counties are more than 50 years behind their international counter parts, 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 actually doubled in two decades, from 6.6 deaths per 100,000 live births in 1987 to 13 deaths per 100,000 in 2007. One reason, a 10 percent cut in federal spending for maternal and child health programs the past seven years.

Those who think giving 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, cost, and quality.

There is an alternative which most of the rest of the world has discovered, a national or single payer system, such as expanding and adequately funding Medicare to cover everyone. Even in other countries where conservative 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. At this point the fight for single payer is being taken up state by state, a movement that we will continue to proudly support.

Rose Ann DeMoro is Executive Director, National Nurses United, AFL-CIO and California Nurses Association


  1. van mungo on March 1, 2012 at 1:56 am

    There’s a big problem with National Nurses United: despite all their admirable rhetoric on behalf of single payer, in practice the group functions as a fund-raising and volunteer arm of the Democratic Party, urging votes for the very people who consistently scuttle single payer on behalf of their slush-fund campaign donors in Big Insurance and Big Pharma.(In the critical 2008 election cycle, Obama raked in $16 million from the health sector, two and a half times as much as McCain and more than all the other presidential candidate combined; the Congressional Democrats took in more than the Republicans from the health vultures in 2008–see for all the ugly data).

    For example, in 2008 NNU campaigned vigorously for Obama, despite the fact that he openly stated his intention to push for just the sort of private-insurance boondoggle that was eventually passed. Their default position is still to call for votes for Democrats–the very Democrats who systematically crushed first single payer and then even a feeble public option during the critical national healthcare debates of 2008-2009. The entire Congressional Progressive Caucus scuttled single payer and the public option to line up behind Obama’s Republican-inspired “free-market” nonsolution to the healthcare crisis.

    Single payer is a radical demand in several respects–it firmly establish the principle of public financing in a key sector of the economy. In doing so, however, it would wipe out a broad swath of big-time capitalist enterprise in America, thereby helping to puncture the current stock-market bubble that is the only thing sustaining the illusion of “prosperity” in this badly broken economy. That’s why not only the insurance sector but the financial sector have opposed single payer with relentless determination and huge washes of campaign cash to both corrupt parties.

    So you have a radical demand in the clutches of essentially liberal groups like NNU, Healthcare Now, and PNHP, which, despite their nominally independent status, have never pursued a true movement-building strategy of independent mass action but have devoted their resources and energies to polite, mincing, and futile verbal lobbying of the bought-off Democrats. You are sure to see a repeat performance of this self-defeating political masochism by these groups in 2012–on the grounds of course, of fending off the Republican bogeyman, despite the lack of any substantive differences on real economic and social policy–as opposed to the cultural food fights that passes for adversary politics on the stump, thus perpetuating the illusion of “differences” between the two wings of the single corporate party–pseudo-differences that are given credence year after year by liberal groups like NNU.

    Moreover, the NNU’s endorsement of a state by state strategy for single payer is a function of their subordination to the Democratic Party. Fearful of confronting the national Democrats for their treachery on healthcare, they retreat to a doomed slog at the level of the states, all of which are too fiscally strapped and fragmented to implement anything resembling real single payer.

    Sad to say, NNU and its ilk are more part of the problem than part of the solution–by calling IN ACTION for support for the Democratic Party, they are sabotaging IN DEEDS, where it counts, what they profess to uphold with their words.

    A divergence between the noble word and the treacherous deed–the very definition of a liberal.

  2. Tom on March 2, 2012 at 12:54 pm

    California had single payer vetoed by Arnold Schwartzenager when the 2 houses passed it a few years ago.. Now Gov. Brown said he would sign it if it came across his desk and it failed in the California House by a few votes..5 Democrats voted aginst it and 3 didn’t vote,,It was revealed that all took huge contributions from health insurance and pharnmceutical companies before the vote..When will this end???

  3. Margie Rece on March 8, 2012 at 10:53 am

    The problem is BIG MONEY, inflated costs to elect candidates.

    Corporate money is dictating to our elected officials,giving the big corporations control over the candidates, before , during and after elections.

    Medicare and Social Security are our healthcare plans for everyone in this nation. We can afford those and they will take care of us.
    As a nation and as people, we cannot afford the profits that go to
    big money. They are bankrupting our nation and our people.

  4. Carolyn Mordecai on March 8, 2012 at 11:59 am

    They don’t even focus on quality care, just health insurance. What about having integrative medical care in our hospitals so people who have allergies have control over their treatments while they are there.

  5. A Solution on March 9, 2012 at 9:36 am

    HERE’S A SOLUTION! Please email and post everywhere:


    Warren Buffett
    Another brilliant idea from Warren Buffett Could this be an idea
    whose time has come?

    Warren Buffett, in a recent interview with CNBC, offers one of the best quotes about the debt ceiling:

    “I could end the deficit in 5 minutes,” he told CNBC. “You just pass
    a law that says that anytime there is a deficit of more than 3% of
    GDP, all sitting members of Congress are ineligible for re-election.

    The 26th amendment (granting the right to vote for 18 year-olds)
    took only 3 months & 8 days to be ratified! Why? Simple!
    The people demanded it. That was in 1971 – before computers, e-mail,
    cell phones, etc.

    Of the 27 amendments to the Constitution, seven (7) took one (1)
    year or less to become the law of the land – all because of public pressure.

    Warren Buffet is asking each addressee to forward this email to a
    minimum of twenty people on their address list; in turn ask each of
    those to do likewise.

    In three days, most people in The United States of America will have
    the message. This is one idea that really should be passed around.

    Congressional Reform Act of 2011

    1. No Tenure / No Pension.

    A Congressman/woman collects a salary while in office and receives
    no pay when they’re out of office.

    2. Congress (past, present & future) participates in Social

    All funds in the Congressional retirement fund move to the Social
    Security system immediately. All future funds flow into the Social
    Security system, and Congress participates with the American people.
    It may not be used for any other purpose.

    3. Congress can purchase their own retirement plan, just as all
    Americans do.

    4. Congress will no longer vote themselves a pay raise.
    Congressional pay will rise by the lower of CPI or 3%.

    5. Congress loses their current health care system and participates
    in the same health care system as the American people.

    6. Congress must equally abide by all laws they impose on the
    American people.

    7. All contracts with past and present Congressmen/women are void
    effective 1/1/12. The American people did not make this contract
    with Congressmen/women.
    Congress made all these contracts for themselves. Serving in
    Congress is an honor, not a career. The Founding Fathers envisioned
    citizen legislators, so ours should serve their term(s), then go
    home and back to work.

    If each person contacts a minimum of twenty people then it will only
    take three days for most people (in the U.S.) to receive the
    message. Don’t you think it’s time?

    If you agree, pass it on. If not, delete.
    You are one of my 20+ – Please keep it going, and thanks