Is Obamacare Enough?

Without Single-Payer, Patchwork U.S. Healthcare Leaves Millions Uninsured

From Democracy Now

Despite helping expanding affordable insurance, “Obamacare” maintains the patchwork U.S. healthcare system that will still mean high costs, weak plans and, in many cases, no insurance for millions of Americans. We host a debate on whether the Affordable Care Act goes far enough to address the nation’s health crisis with two guests: Dr. Steffie Woolhandler, a primary care physician and co-founder of Physicians for a National Health Program; and John McDonough, a professor at the Harvard School of Public Health and former senior adviser on national health reform to the U.S. Senate Committee on Health, Education, Labor, and Pensions. Between 2003 and 2008, McDonough served as executive director of Health Care for All in Massachusetts, playing a key role in the passage of the 2006 Massachusetts health reform law, known as “Romneycare,” regarded by many as the model for the current federal healthcare law.


  1. Carla Skidmore on November 11, 2013 at 3:52 pm

    Kudos to Dr. Woolhandler! She is so correct, for profit insurance companies have no business in health care. Medicare for All is the way to go, but we will need a new congress to have this happen. Insurance company lobbyists have congress by the “short hairs.” Lobbyists, as a whole, own congress.

    • Janice P on November 11, 2013 at 4:11 pm

      I agree with you, Carla. But the only real way to do that is to search for candidates OUTSIDE of the corrupt two-party system. Almost all of the people in office (in BOTH parties) care only about getting re-elected, which means they have to ingratiate themselves to the wealthy and to corporations for campaign money. The piper must be paid for those contributions, and the time for those payments will arise every single time legislation is crafted or voted on. Because of that, we have essentially lost power over our own government and over our own destinies. In short, our elected officials have sold our democracy tot he highest bidders. Most of those seeking office do so with the primary objective of becoming very wealthy – also a result of their relationships with the monied in this country. I see almost no problem the US has, which could not be moved to a solution if campaign finance reforms were put in place, allowing candidates ONLY a federally-allocated sum for every candidate and nothing from outside sources. The revolving door between Congress and all other government positions would also have to be nailed shut, and we would need strict term limits. Given the people we now have at every level of government, we simply cannot expect change without stringent and thorough election finance and related laws put into place.

  2. Jake Green on November 11, 2013 at 5:58 pm

    Here is what i think.
    I live in New York City. I personally know people and am aware of large groups of people of various backgrounds and nationalities who chose not to work period. They abuse the system either by just not contributing to the bucket and not working, or by not working legally and not paying taxes.
    I came to the US 25 years from the former USSR and the first 15 years I worked 2-3 jobs to provide for my family and to build a better life for myself and for my kids. I am working hard now and I am paying my taxes. The cost of the medical insurance is high, and I am paying for it too. So, the question is: why should I pay for someone else, who chose not to work and enjoy entitlement benefits while someone else is paying for them?
    Look, I came from the Socialist country, I have been there, I ate it and I hated the system greatly. What I see now is that we are moving there slowly, and the place we are moving to is a black hole, and there is no way we will be able to get out of this hole easily.
    What is going to happen is that we will kill our middle class slowly, but believe me, fast enough. We will force small and medium size busineses to downsise and to use part time labor. We will start expropriating from “rich”, most of them are good hardworking businessmen, and believe me, they will start finding ways to beat the system to their advantage. Remember sick minded Lenin in 1917? Remember what he turned his country into? Poor took over, killed or destroyed the “rich” and enjoyed the chaos for many years to come. The outcome? Back to capitalism, where people have to WORK for a PIECE OF BREAD, and the entitlements are only for sick and elderly.
    My point is that entitlements, or something for free will eventually kill this great country. Now the generations of americans do not know anything but entitlements and will vote for them and for anyone who offers more of a free cheese. I do not see any common sense in what is being done, unless the goal is to bring this country to the level of Cuba.

  3. Jill Friedman on November 12, 2013 at 3:26 am

    I am very disappointed in the ACA. The “Patient Protection” part of the law is good. But the actual plans are not affordable by any means. The premiums are high and the deductibles and copays so high that those in the lower income ranges-for instance below the median income– will not be able to use the insurance. Many will be unable to actually get health care when sick, or to catch emerging health problems early before they become chronic and debilitating and expensive to treat. The government subsidies for premiums will benefit the insurance companies, and the deductibles will ensure that the insurance companies in most cases will never have to pay a claim. A giveaway to the insurance industry, and a very poor deal for the people.
    But even without the insurance companies, the prices for medicines and services are still way too high. Single payer alone will not solve the problem. Even Medicare premiums are becoming more expensive, and the government refuses to control prescription prices. The government needs to control healthcare prices, and that will not happen anytime soon.
    In the meantime, maybe we could form large non-profit, non-governmental healthcare buying co-ops, to provide members with more affordable healthcare. I understand something like this was attempted as part of healthcare reform but they lost government funding. So it would have to be done without government funding. Then continue to push to expand Medicare downward and Medicaid and Chip upward while insisting on price controls.

  4. Mary Peterson on November 12, 2013 at 12:22 pm

    Single payer is best, I agree, but we cannot get there from here. YET. Having insurance companies out of the middle, we couldn’t get there from here in the 1980s either. Look what happened to the Clintons’ efforts- tons of money by healthcare and insurance companies lobbying to stop national health insurance which would bring federal regulation.. And they did stop it cold. The Affordable Care Act has insurance companies on board and is now the law of the land. Outrages may still occur and many who held policies all along will see premium increases, but that is necessary because low-cost policies were available while the companies were not required to include the very sick and needy in their pool. Now they are required to do so, and those healthy people with cheap policies will now pay more. Two reasons: the pool now includes those sick people formerly excluded, and whose payout will be more costly for the companies. The second reason: insurance companies are required to offer coverage for many possible illnesses and conditions that they could exclude before, and so they could sell cheap policies which were not real coverage. This oversight by the federal government will bring insurance costs onto a level playing field, with eventually a broad cross section of the populace covered. It will take some time to settle out, but the promise is there for fairness and inclusion in the pool of those left out. The insurance industry has lobbied hard to keep their industry regulation only at the state level until now. No more whack-a-mole practices by the industry, closing shop if one state won’t allow their practices, opening in another state, bribing local officials. For this one law, The Affordable Care Act, the insurance company must be regulated by the federal government if they want to participate in this enormous, comprehensive customer pool available. And they must provide coverage that is real. Having some part of the insurance industry, medical coverage, federally regulated is an important first step, one that I hope will lead to closer examination and regulation of all other types of insurance and the smoke-and-mirrors tactics which have confused and oppressed so many citizens for so long about what they are actually getting for their payments..