At the Healthcare for All, Y’All event Sunday at Blue Ridge Community College in Flat Rock, Joel R. Segal, who as a legislative aide to U.S. Rep. John Conyers of Michigan worked to help pass the Affordable Care Act, offered a surprising take on it: “None of us wanted that bill. The basic idea was — let’s get this, then proceed to move toward single payer.”
Gruffly charming in the manner of Joe Biden, Segal outlined the contours of a more radical plan he helped Conyers author in 2003: House Resolution 676, or the Expanded and Improved Medicare for All Act. Conyers has proposed the bill in every Congress since then. If adopted, it would transition the entire American health care system to one in which private providers are reimbursed by public dollars, as with Medicare.
Segal was invited to headline the event by Kyra Moore, who organizes Henderson County’s chapter of Our Revolution, the progressive political group spun out of U.S. Sen. Bernie Sanders’s 2016 presidential campaign. After seeing Segal speak in November, Moore asked him to come to Henderson County and reprise his talk. Afflicted with bipolar disorder, a condition that prevented her from getting health insurance through the years, Moore told Xpress a list of horror stories. Once, she stopped treatment to disprove her pre-existing condition and ended up in a psychiatric institution; another time, she was dropped from her employer-provided insurance during a stay in an institution and left with tens of thousands of dollars of debt.
Thanks to her experience, she emphasizes the potential social impact of the transition to universal health care. “Really, it’s better not to look at this as a political issue,” she said. “Look at it as a social issue, an economic issue, a health issue and an ethics issue.”
Local organizations of various stripes helped to sponsor the event and set up booths outside to schmooze before the talk began. Scott Donaldson, a Democrat and doctor hoping to challenge Mark Meadows for his congressional seat, was in attendance, as was the team of Philip Price, Donaldson’s primary opponent and himself a supporter of universal health care. The county NAACP, Asheville’s Democratic Socialists of America, and the Namaste Center of Flat Rock also sponsored and brought booths.
Marsha Fretwell, an introductory speaker from Healthcare for All WNC, recalled that in her work as a doctor in a federally qualified health center, the absence of sufficient funding meant that “we had to knit things together.”
People cannot wait to get to 65, Fretwell said, and get Medicare. “It’s like the golden ticket.”
Segal detailed the many benefits that expanding Medicare could have. After an initial transitional cost to establish the new system, a universal Medicare-style program would save money, he explained, by emphasizing preventive care and by keeping the cost of prescription drugs down — the government would have more negotiating power, after all, than do private insurers.
Segal did not spare many kind words for those private insurers, who he sees as sweeping up dollars that could otherwise be spent on care. Blaming administrative bloat and inflated drug costs, Segal presented data that indicated the U.S. spends more than twice what other industrialized countries spend per capita on health care and has worse health outcomes than countries using public models.
Changing the model to single payer will require political pressure not only “in the streets, but in the suites,” Segal said. Success will involve both “relentless organizing” and a “good lobby” to reach those on Capitol Hill. But everyone in attendance could start, Segal suggested, by pressuring Hendersonville’s City Council to pass a resolution in favor of HR676.
Given the high cost and poor performance of American health care, why has single payer not been more popular before now? “The insurance industry stokes fear into the hearts of Americans,” Segal said. “Because they know that single payer works.”