Looking for a place to draw a line in the sand with President Trump, Democrats cited cuts to Medicaid and subsidies to the Affordable Care Act as their reason for blocking a continuing resolution to fund the government for more than a month. Now that the stalemate has ended without a clear resolution for the ACA, Democratic leaders need to finally champion a national health insurance plan for everyone.

       Listen to the audio edition here:

Ever since Harry Truman’s national health insurance system bill died in Congress almost 80 years ago, thinking among Democratic leaders was that universal health insurance plans (e.g. single-payer or a public option) were political kryptonite. Government programs for special populations like the old (Medicare), or the poor (Medicaid) were okay, but something similar for everyone else? Electoral suicide.

Yet the landscape of private health insurance has changed and so have American attitudes. Now, more that 62 percent say it is the responsibility of the federal government to provide health insurance to all Americans. So, could Democrats really win elections promoting something as “radical” as a national health insurance plan? For several reasons I believe they could.

Let’s start with the fact that Americans have never been so unhappy with the state of their health coverage. Just 28 percent describe their coverage as excellent or good. And it’s no wonder. In a country that leads the world in medical innovation, accessing care through the private health insurance system is increasingly complex and inefficient. And having insurance no longer means an end to your financial worries. With rising deductibles, co-pays and caps on annual benefits, even “good insurance” doesn’t necessarily protect you from hardship should you get sick.

Nor does having insurance guarantee you will get the care you need when the preauthorization process is weaponized to protect profits by denying essential care. Even claims — no matter how inaccurate — that national health insurance schemes cause excess wait times for non-emergent care should hold less sway when wait times for doctor appointments in the US have increased 48 percent since 2004; the average wait time in Philadelphia for a new doctor’s appointment is now 36 days. By the way, the group of Americans consistently happy with their health coverage? People on public insurance like Medicare, where 92 percent of people over 65 rate their coverage good or excellent.

There is an old joke about a health care policy expert who dies and upon arriving in heaven asks God if the U.S. will ever have universal health insurance. “Yes,” God says, “it will,” only to add, “but not in my lifetime.”

Second, employer-based health insurance (EBHI) — the prevailing method by which Americans get coverage – not only endangers our health, but also our wallets. EBHI not only makes us feel economically insecure – worried about what we would do if we lost our job and got ill — it also depresses our wages. This is because the money employers pay to insure their employees is money that would otherwise go into salaries.

And the cost of the EBHI benefit is steadily rising – with the average employer now contributing $25,000 a year in pretax dollars to insure a worker’s family of four. Furthermore, the tax benefit on employee-sponsored health insurance goes disproportionately to upper-middle and high-income households. Meanwhile, in a national health insurance plan paid by payroll taxes (as Truman proposed in 1948) the costs would be scaled to income.

Lastly, championing a national health insurance plan could be the centerpiece of new and potent political message for Democrats. Antipathy towards the private health insurance industry has never been greater, and the industry is full of unsympathetic characters ripe for political takedown. From corporate middlemen — like pharmacy benefit managers and health insurance brokers — who extract wealth from our complicated system while adding little more than inefficiency and expense, to the almost comically villainous private equity firm, who, when not gutting hospitals for obscene windfalls, use sketchy business practices to increase their profits by increasing the cost of care for the rest of us. If communicated as a matter of economic freedom and a fight against the creeping corporatization of American life, a national health plan could form the cornerstone of a new economic populism from the left.

There is an old joke about a health care policy expert who dies and upon arriving in heaven asks God if the U.S. will ever have universal health insurance. “Yes,” God says, “it will,” only to add, “but not in my lifetime.” But if these turbulent times teach us anything, it’s that political dogmas can’t change, until they do. And for a party searching for a way to break out of their malaise and build something new, the political kryptonite of the past just might be the political gold of the future.

Dave Oxman is a physician, a medical school professor and a candidate for Congress in Pennsylvania’s Third Congressional District.

The Citizen welcomes guest commentary from community members who represent that it is their own work and their own opinion based on true facts that they know firsthand.

OUR COVERAGE OF THE SHUTDOWNC