WHAT'S STANDING IN THE WAY? 

 By Sonali Kolhatkar

It’s true that the number of uninsured Americans has dropped to an all-time low. But that fact obscures the failures of our patchwork, profit-driven health care system.

Here’s one of many indicators about how broken the United States health care system is: Guns seem to be easier and cheaper to access than treatment for the wounds they cause. A survivor of the recent mass shooting in Half Moon Bay, California, reportedly said to Gov. Gavin Newsom that he needed to keep his hospital stay as short as possible in order to avoid a massive medical bill. Meanwhile, the suspected perpetrator seemed to have had few obstacles in his quest to legally obtain a semi-automatic weapon to commit deadly violence.

Americans are at the whim of a bewildering patchwork of employer-based private insurance plans, individual health plans via a government-run online marketplace, or government-run health care (for those lucky enough to be eligible). The coverage and costs of plans vary dramatically so that even if one has health insurance there is rarely a guarantee that there will be no out-of-pocket costs associated with accessing care.

It’s hardly surprising then that the latest Gallup poll about health care affirms what earlier polls have said: that a majority of Americans want their government to ensure health coverage for all. In fact, nearly three-quarters of all Democrats want a government-run system.

Gallup also found that a record high number of people put off addressing health concerns because of the cost of care. Thirty-eight percent of Americans said they delayed getting treatment in 2022—that’s 12 percentage points higher than the year before. Unsurprisingly, lower-income Americans were disproportionately affected.

Women are especially impacted, with more women than men delaying treatment as per the same Gallup poll. The findings were consistent with results published by researchers at New York University’s School of Global Public Health—that women’s health care was increasingly unaffordable, compared to men’s—in a study that solely focused on people with employer-based health coverage. Imagine how out-of-reach health care is for uninsured women.

Added to that, Republican-led abortion bans have made it even harder for American women to obtain reproductive health care. On the 50th anniversary of the recently overturned Supreme Court decision Roe v. Wade, abortion providers in Massachusetts, for example, reported a steady stream of people driving to their state—one where abortion remains legal—to access care.

President Joe Biden and the Democratic Party appear to think that this grim status quo is perfectly acceptable. Democrats’ reliance on the Obama-era Affordable Care Act (ACA) as a bulwark against Republican opposition to any government intervention in health care seems to be resoundingly successful—on paper. In December 2022, Biden touted the fact that 11.5 million Americans, a record high number, had signed up for ACA plans during the last enrollment period. He said, “Gains like these helped us drive down the uninsured rate to eight percent earlier this year, its lowest level in history.”

His administration, rather than working to fulfill what a majority of his party’s constituents want—a government-run health care system—has continued instead to tweak the ACA by extending a period of discounted monthly premiums for private insurance plans. Such tweaks are not permanent. Neither are they a panacea for accessing adequate care. If anything, they are a façade protecting profit-based private insurance companies.

A survey by the Commonwealth Fund found that although the number of insured Americans is now at an all-time high, more than 40 percent of those who bought ACA plans and nearly 30 percent of those with employer-based plans were underinsured—that is, the plans were inadequate to cover their health care needs.

By focusing solely on the number of people who had health plans as a measure of success, the White House is participating in a great coverup of the ongoing American health care tragedy.

Meanwhile, just over the horizon from Biden’s celebration of record numbers of ACA signups is the fact that millions of people currently enrolled in the Medicaid government health plan could lose access because of the end of an emergency provision that allowed for “continuous enrollment.” That provision expires at the end of March 2023. If all Americans were automatically enrolled in government-provided health care regardless of eligibility, this would not be a concern.

Right-wing sources, so terrified that too many Americans want a government-run health system, are busy shaping public opinion against it. The Pacific Research Institute’s Sally Pipes published an op-ed about how Canada’s national health system was a good reason why the U.S. should not have a similar program. Using the deadly logic of a free marketeer, she wrote, “In Canada, health care is ‘free’ at the point of service. As a result, demand for care is sky-high.”

The implication is that charging people for service would reduce the demand, just as it would for, say, an electric vehicle. In Pipes’ world, people are accessing health care just for fun, and if they were charged money for it, their ailments might resolve themselves without treatment.

The Heritage Foundation also published an attack on Britain’s National Health Service (NHS), gleefully claiming that it is “cratering,” and warning that it is a lesson for American liberals who might support a similar “single-payer” system in the United States.

The Wall Street Journal’s editorial board published a similar warning, claiming that the NHS was “failing patients, with deadly consequences.”

It’s puzzling why the Pacific Research Institute, Heritage Foundation, and Wall Street Journal appear unconcerned about the 330,000 Americans who lost their lives during the COVID-19 pandemic simply because they don’t live in a nation with a universal health care program.

The U.S. spends nearly twice as much per capita on health care than other comparable high-income nations. According to Health Affairs, excessive administrative costs are the main reason for this discrepancy—these are nonmedical costs associated with delivering health care in a patchwork system of employer-based private health and publicly subsidized plans. In fact, “administrative spending accounts for 15–30 percent of health care spending.”

Again, right-wing media outlets and think tanks appear unconcerned by this disturbing fact. They only want to convince Americans that a government-run health plan is a bad idea. And, sadly, the Democratic Party leaders like Biden seem to agree implicitly.

The National Union of Healthcare Workers together with Healthy California Now created an online calculator for individuals to determine how much money they would save if the U.S. had a single-payer system.

I have an employer-based health care plan that is considered very good. Using the calculator, I determined that I would save more than $16,000 if California, the state where I live, had a single-payer system. That’s money I could be saving for my children’s higher education or for my retirement.

The victims of mass shootings, like the Half Moon Bay survivor, are saddled with high costs of care on top of the trauma of having been shot. Every year, there are more than 80,000 survivors of injuries from firearms in the United States. Having a single-payer health care system would not fix our epidemic of gun violence. But it would certainly make it easier to bear.

Canada and Britain’s state-run systems of health care may be imperfect, but they are a vast improvement on the survival-of-the-fittest approach that the U.S. takes.

This article was produced by Economy for All, a project of the Independent Media Institute.

Author Bio: Sonali Kolhatkar is an award-winning multimedia journalist. She is the founder, host, and executive producer of “Rising Up With Sonali,” a weekly television and radio show that airs on Free Speech TV and Pacifica stations. Her forthcoming book is Rising Up: The Power of Narrative in Pursuing Racial Justice (City Lights Books, 2023). She is a writing fellow for the Economy for All project at the Independent Media Institute and the racial justice and civil liberties editor at Yes! Magazine. She serves as the co-director of the nonprofit solidarity organization the Afghan Women’s Mission and is a co-author of Bleeding Afghanistan. She also sits on the board of directors of Justice Action Center, an immigrant rights organization.

ARE WE READY to SHRINK POLICE BUDGETS?

The year 2022 was the deadliest year on record in the United States for fatalities at the hands of law enforcement. According to the Washington Post’s police shootings database, law enforcement officers shot and killed 1,096 people last year. In comparison, there were 1,048 shooting fatalities at the hands of police the year before, 1,019 the year before that, 997 the year before that, and so on.

These numbers are most likely underestimated. According to Abdul Nasser Rad, managing director of research and data at Campaign Zero, which runs Mapping Police Violence, the Post “only captures incidents where a police officer discharges their firearm and the victim is killed.” This means that it doesn’t count events like the 2014 killing of Eric Garner in New York and the 2020 killing of George Floyd in Minnesota, as both deaths resulted from asphyxiation.

In contrast, Mapping Police Violence includes any action that a law enforcement officer takes that results inpolice killed 1,158 people in 2021 compared to the Post’s figure of 1,048 (final results for 2022 are not yet available). a fatal encounter. For example, Rad’s project concluded that 

There are other databases of police violence like Fatal Encounters, run by the University of Southern California, that have their own criteria for counting police-related killings. Such projects track police violence because the federal government refuses to, in spite of a 1994 law requiring the Justice Department to keep records. Moreover, there is evidence that biased reporting by medical examiners and coroners in individual cases is helping significantly to cover up the extent of police violence.

The upshot is that in spite of the huge public attention on police violence since 2020, every year cops kill more and more people. We can expect 2023 to be even deadlier if the years-long trend continues.

Another clear conclusion is that police violence is dramatically focused on communities of color. According to the Washington Post, Black Americans “are killed by police at more than twice the rate of White Americans,” while Mapping Police Violence finds that “Black people are 2.9x more likely to be killed by police than white people in the U.S.” Police killings of Latinos and Indigenous people are similarly disproportionate.

Recall that in the aftermath of Floyd’s murder in 2020 at the hands of officer Derek Chauvin, activists demanded a defunding of the police. The well-documented assumption underlying that demand was that generously funded police departments were using their resources to kill people, especially poor people of color whose needs in turn were not being funded.

Rad explains that the disproportionate police killings of people of color are “due to historical disinvestment and how the U.S. state has used punitive and carceral responses to social problems, specifically to Black and Brown communities.” Therefore, the only just conclusion is to divert tax revenues from fueling death to fueling life.

Instead of city governments embracing the life-affirming idea of diverting money away from murderous police, media pundits and politicians led a reactionary backlash. President Joe Biden, in a clear clapback at the defund movement, promised to fund the police, and even begged local governments to use federal stimulus funds to bolster their police departments in 2022.

In Minneapolis, which became the focus of international attention in the wake of Floyd’s murder, lawyers Doug Seaton and James Dickey opined in a piece titled “Minneapolis Needs a Fully-Funded Police Department,” that “the city’s most vulnerable… have suffered from” the demand to defund police. One might conclude that Minneapolis’ police are struggling for funding, but in fact more than a third of the city’s entire general fund is poured into police coffers. Mother Jones’ Eamon Whalen rightly concluded that “The Police Are Defunding Minneapolis.”

According to Rad, “In 2022, funding actually continued to increase across U.S. cities into law enforcement agencies.” He adds, “what might be the media narrative actually doesn’t match up to what is actually going on.”

Does giving police more money result in greater public safety, as Seaton and Dickey claim, and as Biden assumes? One recent study analyzing funding of hundreds of police departments over nearly three decades concluded that “new police budget growth is likely to do one thing: increase misdemeanor arrests.”

One of the study’s authors, Brenden Beck, a sociology professor at the University of Colorado Denver, writing in Slate about his team’s results, said, “The trend was clear: When cities decreased the size of their police departments, they saw fewer misdemeanor arrests and when they increased them, they saw more.”

According to Beck, “misdemeanor enforcement is concentrated in poor neighborhoods and in communities of color.” He is confident that, “One thing… [increased police funding] is likely to do, even if paired with community policing, is generate more misdemeanor arrests. Arrests that will disproportionately hurt poor and Black people.”

It is during such arrests that police tend to kill Black and Brown people. Those cities that specifically took steps to reduce arrests for petty crimes saw a decrease in police killings, according to data scientist and cofounder of Campaign Zero Samuel Sinyangwe. He also concluded that crime rates in those cities did not increase.

There is so much data bolstering the fact that more police funding means more violence and death at the hands of police. And yet, police departments remain flush with cash.

How can we simply accept that police will continue to kill more and more people each year?

Not everyone accepts this deadly status quo. In spite of the backlash, police abolitionists are continuing to organize. They have created a powerful internet tool, DefundPolice.org, to help communities put police spending into perspective and reimagine their city budgets. The site includes a detailed video tutorial on how to use tools like a “people’s budget calculator.”

In Los Angeles, whose police budget receives massive infusions of private foundation cash on top of generous public funding, activists have been using the idea of a “people’s budget” to “reimagine public safety.” Vocal critics of police funding like Eunisses Hernandez and Kenneth Mejia have won elections to powerful local offices.

It’s not enough to call out police when they kill people. It’s not enough to march in the streets or write op-eds. Police will continue to murder more people every year with impunity, their violence nurtured by powerful allies. If we want to see a significant reversal to the ruthless march of police savagery, we’re going to need to put our money where our mouths are: toward people’s needs, not police’s deadly deeds.