With many others, I spent years as a professor and public servant considering some form of national health insurance for the U.S. I say "some form" because I believe there are variations on providing health care for all: witness Canada, England, France, and Germany.
I know most about Canada's form of single payer, and I also spent some weeks in Germany in the early 1990s studying their mixed system. I have had colleagues (and former student) like Tom Ricketts help me better understand France's system. And so on. And a lot of what I used to know has become part of my younger past.
I am closer to being truly old than I thought I would ever be (I am 80). Yikes! I am still fascinated by the failure of Democrats in some way to get behind some form of "single payer" for health care coverage for all Americans. Okay, I know Dems are tired of political accusations of 'socialism' but why not just fight back? The GOP has embraced market populism, the 'market as God', and all the rest. If 'the market as God' isn't blasphemy I don't know what is.
Surely some form of national health insurances should be on the Democrats Agenda for the future. FDR wanted it, and so did Harry Truman. Wilbur Mills, the late chairman of Ways and Means in the House offered a variation on national health insurance. Richard Nixon also wanted to work out some form of a national plan, perhaps working with Wilbur Mills, at least before Mills met that stripper from Baltimore.
In the early 1990s, I worked with the office of the late governor of New York, Mario Cuomo to devise something close to a single payer system, for New York. We used private insurance companies as "carriers" and proposed, creating a claims clearinghouse to transform the health insurance system, one where insurers must meet state standards on coverage, into something close to a claims clearinghouse. (Of course, Cuomo didn't run for President in 1992. Clinton did. Oh, well.)
In the 1990s I studied the mixed system of universal health care in Germany for three weeks courtesy of the World Health Organization.
I recently witnessed the GOP in the House and Senate attempt to kill Obamacare, and I am pleased that courageous Republicans have stopped them. As we live through the horror of the Trump presidency, circled by a staff of really crazy adviser and two sane generals trying to prevent chaos, others in the GOP want more of white nationalism to rule our lives.
Here are some of my thoughts on this hardy perennial of political reforms.
As a preliminary and guiding thought: national health insurance should be the centerpiece of social justice in the American democracy. Our failure to enact this foundational legislation constitutes the central weakness and divide of our political system: the fear of social justice, or changing society to advance equality of opportunity.
First, because of inaction, we are being victimized by the Pharmaceutical Manufacturers Association (PMA) that annually blocks any attempt by the U.S. or private health insurance, to buy pharmaceuticals invented in the U.S. to pay a fair price. Put another way, we citizens can buy American pharmaceuticals in Europe at relatively low prices. Those same drugs are prescribed and sold here in the U.S. with outrageous markups. The VA and the DOD are mercifully exempt from this price-fixing scheme, a flagrant violation of free market principles.
Second, our health care system itself is extraordinarily expensive because we don't have national health insurance.
Then why the title, "Medicare for All is Social Justice?" Because, as with the struggle for racial equality and gender equality, the battle to challenge our bloated, expensive, dangerous and unfair health care system demands societal change, or social justice in health provision as central to a more fair and equal future for all.
Medicare for All needs substantial working through, and Senator Sanders has done more than enough to make it politically possible. France, Germany, and other European nations have taken this path, each system a variation of the single idea: health care for all.
The vast public ignorance about societal reality is astonishing in the U.S. One of the saddest comments I recently read was from one citizen saying that they don't want universal healthcare because 'then I would be paying for other people's responsibilities.' But the very idea of insurance for health or any other social good is to pool resources along communal or societal lines, and when we do so we are always "paying" for other people's insurance so that we can afford health insurance for ourselves.