Tag Archives: Affordable Care Act

Why America’s health care is so bad

Images Money, Creative Commons

May 5, 2017

First, a personal observation. I lived under the Canadian healthcare system for my first 38 years, and in the American healthcare system for the past 22. Based on extensive experience in both, I say that, hands down, Canada’s system provides care every bit as good as in America, has far fewer hassles, and just plain works better.

Oh, I know, I remember the complaints I used to make when I lived in Canada. Sometimes you had to wait longer than you wanted for an appointment. Elective surgery might take a few months to get. In my experience, a lot of that depended upon where you lived. When I lived in rural Nova Scotia, near a hospital, I never had any waiting time. When I lived in the Halifax and Dartmouth urban area, there were occasional delays, but never anything outrageous. My mother said once, when I asked if she minded waiting two months for a procedure she needed, “Having to wait a while is better than not having it at all.”

Under the health care bill passed this week by the Republican Party in the House of Representatives – a bill which they did not read, did not have the Congressional Budget Office score, and obviously did not consider in light of the future consequences for their own political careers –  many people will “not have it at all.”

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But rather than go through this piece of legislation, that is a dead letter already, I want to talk about why the American system is so bad.

America is the only advanced nation in the world without a universal healthcare system. There are two reasons for this: 1) the companies that provide healthcare, and make billions and billions doing so, spend lots of money every year making sure politicians don’t mess with their golden goose; 2) the American notion of individuality.

Many Americans would tell you they see no reason why they should be responsible for the care of anybody else but themselves and their own families. They say they’d rather have the freedom to die than to have the government provide them with healthcare and live longer.

This is no joke. Conservative and far-right Americans have somehow convinced themselves that a single-payer system is “evil.” And the politicians who rake in the money from the healthcare companies that want to maintain this myth are more than happy to paint universal healthcare as a boogie man.

A variation on this attitude was illustrated this week by Republican Representative Mo Brooks, who told CNN’s Jake Tapper in an interview that “people who live good lives” don’t have pre-existing conditions.

Aside from the hint of religious bigotry implied in his comment (God-fearing folks don’t have to worry about getting sick), Brooks’ comments leave little doubt that far-right Republicans like him see no reason why they should help other sick people.

His comment made me think of a Canadian friend with a defective kidney. A single mother, she was able to get a kidney transplant without being shamed by people like representative Brooks for apparently not “living a good life.” She probably would not be able be able to afford such an operation in the United States in the first place.

There are other factors. The American system is clunky, riddled with inconsistencies, overwhelmed with paperwork, anti- rather than pro-healthcare, and so bad for business that it amazes me that American entrepreneurs and business people aren’t marching in the streets of Washington for a single-payer system.

Businesses in the United States, both large and small, are often forced to lay off much-needed employees so they can offer healthcare to remaining employees. (I know of cases where people have been laid off because the company considered them a financial burden because their healthcare costs were so high.) In other cases, they will charge employees outrageous amounts in order to purchase employer subsidized healthcare.

In Canada, Australia, England, France —  or just about any other first-world and many others as well,  businesses do not need to worry about healthcare, because it is provided by a single-payer system. In some cases, but not all, taxes can be higher to provide this benefit.

One would think that for the reduced paperwork, lower costs, and ability to help retain good people, more American businesses would be 100% behind the idea of universal healthcare.

Even Donald Trump spoke favorably about universal healthcare before he decided he would lie his way to the Republican nomination and later to the presidency. This week he also praised the Australian healthcare system as better than America’s. Australia has a two-tiered system that provides basic universal healthcare to all Australians, but they must purchase private insurance for some specialty medical services.

The flaws all come down to the never-ending American desire for profit: there is just too much money to be made providing Americans with an inferior healthcare system.

It’s the same reason why some argue for a different kind of system in Canada. There’s money to be made, and they have dollar signs in their eyes. All the other reasons they give you are just so much malarkey.

It’s hard to say where this healthcare fight in Congress will lead. It’s obvious that Americans are waking up to the reality that the Affordable Care Act, also known as Obamacare, is a pretty damn good thing. Republican representatives, especially from moderate or more liberal districts, who vote to replace it are putting their political futures on the line.

We can only hope that the Senate produces a better, fairer bill until the day comes when Americans wake up to the reality that what they need is a universal healthcare system and nothing else will do.

Copyright Tom Regan 2017

Contact Tom Regan:  motnager@gmail.com



Tom Regan Tom Regan is a journalist in the Washington, D.C., area. He worked for the Canadian Broadcasting Corporation and with the National Film Board in Canada, and in the United States for the Christian Science Monitor, Boston Globe, and National Public Radio. A former executive director of the Online News Association in the U.S., he was a Nieman fellow at Harvard in 1991-92, and is a member of the advisory board of the Nieman Foundation for journalism at Harvard.

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Americans turn Canadian about health care

After six years with Obamacare, public opinion forces Republicans to think “expansion,” not “repeal.” 

April, 2017

American attitudes towards universal healthcare insurance have long baffled the rest of the world. Only in the US is serious illness a ticket to bankruptcy and the food bank.  How is this conducive to healing?

The Republican party has always insisted that Americans would rather die free than depend on socialist medical care. One result is that the American infant mortality rate is a “national disgrace,” according to the Washington Post. And Americans seemed okay with that – until lately (1).

Many presidents have attempted to introduce a universal state-run healthcare system similar to Canada’s or Europe’s.  Bill Clinton won the 1992 election after campaigning heavily on health care, HRC, Hillary Rodham Clinton, introduced a national health care plan in 1993, when she was very popular First Lady. Her policy ran into trouble immediately.


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US conservatives, libertarians, health insurance and pharmaceutical industries furiously rejected anything that smacked of universal health care, saying patients would be stigmatized by having public rather than private insurance. They also launched vicious personal attacks on HRC that destroyed the proposal and permanently damaged her reputation.(2)

President Barack Obama campaigned on health care reform in the 2008 campaign and managed to pass the Affordable Care Act (ACA) during the two-year window (2008-2010) when the Democrats held the White House, a majority in the House of Representatives, and a Supermajority in the Senate. The ACA expanded Medicare and expecially Medicaid, the existing public health insurance programs. (3.)

Since the president signed the ACA into law in August 2010, House Republicans have voted more than 60 times to repeal it, knowing the president would veto the Bill, even if the Senate passed it.  (4.)

Part of President #45’s 2016 election triumph was the GOP’s opportunity to introduce yet another Bill to repeal the ACA (“Obamacare”), in full expectation that the majority Republican Congress would whisk the Bill through promptly.  Wrong! How mortified they must feel that the Speaker of the House had to withdraw the (empty) repeal-and-replace motion for lack of supporting votes!

Remember the old bumper sticker, “My karma ran over my dogma”? Between 2010 and 2016, US public opinion on healthcare changed dramatically. As with affirmative action programs, once people actually had to live and work with an “other,” they found the situation more congenial and less threatening than they ever expected.

While the greatly expanded Medicaid included 20 million more people, the catch is that each state has to sign on to the program and design its own system. Thirty-two states joined Medicaid, each with its own version and requirements.

As the New York Times editorialized, “….Medicaid now provides medical care to four out of 10 American children. It covers the costs of nearly half of all births in the United States. It pays for the care for two-thirds of people in nursing homes. And it provides for 10 million children and adults with physical or mental disabilities…

“The program is so woven into the nation’s fabric that in 2015, almost two thirds of Americans in a poll by the Kaiser Family Foundation said they were either covered by Medicaid or had a family member or friend who was….” (5)

Those people, and their loved ones, resisted the Bill. They contacted their Republican Congressional reps to protest this was not why they voted them in. Their vocal opposition forced their  representatives to back away from #45’s ill-conceived plan.

More than resistance, what the Republicans encountered is a parade marching in the other direction. Pew Research found that by February 2017, a majority of Americans (54%) supported Obamacare. In 2010, only 40% approved of the Act, and 44% disapproved of it. Ten percentage points is a lot of growth in seven years. (6.)

Medicaid has won over participating state governments, several of which moved quickly to expand their Medicaid programs just as soon as it was clear Trumpcare had failed.  Kansas and Missouri moved to expand; recalcitrant Governors in Virginia, North Carolina, and Georgia have indicated interest in joining Medicaid to get health coverage for their poor people.

The NYT notes that, “The A.C.A. offered a tempting deal to states that agreed to expand Medicaid eligibility to everyone with incomes up to 138 percent of the poverty level — $16,400 for a single person — mostly low-wage workers like cooks, hairdressers and cashiers.

“The federal government would initially pay 100 percent of the costs of covering their medical care, and never less than 90 percent under the terms of the law. Over the past three years, 31 states and the District of Columbia took the deal….”

Remember, many states are facing the twin opioid and suicide epidemics now wracking the US. Disability rates are at an all-time high, although people may turn to disability when faced with lifetime limits on welfare eligibility.  There’s evidence that cash-short state governments are encouraging welfare recipients to apply for federal disability funds instead.

States that sign Medicaid agreements for convenience or out of desperation, soon find they are saving money and producing goodwill among voters.  Patients bring home healthy babies; they take their children to the doctor. They visit family members in long-term care.  People with disabilities rely on Medicaid for adaptive equipment and physiotherapy. And oddly enough, they don’t seem to worry about any social stigma at all.

In short, just as Canadians have come to love our Charter of Rights as much as Americans love their Bill of Rights, now it seems that Americans have come to embrace health care for all the way that Canadians do (and most of the rest of the world.) As Joni Mitchell sang, “You don’t know what you’ve got” until somebody tries to take it away.

Copyright Penney Kome 2017

Contact:  komeca AT yahoo.com


  1. https://www.washingtonpost.com/news/wonk/wp/2014/09/29/our-infant-mortality-rate-is-a-national-embarrassment/
  2. https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993
  3. https://www.reference.com/history/did-obamacare-pass-congress-8fb44b73f7bcdcb6
  4. http://www.reuters.com/article/us-usa-obamacare-idUSKBN14X1SK
  5. https://www.nytimes.com/2017/03/27/health/medicaid-obamacare.html
  6. http://www.pewresearch.org/fact-tank/2017/02/23/support-for-2010-health-care-law-reaches-new-high/

Read more F&O columns by Penney Kome here

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Penney KomePenney Kome is co-editor of Peace: A Dream Unfolding (Sierra Club Books 1986), with a foreward by the Nobel-winning presidents of International Physicians for Prevention of Nuclear War.

Read her bio on Facts and Opinions.

Contact:  komeca AT yahoo.com




Facts and Opinions is a boutique journal, of reporting and analysis in words and images, without borders. Independent, non-partisan and employee-owned, F&O is funded by you, our readers. We are ad-free and spam-free, and we do not solicit donations from partisan organizations. Please visit our Subscribe page or use the PayPal button below to chip in at least .27 for one story or $1 for a day site pass. Tell others about us, and follow us on Facebook and Twitter.


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