Supporters of the Affordable Healthcare Act celebrate in front of the Supreme Court after the court upheld the legality of the law in Washington June 28, 2012. Reuters/Joshua Roberts
There have been few steadier Congressional hands throughout he debate over health-care reform than that of Vermont Senator Bernie Sanders. Principled in his support for the real reform of "Medicare for All," yet pragmatic in his advocacy for Affordable Care Act provisions that expand public health programs and allow states to experiment with single-payer options, Sanders has been in the thick of every fight over President Obama's signature reform. And the ensuing legislative and legal battles over its implementation.
What Sanders says about Thursday's Supreme Court decision upholding the ACA provides important insights for progressives as they respond to a complex decision that, in the words of the National Nurses United union, "should not be seen as the end of the efforts by health care activists for a permanent fix of our broken health-care system."
So what does Sanders say?
On the ruling, his line is upbeat:
"Today is a good day for millions of Americans who have pre-existing conditions who can no longer be rejected by insurance companies. It is a good day for families with children under 26 who can keep their children on their health insurance policies. It is a good day for women who can no longer be charged far higher premiums than men.
"It is a good day for 30 million uninsured Americans who will have access to healthcare. It is a good day for seniors who will continue to see their prescription drug costs go down as the so-called doughnut hole goes away. It is a good day for small businesses who simply cannot continue to afford the escalating costs of providing insurance for their employees. It is a good day for 20 million Americans who will soon be able to find access to community health centers."
But that does not mean that Sanders is satisfied.
"In my view, while the Affordable Care Act is an important step in the right direction and I am glad that the Supreme Court upheld it, we ultimately need to do better," the independent senator says...
"If we are serious about providing high-quality, affordable healthcare as a right, not a privilege, the real solution to America's health-care crisis is a Medicare-for-all, single-payer system. Until then, we will remain the only major nation that does not provide health care for every man, woman and child as a right of citizenship."
Sanders's Vermont is taking the lead in seeking to implement a state-level single-payer system -- much as Canadian provinces took the lead in the 1940s and 1950s in developing who would eventually be that country's national health-care system. The court's ruling won't slow that push down, and it could actually speed it up, as attention focuses on fights over state-run Medicaid programs. Sanders says, "I hope our state will be a model to show the rest of the nation how to provide better care at less cost to more people."
Agreed. Amid the celebration of the Supreme Court ruling by those who did not want to go backward, there is a need for a firm focus on going forward. "Stepping up the fight for Medicare for All is even more critical in the midst of the still persistent economic crisis," notes National Nurses United co-president Deborah Burger, RN, who noted that nurses have seen deep declines in health status among patients who have suffered the loss of jobs, homes and insurance coverage.
NNU notes that "the Affordable Care Act still leaves some 27 million people without health coverage, does little to constrain rising out of pocket health care costs, or to stop the all too routine denials of needed medical care by insurance companies because they don't want to pay for it."
It is for that reason that NNU co-president Jean Ross, RN, echoes Sanders:
"The continuing fiscal crisis at all levels of government and the anemic economic recovery remind us that rising healthcare costs and shifting costs to workers burden our society, cause much of these fiscal problems, and limit the opportunities for working people. Only real cost control through a national health program can solve this crisis. Improved Medicare meets that challenge."
"Medicare is far more effective than the broken private system in controlling costs and the waste that goes to insurance paperwork and profits, and it is universally popular, even among those who bitterly opposed the Obama law," adds NNU co-president Karen Higgins, RN. "Let's open it up to everyone, no one should have to wait to be 65 to be guaranteed healthcare."
The Supreme Court's ruling can be celebrated on some levels, as Sanders well notes.
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