We still need ACA 2.0: “Medicare for All”


by Sylvia Moore

At the March 11 General Meeting, the Culver City Democratic Club voted in favor of joining the AllCare Alliance movement for universal health care. I’m very happy that the membership decided to join this important coalition of community and progressive organizations. The Alliance’s goal is to get a publicly-financed healthcare program established in California based on “Medicare for All.” There was no time to share my personal story with the membership at the meeting, so I share it here now. Last year, I injured my hand in a car accident. I briefly had employment for a few months, and got a silver health plan, thanks to the Affordable Care Act (aka “Obamacare”). I was eventually able to get surgery for my hand. But, the ACA just isn’t good enough. It was a first step, and only a step. The accident was in February 2014, and because of CoveredCA website hiccups, I didn’t get my coverage until May 2014 (I started the application process in December 2013, and restarted it in March 2014 because of the new job).

It was not easy for me to find a surgeon because of the limited networks of ACA/Covered California plans. Even with my silver plan, I still had to pay high out of pocket costs for an MRI ($400), and co-pays for my primary care doctor ($55 a visit), and specialist visits ($65 a visit). At the time, my job didn’t pay a whole lot. When that job ended, I paid premiums and costs out of savings I accumulated. I did, however, get some of these medical costs reimbursed from my auto insurer. I’m unemployed again and was eventually forced out of my silver plan, and put into the MediCal application process. Unfortunately, I could not locate a physical therapist who would take MediCal. I delayed possibly effective treatment trying to locate a PT who would take MediCal. For the PT I chose, my mother (who’s helping me out) ended up paying $75 out of pocket (this was a discount!) for each visit.

My thumb has improved, but not enough where I have restored range of motion. I am going back to the surgeon, this time, uninsured. He does not take MediCal. The visit will cost $250. I may need more surgery, and if I don’t get employment with health benefits soon, I shudder to think how much more surgery will cost. I will have to try to get all of these costs reimbursed by the other driver’s insurer (I was not at fault). My auto insurer will not pay out for most of the out of pocket costs. Granted, this is not a life or death situation, but since I am a writer, having a bum hand is potentially career-affecting.

For some Californians on MediCal, they still have problems finding a doctor because of low-reimbursement rates. We have a two-tier health system in this country: a pretty good one for the affluent, employed and middle class, and a lesser quality one with harder or no access for the unemployed and low income. To me, that is unfair. When so many of us are still struggling to land jobs in a difficult economy, especially jobs with good health coverage, when wages are stagnant for many, having employment and/or access to a good income stream shouldn’t determine the kind of coverage you get or whether you get coverage at all. That is unfair. In my opinion, health coverage must be decoupled from employment/income level. Health care is a right and should be paid for through taxation. Everyone accepts that public schools, police and fire are paid through taxation – why not health care?

If we had a universal system like Canada, Japan or Europe, I would have been able to seek treatment immediately or fairly soon after my accident at little to no cost. I would have been able to see any specialist no matter my employment/income situation. I wouldn’t be “churning” in and out of MediCal/the private system and have my care interrupted because of bouts of unemployment. So, for those who have been lucky enough to have had continuous employment and generous health benefits most of your life, and consider the ACA to be the best we can do, please consider my experience and that of other people – particularly freelancers – who routinely experience bouts of unemployment. I have a good friend who is a freelance artist who is also experiencing coverage affordability issues despite the ACA.

I know President Obama and Congressional Democrats did as much as they could in getting some sort of improvement to our healthcare system passed. The ACA was what we got under the difficult circumstances at the time. But, we STILL need a publicly financed health system that covers everyone. Four million Californians will remain uninsured even when the ACA is fully implemented. What about them? This is where the states and the AllCare Alliance come in. California can lead the way to passing a truly universal healthcare system based on the ones in Canada, Japan, Europe, based on Medicare for All. California can be a model for the rest of the country. I’m imploring our state Democratic legislators, and Gov. Brown to support this effort. www.allcarealliance.org