Occupy Health Care!

It’s stirring to see all the activity around the “Occupy Wall Street” movement around the country, from the New York City epicenter to California’s most high-profile site, #OccupyOakland, including yesterday’s bridge occupations from the Brooklyn Bridge to Los Angeles.

While protestors keep coming back, this raises the question of what’s next for the movement, and what the Occupy movement is about.

Among the many issues that Occupy addresses, health care does keep coming up.


If you browse through the “We Are the 99%” feed of people taking photos with their handwritten stories, many of them describe issues with the health care system–from the high cost of health care, to going without health care, to facing medical bills or bankruptcy. It’s moving to read these stories, and to see the faces of people describing a broken health system.

But health care isn’t just one many greivances of the Occupy movement, along with financial industry regulation, bank practices and tax fairness. Our broken health care system is major factor in the central issue of income inequality.

Clearly there’s a correlation between income and health coverage. Those with lower income are less likely to get coverage on the job, and are more likely to find buying coverage unaffordable (or unavailable, because of pre-existing conditions). In this way, health benefits are extremely regressive, exacerbating the differences in financial security.

The the causation also works the other way. Lack of comprehensive health coverage leads not just to less care and worse health care outcomes, but also places people one emergency away from financial ruin. As people face medical bills and bankruptcy, uninsurance helps drive poverty.

To fix these issues, we passed the Affordable Care Act: securing and expanding coverage, providing financial assistance to low- and moderate-income families to be able to afford coverage, and attempting to deal with the cost of care.

But given the nature of the broken health care system, the Affordable Care Act by default ends up going to the heart of the issues of the Occupy movement–perhaps more so than the Dodd-Frank financial regulation law.

On the day the bill was signed, March 23, 2010, David Leonardt of The New York Times wrote:

For all the political and economic uncertainties about health reform, at least one thing seems clear: The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.

It’s a big statement. The whole article is worth reading, but here’s just an excerpt (and to Leonardt’s credit, he was reporting on this well before the Occupy movement got more of the media interested):

Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor.

Nearly every major aspect of the health bill pushes in the other direction. This fact helps explain why Mr. Obama was willing to spend so much political capital on the issue, even though it did not appear to be his top priority as a presidential candidate. Beyond the health reform’s effect on the medical system, it is the centerpiece of his deliberate effort to end what historians have called the age of Reagan…

The bill is the most sweeping piece of federal legislation since Medicare was passed in 1965. It aims to smooth out one of the roughest edges in American society — the inability of many people to afford medical care after they lose a job or get sick. And it would do so in large measure by taxing the rich.

A big chunk of the money to pay for the bill comes from lifting payroll taxes on households making more than $250,000. On average, the annual tax bill for households making more than $1 million a year will rise by $46,000 in 2013, according to the Tax Policy Center, a Washington research group. Another major piece of financing would cut Medicare subsidies for private insurers, ultimately affecting their executives and shareholders.

The benefits, meanwhile, flow mostly to households making less than four times the poverty level — $88,200 for a family of four people. Those without insurance in this group will become eligible to receive subsidies or to join Medicaid. (Many of the poor are already covered by Medicaid.) Insurance costs are also likely to drop for higher-income workers at small companies.

Finally, the bill will also reduce a different kind of inequality. In the broadest sense, insurance is meant to spread the costs of an individual’s misfortune — illness, death, fire, flood — across society. Since the late 1970s, though, the share of Americans with health insurance has shrunk. As a result, the gap between the economic well-being of the sick and the healthy has been growing, at virtually every level of the income distribution.

The health reform bill will reverse that trend. By 2019, 95 percent of people are projected to be covered, up from 85 percent today (and about 90 percent in the late 1970s). Even affluent families ineligible for subsidies will benefit if they lose their insurance, by being able to buy a plan that can no longer charge more for pre-existing conditions.

The article goes on to talk about the last 30 years of rising economic inequality, abetted by the Reagan-era policies of “tax cuts, light regulation, a patchwork safety net.” In Washington, this debate continues, and the efforts to change direction, however ambitiously or modestly (health reform, financial regulation), are hotly contested, with all of the President’s challengers seeking to reverse them.

Among the many issues it raises, the Occupy movement should include defending recent progress, like the Affordable Care Act, in addition to the broader and necessary efforts for a fairer tax system, additional reforms in health, and more oversight in making banks, insurers, and other financial institutions accountable.

Health Access California promotes quality, affordable health care for all Californians.
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