The Unspoken Question



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In the game of Jeopardy it’s not the answer that’s called for–it’s the question.

We’ve been bombarded with a lot of “answers” recently, but somewhere in the barrage of outrage, a basic question exists that hasn’t been spoken. When the Congressional Budget Office (“CBO”) announced their estimates of Americans who’d lose their health care if the Republican plan took effect, eyes popped and jaws dropped at the staggering statistics. Even self-professed conservatives admitted to feeling a bit uneasy about the proposed plan and some have distanced themselves from it.

Why all the uproar? The CBO predicts that, by 2020, 21 million Americans will be without any health insurance coverage whatsoever. By 2026, the number soars to 52 million Americans as the Republican health plan takes effect. In contrast, if the Affordable Care Act (“ACA”) remains in effect, there would be only 28 million without health coverage by 2026. The biggest surprise seems to be how popular and well-utilized the Medicaid extension program of the ACA. has become. Of course, several Southern states flat-out refused to enter into the program, which explains the 21 million currently uninsured. Even more Americans would have coverage today if all qualified in the opted-out Southern states were allowed to receive health care through the Medicaid extension program, as well.

With a growing number of Americans unable to obtain private health insurance due to pre-existing conditions, unemployment, under-employment and outright loophole finagling by employers to avoid insuring any employee, the time for a single-payer or “Medicare for all” plan seems at hand. Study after study has shown that it is the most efficient health delivery model in the U.S. In fact, in 1995, the Tawainese government modeled their national health care delivery program after U.S. Medicare because of its cost efficiency. If our bloated defense budget can be expanded another $52.3 billion, surely a program which pays for itself through payroll taxes can justify its cost effectiveness. To any rational mind, it seems the answer to the question, “How best do we provide health care to all Americans?” is “By implementing Medicare for all.”

But why are Republicans and many corporate Democrats avoiding the most rational answer to this question? There doesn’t seem to be any one answer, but one reason could be that they’re being paid good money not to recommend Medicare for all. According to Term Limits for U.S. Congress, from 1998 – 2015 the following amounts of lobbying money were spent in Congress by the health care industries:

Pharmaceutical/Health Care Products: $3,146,090, 212 (Yes, that’s trillions of dollars.)

Insurance Industry: $2,190,651,832

Hospitals/Nursing Homes: $1,310,021,801

Health Professionals: $1,189,983,794

HMOs: 863,410,051

Even more telling, according to, from 2005 – 2016, Senate Majority Leader Mitch McConnell accepted $5.9 million dollars from the health care industry lobbyists, while House Speaker Paul Ryan accepted over $3.5 million dollars from lobbyists. When those in congressional leadership positions are paid so well by the private health care industry to keep things the way they are (or make it even better for private industry), can anyone really expect they’d promote the more efficient and egalitarian Medicare for all program?

Possibly the cruelest cut of all is the fact that the Republican plan allows private health insurers to write off as a business expense the entire amount of their executives’ salaries on their taxes and not just the first $500,000, as is the case presently under the ACA. The rich get yet another big tax break at working class Americans’ expense.

According to Harvard Medical School researchers, an estimated 45,000 Americans die each year simply because they lack insurance and cannot receive a decent standard of health care. These preventable deaths outnumber yearly drunk driving deaths and homicides combined.  It has been noted that over 60% of all bankruptcies filed in the U.S. involve medical bills–the leading cause of all filings, far outpacing credit card debt. (That’s 643,000 Americans per year in bankruptcy court according to Nerd Wallet Health Analysis.) Someone is making a lot of money off of these individuals and families going bankrupt and losing their homes, cars, and property. Some group is directly benefiting from so many Americans’ premature deaths.

There’s something deeper, more profound going on here than simple greed. There is a desire to exert the power of life and death over others less fortunate. There is a desire to take money and property away from those who have little and redistribute it upward to the richest echelons of society. There is a desire to put those of a different class, ethnicity, race, religion, gender, age, sexual orientation–or any of a number of protected statuses (at least, currently)–in their place. There is a desire to discriminate in one group’s favor. More than likely, it’s not a group whose members would allow ordinary working class Americans to join them.

The basic question remains unspoken.  Why do we allow so many of our fellow Americans to suffer and die needlessly without guaranteed access to adequate health care?  Face it, we know the answer. So, the essential question for ordinary Americans becomes: what are we willing to do to make a lasting change in our health care delivery system for the betterment of all Americans?


Bio: Cindy A. Matthews is a freelance writer, novelist and editor of Our Revolution Continues blog: