The US federal government shutdown has entered its 28th day, with Democrats demanding that Republicans agree to extend healthcare subsidies from the Affordable Care Act that are set to expire. If Congress does not act, health insurance premiums are expected to more than double for 20 million people. Dr. Steffie Woolhandler, a distinguished professor of public health at Hunter College-CUNY and co-founder of Physicians for a National Health Program, explains that the purpose of healthcare has become profit-making rather than a public service.
The enhanced subsidies, which were put in place during the pandemic, are a crucial lifeline for many Americans who rely on the Affordable Care Act for healthcare coverage. However, Republicans have refused to extend these subsidies, leading to a standoff with Democrats who are refusing to vote to end the shutdown until the subsidies are extended. Dr. Woolhandler notes that this is just one example of how the Trump administration and Congress are prioritizing the interests of private insurance companies over the needs of the American people.
The refusal to extend the subsidies will affect not just Medicaid recipients, but also small business owners, the self-employed, and middle-income individuals who rely on the Affordable Care Act for coverage. Additionally, the Trump administration’s cuts to Medicaid will have far-reaching consequences, affecting not just the poorest Americans but also community hospitals and rural healthcare providers.
Dr. Woolhandler also criticizes the Medicare Advantage program, which she says is a “giant waste of money” that has raised costs to taxpayers by $80 billion last year alone. She argues that the program is a mistake and that the US should be moving towards a single-payer Medicare for All system, similar to those found in other developed nations.
In a global context, the US stands out for its high healthcare costs and poor health outcomes. Dr. Woolhandler notes that every other developed nation has some form of national health insurance or national health service, and that these systems have been more effective at guaranteeing universal access, making healthcare affordable, and controlling costs. She argues that the US needs to move towards a single-payer system, and that this is the vision that Senator Sanders and others have put forward.
Overall, Dr. Woolhandler emphasizes the need for a fundamental transformation of the US healthcare system, one that prioritizes people’s health over profits. She argues that the current system is unsustainable and that the US needs to learn from the experiences of other countries and move towards a more equitable and effective healthcare system.