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John Geyman explains the ‘new normal’ we urgently need in health care

August 10, 2020

Topics: Quote of the Day

Foundation of a ‘New Normal’ In U.S. Health Care

By John Geyman, M.D.

Note to the Reader: In his famous pamphlet, Common Sense, written for the people of the Thirteen Colonies in 1775-1776, Thomas Paine made a strong case – based on simple facts, plain arguments, and common sense – to gain independence from England.

In this pamphlet, I also offer simple facts, plain arguments, and common sense about today’s triple crises impacting U.S. health care – the coronavirus pandemic, the resultant economic downturn on the scale of the 1930s, and the uprising against systemic racism and police brutality that is sweeping across our country. Together, these crises have exposed the failure of our present health care system to meet the needs of ordinary Americans.

As the costs of health care in our corporatized, unaccountable non-system continue to spiral upward and become less affordable for much of our population, and as the rolls of the unemployed without health insurance grow unabated, much of the population can no longer gain access to our health care “system” based as it is on the ability to pay, not medical need. The stakes have been further raised by the risk of becoming exposed to the coronavirus while seeking care in ERs, hospitals and clinics. It has become the leading cause of death in the U.S. while patients are postponing or foregoing care for other major medical problems.

We have a long history in this country of failed incremental attempts to reform health care for the benefit of patients and their families. The Affordable Care Act of 2010 (ACA) made some progress, but is no solution to the tens of millions of Americans without health care. It did not contain health care costs, and has ended up as just one more failed incremental attempt. This was predictable, since armies of well-funded lobbyists succeeded in protecting the profits of stakeholders in the medical-industrial complex.

Health care is once again a leading issue in this turbulent election season. Three major reform alternatives are being debated: (1) building on the ACA; (2) one or another variant of a public option; and (3) single-payer Medicare for All.

This pamphlet is intended to inform the debate, drawing on traditional American values, and our experience over the years. It is targeted to legislators in Congress, opinion leaders, grassroots activists, and everyone seeking to better understand the issues.

This pamphlet has six parts:

I. How the ‘old normal’ of U.S. health care is breaking up

II. The inadequate response to the pandemic by the Trump administration

III. Why the ‘old normal’ should be replaced

IV. The case for and against three major reform alternatives

V. What the ‘new normal’ will look like after replacing our dysfunctional, largely private health insurance industry with a not-for-profit single-payer financing system with the mission to extend universal coverage for health care to our entire population

VI. Useful resources

Common Sense: Medicare For All

Foundation of a ‘New Normal’ In U.S. Health Care

Paperback: https://www.lulu.com…

Ebook: https://www.lulu.com…


By Don McCanne, M.D.

We are facing the worst health care crisis in a century. The impact is so severe that we are also facing the worst economic crisis in a century. John Geyman’s pamphlet could not be more timely.

We can do something about it. We have three choices to begin to immediately address this crisis – (1) building on the ACA; (2) one or another variant of a public option; and (3) single payer Medicare for All – and only one will work.

Our presidential election is right around the corner. One major party candidate has selected two of the approaches – build on ACA and add a public option – but rejects the one reform that will work – single payer Medicare for All. His choices only tweak our complex, expensive but grossly inadequate health care financing system that has left tens of millions exposed to financial hardship while failing to provide adequate access to the health care that they desperately need.

The other major party candidate is currently in office and has been bumbling around in a display of the greatest incompetence that this nation has ever seen in its leader. He has promised “phenomenal” health reform, though nearing the end of his current term in office, he has never revealed what that reform is, no doubt because he does not have an effective proposal. (Lest this comment be criticized for being political rather than being limited to a discussion of policy, it has to be acknowledged that the prevailing process has been so highly political that it has created almost impenetrable barriers to reform – barriers that we must overcome.)

We desperately need a major reset, and it is the third option that would establish policies that will effectively begin to address the combined health and economic crises that we face: the single payer model of Medicare for All. True, we will need to be doing much more, but we cannot begin until we have the health care financing infrastructure that will organize us and start to move us in the direction in which we need to be headed.

We need a movement of the people – a movement that will bring us a Congress that will do the right thing by, in turn, forcing the president who will be in office in 2021 to do the right thing for all of us. John Geyman’s latest in his series of Common Sense pamphlets can be very helpful as a valuable tool for sending us in the right direction. His common sense description of where we are, the three directions that we could take, and the one that will actually achieve success – single payer in all its simplicity – can be used as a basis for moving the process.

This edition of Common Sense has already been sent to every member of Congress. It is now the job for us, the people, to be sure that every member of Congress, along with their staff members, familiarize themselves with this straightforward action – single payer Medicare for All – and then enact it and require the president to implement it, even if a veto override is required.

Congress and the president aren’t fixing this thing now. We, the people, have to make them do it. To the streets!

And, yes, for the loudest voice of all, we need to make sure that everyone votes!

PNHP does not endorse any political candidates nor any political party, and any suggestion here otherwise represents the independent views of the author of the comment.

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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