GOP's Failure to Replace Obamacare Opens Space to Debate Medicare-For-All System

Posted March 29, 2017

MP3 Interview with Carol Paris, president of Physicians for a National Health Program, conducted by Scott Harris


Despite having a strong majority in the U.S. House of Representatives, President Donald Trump and the Republican Party failed in their effort to pass the American Health Care Act, their proposed replacement for Obamacare. After so many years of overblown rhetoric condemning President Obama’s signature health care achievement, and passing more than 60 bills to repeal the Affordable Health Care Act, it was stunning to see the GOP utterly fail in their effort.

The healthcare legislation offered by the Republicans was rejected by an overwhelming majority on all sides of the political spectrum. Across the country, working families flocked to town hall meetings with their federal legislators to denounce the GOP plan that would have thrown 24 million people off their current health insurance policies. From the right, members of the so-called Freedom Caucus took a hardline position that the government should have little or no role at all in the nation’s healthcare system.

After his first major legislative defeat, Trump blamed the Democrats and warned that Obamacare would soon implode, bringing all sides back to the negotiating table to hammer out a new healthcare measure. The real estate billionaire, who complained that no one knew healthcare was so complicated, hinted that his administration could sabotage Obamacare by non-enforcement of existing tax penalties and/or withholding subsidies. Between the Lines' Scott Harris spoke with Dr. Carol Paris, president of Physicians for a National Health Program, who assesses the failure of the Trump/GOP healthcare bill, and talks about her group's long-term campaign to establish a universal, single-payer healthcare system in the U.S., such as the proposed Medicare for All. [Rush transcript]

DR. CAROL PARIS: Neither party is championing a piece of legislation that actually is going to solve the problem. And what I'm seeing is that the groundswell of energy by people – just everyday working-class people – since the election of Donald Trump has really galvanized an interest in what's going on in our country. And one of the major areas people focused on was health care. So, while many people were attending town halls to voice their defense of the Affordable Care Act, what we saw over and over at these town halls is that as soon as someone stood up and said, "What I'd really like is a national Medicare For All", the whole place would begin to cheer and clap. So, there really is a growing movement and interest in moving beyond the Affordable Care Act, of which we at least now can do because we don't have to deal with – hopefully – we will not be, in the future, be dealing with the American Health Care Act. But it's time to move on. The time is now to get on with doing what we should have done in 2009.

BETWEEN THE LINES: Dr. Paris, say a word, if you would, about the condition of the Affordable Care Act, Obamacare. Donald Trump and many Republicans are saying, Obamacare is in a death spiral, that it's ready to implode. Trump even said, after the failure of the Republican replacement plan, that politically it'll be very good for Republicans if he just stands aside and lets Obamacare collapse. It'll hurt the Democrats. What can you tell us about this death spiral? Is that accurate?

DR. CAROL PARIS: That is not accurate. Although there are things that the Republicans can do to make it more difficult for the Affordable Care Act to continue to provide at least the provisions that have been helpful to the people who both are insured now through the Medicaid expansion and the people that are able to purchase insurance through the subsidy. And I'm not taking anything away from that. Actually, I think even in my state of Tennessee, which did not originally accept the Medicaid expansion, there is now a huge groundswell of people who are demanding the Medicaid expansion. I think that will make the Affordable Care Act more sustainable for a longer period of time. But please don't think that I'm saying that is good enough. Even at full implementation, we're going to have 28 million people uninsured in this country. And let's say we do, the other states that didn't expand Medicaid, let's say they do expand it. So maybe it's not more than 20 million uninsured. If that's still okay in a country where we're spending more, almost twice, what any other country spends – and they're covering all of their citizens – and we're leaving anywhere from 20 million to 50 million people uninsured. So the Affordable Care Act, even at its best, is going to leave people uninsured, and even more importantly, it's leaving people underinsured.

So, it's one thing to have a health insurance card, but when you still have to stop and decide whether or not you can afford to use that insurance to go to a doctor because you've got a several thousand-dollar deductible – and maybe you just don't have that money right now – that's what under-insurance means. So, I don't find that acceptable and I don't think most people find that acceptable. And that's the growing number of people in this country who have insurance, are actually under-insured. They may not realize that they're one job loss or one major illness away from bankruptcy. And the Affordable Care Act is not going to change that.

BETWEEN THE LINES: How is your group, Dr. Paris, moving to capitalize on this moment of crisis in the U.S. health care system to really provoke a serious debate about a universal healthcare, single-payer system, such as Medicare-for-All? Sen. Bernie Sanders, a former presidential candidate from Vermont, is planning to propose a Medicare for All bill in the U.S. Senate. But at the same time, you've also got states moving to try their hand at implementing their own universal health care system, such as California. Which root do you think will bear the most fruit?

DR. CAROL PARIS: I do think that the California effort is a really good one to watch because it is such an enormous population and they have such a groundswell of support for their legislation in California. So I think that is going to be a very important situation to follow.

As far as the position of PNHP, we've been working with Congressman (John) Conyers' HR-676 for a long time time and we know that legislation and we back that legislation. That truly is improved and expanded Medicare for All and much of the economic policy work that Dr. (David) Himmelstein and Dr. (Stephie) Woolhandler do – their most recent one suggesting a savings of $506 billion a year if we implemented improved and expanded Medicare for All. It's based on that piece of legislation. It remains to be seen what Sen. Sanders' legislation is actually going to be. So, I just think the devil is in the details. I'm going to be interested to see how this evolves.

For more information, visit Physicians for a National Health Program at; Health Care Now at; and Health Care Over Profit at

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