Healthcare: The Defining Issue of our Day

Healthcare: The Defining Issue of our Day

The first American president to promote national health insurance was Republican President Theodore Roosevelt, who believed that no country could prosper if its people were sick and poor.

Today not everyone accepts that view.  Yet, a recent study by the conservative think tank, the Heritage Foundation, notes that the U.S. ranks 12th in the world in measures of economic freedom and 10 of the 11 nations ahead of us have achieved universal coverage.  This isn’t a coincidence—our lack of universal coverage is holding us back economically.

The fact is, universal healthcare is the best way – along with education – to ensure a level playing field for all Americans to fulfill their highest potential and live a productive life. Today, middle and low-income workers and their employers struggle to pay for healthcare, and millions more of our poor are shut out of the system altogether, saddling too many with staggering debt or forcing them to live with debilitating pain that keeps them from working or being the parent their children need.

And the sad fact is, many who lack coverage end up falling out of the middle class, due either to massive debt or untreated conditions. Health insurance costs, subsidies, and coverage are extremely uneven in America. Seventy-five percent of Americans receive some form of subsidized healthcare, but, according to the Kaiser Family Foundation, about 50,000 South Dakotans remain uninsured, or with very expensive, insurance, about half who are middle income employees and employers. These individuals get NO premium tax credit and also must pay the exorbitant premiums and high deductibles for insurance purchased on the ACA health insurance marketplaces.

The other half are low income individuals – often workers who do not qualify for Medicaid and who earn too little to qualify for premium tax credits under the ACA, so lack any access to coverage, because South Dakota state government elected not to expand Medicaid to include them.  Imagine the devastating effect of a major illness on those families making between $11,880-$24,300 with no insurance! Nearly all of us get healthcare eventually; it’s often neither timely, nor affordable.   To paraphrase what Almanzo told Laura about ice, as she later recounted in the Little House books: everyone gets their ice. It’s just that the rich get their ice in the summer, and the poor get theirs in the winter.

That is true of healthcare in America. The poor get their healthcare in our emergency rooms, our jails and our prisons, often erratically, at extremely high costs we all end up paying, and often, when it is too late to easily treat.   During my time as a judge, those who appeared before me in felony court and those I sent to prison often were beset by addiction and mental illness that led to crime, and nearly all lacked access to mental health and addiction treatment on the outside.

Our Native American neighbors and friends face a crisis of a different sort – people there are dying because their facilities are some of the worst in America, and no one in government seems to care. The high cost of healthcare also hinders our manufacturers’ ability to compete internationally; Warren Buffet calls it “the tapeworm of American competitiveness.”  And he’s right.

Let’s debate the best fit for us as South Dakotans, but to work, any plan must provide timely, affordable healthcare for all Americans.  Everyone who is able to work should pay for their care, but no one should pay too much. It’s the right thing, both morally and economically.  And while we address the best way to ensure affordable care for all, let’s allow those who currently lack access to employer or other coverage the option to enroll in Medicare. The conservative business magazine, Forbes, has shown that if we enact sensible universal healthcare we not only will save  money, we can actually balance our budget!  The reason is that we already pay for universal care, just not in obvious ways: in county care for the poor, jail inmate and prison care, and in higher healthcare costs and
increased crime.

We’re entitled to know how the candidates for our sole seat in Congress would have voted on the morally and economically disastrous bill the House passed six months ago; so far, none of the announced candidates have told us.  That’s not leadership. They owe it to South Dakotans to let us how they would have voted on this monumental legislation.

Access to healthcare is a solvable problem, and it’s one every other developed nation has already solved.  America is economically stronger and wealthier than them all.

We need  members of Congress willing to set aside partisan politics in order to reach a broad agreement and common sense plan that reflects who we are as Americans, and that covers everyone. That is the only way we will achieve what every other developed nation has already accomplished: affordable healthcare for each of our citizens.


  • Kathleen Holen

    By Kathleen Holen

    I agree that the US health care industry is broken. Insurers do not serve the health care interests of the patient. Their goal is to be the last one holding the bill. Some say Medicare for all. If by that they mean a single payer system that’s fine. But I think we can do better. Kaiser Permanente, by whom I was briefly employed some years ago, not only manages Medicare funding but provides coverage for children’s healthcare, pregnancy and focuses on health promotion and medical cost control. It was started by a corporation to provide healthcare for it’s employees and so has a foot in the private rather than government sector, perhaps making it more palatable to my conservative fellow citizens. To my mind, it could be expanded to a national health care system more readily than Medicare.

  • Mike Dietrich

    By Mike Dietrich

    It is interesting as a South Dakota resident I can’t comment on your facebook issues.

  • Pingback: We must lower healthcare costs - Tim Bjorkman for South Dakota

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