WHAT IS NATIONAL IMPROVED MEDICARE FOR ALL (NIMA)?
National Improved Medicare for All (NIMA) would create a national health insurance that covers every person living in the United States with comprehensive benefits from birth to death. It’s that simple. One set of rules. One pool of people. And one network of health professionals. This is the most efficient system.
Under NIMA, patients (not insurance company CEOs) choose where they go for care and patients and their health professionals decide what care is appropriate.
NIMA would be paid for up front through progressive taxes that would replace premiums, co-pays, deductibles and out of pocket costs. It would end the burden of having to decide whether one can afford care before seeking it. And it would end bankruptcies due to medical costs.
NIMA has three major proven cost controls that would slow the increase in health spending and make medications and services more affordable:
- Simplified administration – We spend a third of our healthcare dollar on administration. The US has the most bureaucratic health system in the world. One set of rules means that we can save at least half of what we are currently spending on paperwork, which is hundreds of billions of dollars that could be put towards direct patient care.
- Negotiating fair prices for pharmaceuticals and health care services – We spend the most in the world for healthcare and pharmaceuticals. NIMA would create a single purchaser of health care, which would have the ability to negotiate for fair prices.
- Global operating budgets and separate capital budgets – We micromanage our health care by charging for every bandaid and aspirin. This takes time away from patient care and requires a large billing staff. Under NIMA, hospitals and other health facilities would receive a monthly check to cover operating expenses. This means that nurses, physicians and other health professionals can spend more time focused on patient care and less time on paperwork.
WHY DO WE NEED NIMA?
We are the only wealthy nation that does not have a universal health care system. Our current market-based system costs the most, covers the fewest and has poor health outcomes. Life expectancy in the United States is now falling.
Here is a power point presentation on our current healthcare crisis, the Affordable Care Act and National Improved Medicare for All. CLICK HERE TO SEE IT.
HOW WILL WE WIN NIMA?
The current political environment has brought National Improved Medicare for All back into the public dialogue. Senator Sanders made it a major part of his campaign platform, which sparked attacks from the Clinton campaign despite polls showing strong support for single payer. A Kaiser Family Foundation poll in December 2015 found that six out of ten people support Medicare for All, including eight out of ten Democrats, six out of ten independents and almost 4 out of ten Republicans. A more recent Pew poll shows that 52% of Republicans earning under $30,000 a year believe the government should guarantee that everybody is covered.
It is not possible to build on the ACA to make it a universal and affordable health system. This mandate model of care has never been able to achieve universal coverage. There have been attempts for decades at the state level in the US to tinker around the edges of the current health system, and none of the changes have succeeded because they do not get at the roots of the crisis. The smallest incremental step that we can take to solve the healthcare crisis is to create a National Improved Medicare for All. This allows the cost savings necessary to provide comprehensive and affordable health coverage for everyone.
For decades, people have accepted tinkering with them system because they have been told that small changes are the only options on the table. They are told that there isn’t political will to pass a single payer system in Congress. Unlike the reality of the health care crisis, which will remain until we take the necessary steps to end it, the political reality can change if people work together to make it so.
The foundation of any movement is education, organization and mobilization. The single payer movement across the nation has laid much of the groundwork. Physicians for a National Health Program has excellent educational materials and more than 20,000 members, many of whom can give talks to community groups and Grand Rounds at medical institutions. There are also grassroots single payer supporter groups such as Heathcare-Now. And National Nurses United, the largest union for nurses, has advocated for Medicare for All for a long time.
The keys to winning single payer are to build a broad movement in support of it and to become more assertive in the tactics that are used. The NIMA movement faces the same obstacles as other social movements, the dominating influence of rich and powerful corporations that control the political system. When single issue movements work together strategically, they have the people power to overcome the power of money.
Health care is a uniting issue because it impacts all of us; we all need it at some time in our life and we all have either had a personal experience or know people who have been mistreated by the current system. And health is connected to everything; even if everyone had access to care, health outcomes would not significantly improve unless we address the social determinants of health such as wealth inequality, lack of education, homelessness, unemployment and low wages, food insecurity, systemic racism, mass incarceration, environmental toxins, and the climate crisis.
The movement for NIMA needs to frame itself as part of the broader struggle for economic, racial and environmental justice and build relationships with other movements. This is already happening on some fronts. All Unions for Single Payer and the Labor Campaign for Single Payer have worked for a long time to connect single payer to labor struggles. Medical students are taking action in solidarity with the Black Lives Matter movement and environmental justice groups.
Escalating the tactics to include protests and other forms of strategic nonviolent direct action will be necessary to advance NIMA. Similar to environmental and climate justice activists who have confronted giant oil and gas corporations to stop harmful projects, and have won in some cases, the NIMA movement will need to confront the medical industrial corporations that prop up the current system. And similar to activists who successfully stopped the Trans-Pacific Partnership, activists will need to pressure individual lawmakers to counter the pressure coming from corporate lobbyists.
Building an effective movement for National Improved Medicare for All means understanding the realities of the challenges we face. The political system is rigged to benefit the wealthy and the medical industries have a lot of resources. The current political system will not put NIMA ‘on the table’ unless a popular movement forces it there. And when it is ‘on the table’, the people will have to fight to advance it.
The good news is that the truth is on our side and social movements have succeeded in the past to win major victories. Moving forward from the popular uprisings that are taking place across the country right now around a number of issues such as systemic racism and police violence, growing poverty and employment insecurity, mass deportations, rigged trade agreements and war, the time has come for people to work together to set the political agenda from here on. We will not win the changes we need without a broad and activated movement that defines and demands the future we want, including National Improved Medicare for All.
WHO WILL WIN NIMA?
We will! All of us are needed in this struggle. Visit the Convince me! page for tools and information that you can use to reach out to people in your community. Together, we will build the movement of movements that will make NIMA the only politically-realistic solution to our healthcare crisis.