by Barry Hermanson
As you look forward to your final year of service to the people of San Francisco, many have and many more will write about what you did and did not accomplish during your 20 terms in Congress. The biggest question for me is: How will you spend your final year?
From the beginning, your fundraising ability for the Democratic Party has been key to becoming a leader in the Party. That fundraising has brought many victories in countless campaigns all across the country. But, it also has given rise to the belief by many that corporate and billionaire interests control the political agenda of the Democratic Party. Not only during the last year of your time in office, but for the rest of your life, that fundraising ability will continue to shape the Democratic Party and the country as a whole.
I write today, not to repeat the many accolades that have been written about you, but to humbly suggest that your legacy can be so much more. You have said that it has been one of your greatest honors to speak for the people of San Francisco. As you approach retirement, I hope you are open to hearing some of the other voices for whom you did not speak.
I am a former four time Green Party candidate for Congress in San Francisco. My campaigns centered around two issues, military spending and universal healthcare. Without the kind of financial resources you enjoyed, I relied on inexpensive 4” x 6” postcards which were hand distributed by standing on street corners and approaching voters at busy transit locations. My comments below are limited to universal healthcare because that is the issue where I believe you can have the most impact during your last year in office.
You are widely recognized as the driving force behind the establishment of the Affordable Care Act or, as it is otherwise known, Obamacare. It has been credited with cutting the rate of uninsured Americans in half. It became illegal for most U.S. health insurance plans (including all Marketplace plans and most job-based plans) to deny coverage, charge higher premiums, or refuse to cover treatment for pre-existing conditions.
Even with these accomplishments, more than 25 million people remained uninsured. In addition, many of the newly insured cannot afford to use their insurance because of sizable deductibles and co-pays if healthcare services are ever needed. Even with Obamacare, tens of thousands of Americans die annually due to a lack of health insurance and the inability to afford care.
Ever since its implementation, Republicans have targeted the ACA and sought to eliminate it. The government shutdown this fall was because they refused to renew consumer subsidies established during the pandemic. David Brooks of the New York Times recently raised an important question. “Why did Democrats set an expiration date for healthcare subsidies instead of making them permanent?” While the economy is better than when the subsidies were passed, Republicans are correct in saying healthcare costs are out of control.
The recent government shutdown made it clear to many Americans, if it wasn’t clear before, that the system of providing healthcare in the United States is broken. Relying on Wall Street, insurance companies and private for-profit healthcare providers results in higher prices and lower quality of care for everyone.
The cuts to Medicaid to be implemented after the mid-term elections next year will dramatically increase the number of uninsured and cause many rural hospitals to close. All of this should increase calls across the political spectrum to look at alternatives. A bipartisan bill introduced in Congress proposes to extend the ACA subsidies for two years while legislators explore other ways to resolve the current healthcare crisis.
An Improved and Expanded Medicare for All
In the many other countries with universal healthcare, everyone enjoys better healthcare at a much lower cost. You could be a leading voice advocating for the establishment of a committee to study what is and is not working in those countries. We can learn much from other nations as we seek to develop and provide healthcare to all Americans that is the best in the world.
The U.S. spends, on average, twice the amount per person of that spent by countries with universal healthcare. Yet, Americans have shorter life expectancy than people in those countries and the quality of healthcare delivered is less. In Canada, no one has to declare bankruptcy because of healthcare expenses.
In the U.S., more than 500,000 people are pushed into bankruptcy each year because of medical bills and related work loss. These represent more than 60% of all personal bankruptcies each year. It is important to note that nearly 80% of those who experienced medical bankruptcy had health insurance at the time they became sick. High deductibles, co-payments and uncovered services can lead to significant out-of-pocket costs.
San Francisco voters support an Improved and Expanded Medicare for All. In 1994, Proposition 186, a California ballot initiative that aimed to establish a government-run, single-payer healthcare system for all state residents was overwhelmingly defeated by voters, with 73% voting “No” and 27% voting “Yes.” Spending by corporate healthcare for-profit organizations who opposed Prop 186 dwarfed the amount raised by supporters.
San Francisco was the only county in California that supported Prop 186. The support in San Francisco is stronger today than it was in 1994. My friend and colleague, the late Don Bechler, organized the collection of tens of thousands of postcards from San Francisco voters asking you to support universal healthcare bills in Congress. We regularly delivered large stacks of postcards to your office.
As a candidate for Congress in 2018, I distributed campaign cards with these words: “Will California lead the way for the U.S.? 100% of Greens, 81% of Democrats and 58% of all voters support an Improved and Expanded Medicare for All. In California, the Healthy California Act (SB 562) will provide better healthcare at lower cost to all California residents. I’ve endorsed SB 562. Nancy Pelosi has not.” That bill did not pass out of the Legislature and reach the governor’s desk. Jerry Brown, like you, only wanted to support the continued implementation of the Affordable Care Act.
Gavin Newsom, as he campaigned for governor in 2018, stood in front of a meeting of the California Nurses Association and said it was a no-brainer to pass and implement universal healthcare. I’m sure that was a major reason the nurses endorsed him. It contributed to his successful campaign. Once in office however, he has discouraged efforts to pass universal healthcare legislation, perhaps because the leadership of the Democratic Party, of which you continue to be a major figure, doesn’t support it.
In the brief time you have left in Congress, the following two actions would help bring better healthcare to everyone in the U. S.
1. Endorse the Medicare for All Act of 2025 – H.R. 3069. Approximately half of House Democrats are listed as co-sponsors. Your endorsement will encourage many others to step forward. It is time that Congress addresses this critical issue, examines what has and has not worked in other countries and pass legislation that will dramatically improve the lives of every single person in the country.
2. Encourage Gov. Newsom to drop his opposition and support the next version of CalCare legislation that will be introduced in the California State Assembly early this year.
In Canada, support for universal healthcare began in the province of Saskatchewan and was gradually adopted by the entire country. The leader of the successful campaign, Tommy Douglas, was named in 2004 as “The Greatest Canadian.” He was selected through a CBC Television-sponsored Canada-wide, viewer-supported survey with more than 10,000 names submitted. He won with more than 1.2 million votes in the final tally.
You may not achieve the lofty status of being named “The Greatest American,” but you may help to change the minds of many voters who have lost confidence in both major political parties, resulting in low voter turnout for elections. If the leadership of the Democratic Party supports an Improved and Expanded Medicare for All, it would encourage many voters to once again go to the polls and vote.
Barry Hermanson is a member of the San Francisco Green Party County Council. Before he retired, he owned and operated a small business and was a leader in the small business community in San Francisco.
