In the wake of venture capitalist Joel Freedman’s decision to close Hahnemann University Hospital, national and local leaders have rallied on broader health-care reform. As Senator Bernie Sanders, City Councilwoman Helen Gym, and others have argued, passing single-payer health-care reform like Medicare for All is a clear way to confront the pernicious corporate greed and capital that plague our health-care system. So why have once-supporters like Rep. Dwight Evans joined other antireform politicians in refusing to sign on to legislation that would address the causes of this public health crisis?
Philadelphia, like the rest of the country, is in desperate need of systemic health-care reform. Almost 10% of adult Philadelphians are uninsured, 13% forgo medical care due to costs, and 18% have no primary care provider. As a result, life expectancy is significantly lower than the national average and the infant mortality rate is the highest of any major U.S. city. Low-income residents, immigrants, and people of color face comparatively worse health outcomes while being overrepresented among the city’s uninsured and underinsured. This is the very population that Hahnemann serves.
While more affluent hospitals can afford to stay open and even expand, those that serve poorer patients are at risk of being sold, closed, or both. Across the U.S., corporate-run hospital chains are acquiring hospitals only to shut down expensive departments like ob-gyn clinics and sometimes entire facilities. The impending Hahnemann closure and Freedman’s plan to sell its lucrative real estate is only the latest example of this trend.
Medicare for All would provide universal care, which would particularly benefit uninsured and underinsured Philadelphians. At the same time, it could combat hospital closures by lowering administrative and billing expenses in half. Additionally, the legislation guarantees federal funding to health-care facilities to cover costs and to stabilize cash flow. This removes the profit motive that incentivizes closures, protecting hospitals that serve low-income populations.
Given its merits, why won’t Evans cosponsor H.R. 1384, the current Medicare for All legislation in the House? While Evans is calling on Joel Freedman to keep Hahnemann open, he has abandoned his previous support for the only proposed health-care reform that could have helped prevent the crisis.
Pennsylvania’s other members of the Medicare for All Congressional Caucus signed on to H.R. 1384 months ago. Like them, Evans campaigned on instituting a single-payer system, tweeting last August he is a “staunch supporter” of Medicare for All. He cosponsored an earlier version of the bill. Yet this month, Evans has sent letters to pro-Medicare for All constituents inquiring about his current health-care position that fail to mention the legislation. Instead, he asserts a need to strengthen the Affordable Care Act and give everyone access to health care. But making health care available to all is not the same as Medicare for All’s call to make health care free to all.
In public, Evans has sidestepped substantive debate about the legislation, instead making technical arguments against H.R. 1384’s two-year proposed rollout, a timeline his office has cited as a primary reason for not backing the bill. However, Sanders’ Medicare for All bill in the Senate features a four-year rollout, a difference which could be resolved in conference committee once both bills have passed in their respective chambers. If a member of Congress truly wanted to ensure passage, they would not undermine the legislation so early in the process, when building support and momentum is key.
Evans’ donors, and a recent political endorsement, further complicate his position in the Medicare for All fight. Since being elected to the House in 2016, Evans has received over $25,000 from Blue Cross/Blue Shield, a company leading the insurance industry’s fight against universal health care. He has endorsed anti-Medicare for All presidential candidate Joe Biden, whose health-care reform proposal keeps 3% of the population uninsured, which stands to result in approximately 125,000 unnecessary deaths over its first 10 years.
Biden, along with members of Pennsylvania’s congressional delegation, such as Rep. Madeleine Dean, have claimed that Medicare for All limits “choice.” Polls show, however, that the choice that matters to people is over their doctor, for which the bill allows. What choice is left when patients go without insurance or care? When their hospitals are shuttered?
Patients and hospital workers in Evans’ congressional district — and well beyond — stand to benefit enormously from Medicare for All. The few who have something to lose are the health-care tycoons, millionaire insurance executives, and politicians who side with corporate power. The question Evans and other members of Congress must answer is: Whose side are you on?
Joanna Wuest is a postdoctoral fellow and lecturer at Princeton University. Carly Regina is a Ph.D. candidate at the University of Pennsylvania. Both are members of the Democratic Socialists of America.