Asheville's Mission Hospital, and its parent company HCA Healthcare, claim to be caring members of the city's community. So why is it using the money that it earns—money that Asheville's residents spend for their health—in order to fund a lobbying group that makes it harder for us to obtain necessary care and stay healthy?

What is HCA Healthcare?

HCA owns thousands of healthcare facilities across the country. It is a for-profit corporation, and 2020 was a year of gains for its shareholders—its share price increased by more than 11 percent.

When HCA purchased Mission Hospital nearly two years ago, it cut staffing levels and canceled services that it deemed unprofitable. So while its shareholders have profited, 2020 has proven to be a tremendously difficult year for the hospital's workers and its patients that have been battling COVID-19.

What is Partnership for America's Health Care Future (PAHCF)?

PAHCF is a lobbying group with one goal—to make sure that Medicare For All doesn't pass.

Medicare For All is a vision for healthcare in America that would eliminate co-pays, bills, deductibles, and out-of-pocket expenses, not just for all necessary medical care, but for mental, dental, and vision too.

Medicare For All doesn't eliminate or change any of the hospitals, clinics, or doctors that you visit. It just eliminates the middleman—the insurance company that only exists to ration your ability to get care and make its shareholders wealthy.

So if Medicare For All does not imperil private, for-profit hospitals and clinics, why does Mission Hospital contribute to the PAHCF? Wouldn't more Americans being able to see doctors and get care help the hospital's bottom line?

The answer might be that with Medicare For All, which is a "single-payer system," the hospital would no longer be able to pit multiple insurance companies against one another in order to drive prices for visits and treatments up. If the government becomes a single payer, it will be a powerful check against the greed of hospital CEOs.

Another answer may be that like many of the country's elite, PAHCF and Mission are concerned that if workers no longer have to rely on their workplaces for health care, they might be more willing to leave the jobs that otherwise exploit them. Medicare For All is a plan that will not only make Americans healthier, but it has the potential to empower them as workers.

The nurses at Mission Hospital have come together to form a union with National Nurses United in a historic moment for Western North Carolina. It's no coincidence that National Nurses United is the largest labor organization for America's nurses, and it's one of the loudest voices in support of Medicare For All.

What is the PAHCF Saying About Medicare For All, and Why Are They Wrong?

Because Mission Hospital believes that it can effectively spread lies about the health care system and the ways we can change it, it's worth addressing some of the tactics that PAHCF uses.

MYTH: Medicare For All will "eliminate consumer choice."

Reality: Medicare For All will actually INCREASE consumer choice!

Contrary to popular belief and poorly worded polls, no one actually "likes" their health insurance. What they like are the hospitals, clinics, and centers where their doctors and nurses work. Medicare For All preserves the places and the people that you like, while getting rid of the middleman.

In fact, Medicare For All allows for more choice. No longer will patients have to avoid a particular doctor or specialist because they are "out of network."

MYTH: Americans will pay more under Medicare For All.

Reality: Most Americans will save money under Medicare for All, and overall costs will be decreased.

Americans spend more money on health care than any other developed nation, and yet they have some of the worst outcomes. But study after study shows that Medicare For All saves money. Most recently, the Congressional Budget Office has shown that under nearly any possible variables, Medicare For All will save hundreds of billions of dollars each year.

Yet there is still some confusion over whether or not Americans will pay more in taxes because of Medicare For All. The answer is simple: only the wealthiest Americans will see their overall costs go up, because they will pay a higher progressive income tax. Middle and working class Americans will only pay more taxes at a rate lower than the savings they will see from the elimination of deductibles, premiums, co-pays, and any other out-of-pocket costs.

MYTH: Eliminating the health insurance industry will destroy the economy.

Reality: Medicare For All safeguards the livelihoods of health industry workers with its "Just Transition" provisions.

The health care industry accounts for about 18% of the formal U.S. economy, according to some estimates. That's a lot. That means that some care does need to be taken in transitioning to a more equitable, more humane, less wasteful healthcare system.

The question then, is the same one we might ask for workers in oil or coal, for example. How do we move workers out of destructive industries democratically and with empathy?

Fortunately, the vision of Medicare For All put forth in Congress includes generous provisions for a "just transition." That means that no one will be left behind.

MYTH: A single-payer system will require the rationing of care.

Reality: Insurance companies already ration healthcare in order to take more money for themselves.

The United States is the only developed nation in the world that still relies on private corporations to manage the payment and provisioning of health care to its residents. Countries such as Canada and England have no difficulty with a shortage of care. For example, according to the Physicians for a National Health Program, the idea that Canada and other countries with single payer systems experience long wait times is "an almost entirely false assertion."

In the United States today, health care is rationed de facto according to economic class. In other words, the wealthiest Americans have all sorts of ways to cut to the head of the line. The poor and working class meanwhile, ration themselves. They do it by waiting to go to the doctor until they can afford it, by skipping or splitting pills because they need to feed their families, and by staying away from doctors for fear of lacking the right documentation.

Medicare For All may in fact lead to longer wait times for the wealthy few. Under single-payer, "Cadillac health plans" may become less prevalent. The elite will no longer get preferential treatment, and their needs will be considered alongside, rather than apart from, the 99 percent.

How Will Medicare For All Benefit Asheville?

Even before the COVID pandemic hit, countless Ashevillians were either uninsured, or underinsured, which means that even though one has health care on paper, the deductibles and other costs related to getting care are so prohibitive that it's like not having insurance at all.

Asheville's economy runs on so-called "casualized" jobs. If you enjoy the city's restaurants, its bars, its music venues, its arts culture, its theater scene, or even its educational institutions, then you are relying upon residents that are either part-time, seasonal, temporary, or contract workers. There's nothing really casual about this work. Many residents work multiple of these jobs to get by. And even when they work more than forty hours per week, they still don't get health insurance through their employer.

In one month alone—April 2020—more than 35,000 jobs evaporated from the Asheville metro area. One in five members of the workforce became officially unemployed, with many more underemployed or having left the workforce entirely.

Medicare For All is necessary because whether there is a pandemic or not, Asheville's residents should be able to care for themselves and one another, regardless of the booms and busts of globalized economic forces or the failures of federal, state, and local public health institutions, which they cannot control.

The pandemic has shown that health is public. When people are afraid or unable to seek and obtain care, it can be devastating to our entire community. We need to put people before profits, and this is why we need Medicare For All now.

Mission Hospital and HCA can get on the side of our community. Or they can get out of the way.