Yet again, Obamacare is in the political fight of its life. Republicans have spent quite a bit of time attacking the Affordable Care Act (Obamacare) since it was first passed on March 23rd, 2010, and has faced a steep challenge ever since, most notably on May 4th, 2017, when a republican controlled house of representatives passed a repeal of Obamacare with 217 votes to 213. The vote was later rejected by the senate in a memorable moment where Senator John McCain’s gave a thumbs down against repealing Obamacare.

Will The People Get What They Deserve?

With the Supreme Court now having a 6-3 conservative majority, the question of the ACA’s survival is thrown into question. It’s possible that everything will end up alright as key supreme court justices have signaled support of Obamacare, likely ensuring its survival, but that might only keep healthcare safe until the next political fight. But this does beg the question, why this fight keeps happening at all?

Universal healthcare is not a new issue in the United States, though it has always been one full of tough fights with little in the way of results. Some form of socialized medicine has been in the works since the late 1883 when Germany passed something like universal healthcare for all workers. American legislators tried forming some kind of bill throughout the first half of the 20th century until President Lyndon B. Johnson passed the Social Security Amendment of 1965 which resulted in the creation of Medicare.

This act provides comprehensive health insurance to their base, but there is a catch: Medicare only applies to people 65 years and older. Far from being a universal program, Medicare only applies to about 61 million Americans, a far cry from the current 320 million people who live in the United States. The United States currently spends 16.9% of its GDP (almost 3.5 trillion dollars), twice the average spending of all other developed countries, while also failing to cover even half of its citizens with health insurance. Obamacare was meant to provide affordable healthcare to every American but has largely failed in that mission.

Part of this failure can be contributed to the same Republican opposition we see today. Mitch McConnell, the Senate Majority leader, has lead an infamous campaign to roadblock every legislative maneuver Democrats have tried to preform, though it is important to stress Republican obstructionism is not a new phenomenon. Republicans also helped throttle Bill Clinton’s 1993 healthcare reform as well as a whole history of resistance stretching back to the Harry Truman in the late 1940s. The reason Obamacare keeps facing all of these challenges is because th e bill itself does not address the real health needs of average workers.

Even though Democrats had super majorities in the Senate and House, the Affordable Care Act changed very little in healthcare coverage. It’s true that there are 20 million fewer uninsured Americans and some other minor benefits, this still leaves two-thirds of the country uninsured with million. Even worse, those who are lucky enough to have insurance through their employers are always at risk of losing their job for reasons out of their control, such as in the case of almost 8 million Americans. Plain and simple, The Affordable Care Act has proven so prone to political attacks is because health insurance is still out of grasp for most Americans. If Obamacare was truly universal, then these attacks from republicans might prove infertile.

The fire department provides the perfect parallel for the strength of a universal program. In the United States, fire departments can be found in every community, are paid for with tax dollars, provide equal access to rich and poor, and face a 90% approval rating from the general public. Universal Healthcare sees a similar level of popularity in Canada with an 86.2% approval rating and the current form of Medicare has a 77% approval rating, which is technically universal if you can survive until 65. So if universal program prove to be so popular and effective, why did Obamacare end up being a bill that helped so few people? Easy. Democrats were never serious about fixing healthcare.

Many Democrats, including our President-elect Joe Biden, opposed healthcare reform in 1993 and much was the same in 2008 with Obamacare. Even though Democrats had the necessary votes to avoid the filibuster, they often squabbled with themselves leading to many of the programs biggest failures like dropping the public option and a skyrocketing cost of premiums. Instead of working on a comprehensive plan that fixed the healthcare problem at its roots, Democrats increasingly took money from industry lobbyists. Bill and Hillary Clinton after failing to pass their reform in 1993, teamed up with the same lobbying group that undermined their reform in the first place.

The healthcare industry has been the single biggest roadblock to affordable insurance in the modern American history. In this most recent primary, Medicare-For-All became an issue of debate under the platform of Bernie Sanders and Elizabeth Warren, much to the ire of the industry. In fear of socialized medicine that’s affordable to everyone, the lobbyists started an effort to misconstrue information about private insurance outright lies when that became insufficient. Comprehensive affordable healthcare coverage is something the industry opposes with every fiber of their being.

For as long as Obamacare fails to make sure every American has health insurance, it will always be attempting to keep itself from ruin. 20 million insured people with more insurance is important, but a policy that does not help everyone will not be fought for by everyone. The main reason is Republicans have proven so potent in their attempts to crush Obamacare is because there is no real support for the program itself. If we want healthcare that belongs to all people, not just those who are privileged enough to afford it, then it must be universal. Anything less is just another fight waiting to happen.