Did you hear about the fracas at the Democratic National Convention Platform Committee meeting regarding Medicare for All? If so, you probably already know they decided against adding it to their platform.

Surprising? Not really. Now that we have the Affordable Care Act (ACA), we don’t expect a re-do on health care by the federal government any time soon, even though the problems of cost and access won’t go away. Any “fixes” on health care will come from the states. For example, Colorado will be voting on ColoradoCare, a state-based universal healthcare system in November 2016.

Unfortunately, most of the state-based fixes will be “band aid solutions.” California has begun addressing the most egregious problems with the ACA starting with expanding Medi-Cal to cover thousands of undocumented kids.

But the problems with rising costs and provider networks will continue to worsen until it’s a disaster that cannot be denied.

Remember, the only reason we got the Affordable Care Act was because health care was such a disaster at the time. Obama’s campaign in 2008 coincided with the beginning of the Great Recession, when the financial services industry lost their bet on derivatives and dragged the world economy – including the United States – into a financial crisis.

Everyday Americans were caught in a vicious trap. Personal incomes were declining while health insurance premiums were soaring (KFF 2015 Employer Health Benefits Survey). At the same time, millions of us were losing employer-provided health insurance because of layoffs. (See: Job losses caused by the Great Recession)

The recession highlighted a major problem with our nation’s primary dependence on employer-provided health insurance – that you need a job to have reliable access to health care! Which is just plain crazy.

In 2008 the situation was so bad, that politicians were forced to do something. So they got together with the big healthcare corporations and came up with the ACA.

It’s true that by reforming health insurance, creating more standard policies, providing online marketplaces and most importantly, expanding Medicaid to more poor people, the ACA has helped. But it hasn’t fixed the problem once and for all.

Even today, 30 million Americans still remain without health insurance and at least that many more are insured but can’t afford their out-of-pocket costs!

President Obama admitted this just a few days ago:

“Too many Americans still strain to pay for their physician visits and prescriptions, cover their deductibles or pay their monthly insurance bills; struggle to navigate a complex, sometimes bewildering system; and remain uninsured,” Mr. Obama said in an article published online in The Journal of the American Medical Association.

And things are rapidly getting much worse! For example, Fierce Healthcare reported that Blue Cross Blue Shield has just requested a rate hike of 60% in Texas.

To address these on-going problems, we have to take a hard look at the core tenet of the health care industry: that health care is a commodity. This is a joke. When you’re a patient, you can’t shop around! Unfortunately, that “commodity” thinking has lead to a system that is incentivized for profit, rather than for health.

Per Kay Tillow, a prominent union activist, recently writing about employer provided healthcare in her article Time to Stand Up and Do Something,

“Profiteers have rigged the system. For-profit insurers and pharmaceuticals are holding our health care, our collective bargaining, and our democracy hostage.”

Here is an excerpt from the testimony of RoseAnn DeMoro, National Nurses United Executive Director, to the Democratic Party Platform Committee,

“…the perverted system we have is really an industry based on maximizing revenue through increasing reimbursements to all sectors—corporate hospitals, insurance companies, medical device manufacturers and most of all, Big Pharma…”

Moreover, by basing access to healthcare on one’s ability to pay, Ms. DeMoro correctly points out that –

“Inequity is hard-wired into the current healthcare system. We continue to see wide disparities in access, quality and cost based on gender, race, age, where you live, and what you can afford.”

Our healthcare system is still screwed up. But the Democratic Party decided that it was more important to protect the limited gains made by the ACA than to boldly lead the country down a path to health care that prioritizes our health and happiness. And this is what we expected.

For one thing, the Republican Party platform explicitly wants to get rid of things – like the ACA! Can you imagine going back to the days when a patient gets a life-threatening diagnosis and then her insurance is cancelled? No way can we ever let that happen!

For another, previous Democratic Party platforms focused solely on expanding insurance coverage to more people. Today the situation has changed. According to an analysis by Caitlin Owens, health care policy journalist for Morning Consult:

“Now, central questions involve affordability and access in a post-ACA world, questions that didn’t exist until the past couple of years.”

Bottom line, don’t lose a minute of sleep about this platform ruckus. It’s up to us to get the facts, be informed about all our health care options, focus our work on state-based solutions and keep our eyes on the prize – Medicare for All!

Join HEAL California! Together we will win!