ACA isn't enough: single-payer is a feminist issue

Any health-care system that depends on employers or wages is going to privilege the people with the highest-paid jobs (men) and take away power from people who do the bulk of unwaged work (women).


The Affordable Care Act decoupled your ability to not perish of preventable disease or misadventure from your relationship with your employer, empowering you to leave a bad boss without risking death.

But because ACA required its users to pay cash into the system, it bound women to abusive men just as surely as it bound employees to abusive employers.


The human potential of a society must not be squandered by shackling good people to bad firms or bad husbands.

Single payer — the system overwhelming used in other developed countries, who spend less per capita and deliver better health outcomes than Americans suffer through — is the only just system.

In short, the dynamics that make the American health-care system so hostile to women remain largely unscathed after the ACA: the pervasive commodification of healthcare and dependent care in the United States, coupled with employment-based gatekeeping, engineers an impossible bind for women: they face more challenges accessing the health-care system and pay more for their care when they do, out of lower incomes that are further squeezed by child and elder care costs.

By removing power over health care from employers and spouses, and replacing unequal tiers with one unified insurance pool, we could fund our health-care system with progressive taxes. That way, we could guarantee everyone the care they need, and make it free at the point of service. Ability to pay, pre-existing conditions, employment status, and gender would cease to be barriers. Building Medicare for All — with robust guarantees for tougher-to-access services like abortion and gender affirming care — would force American society as a whole to address the care disparities women face.

The Feminist Case For Single Payer >[Natalie Shure/Jacobin]