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Vox: The Medicare-for-all paradox

Passing single-payer means disrupting health insurance for 160 million people who get coverage through their jobs 

​HCCI Data was featured in Vox showing the annual growth in per capita health care spending. 

By: Dylan Scott

Jessica Salfia knew the pay wasn't going to be great when she became a teacher in Martinsburg, West Virginia, but she did have really good health coverage. She felt like she could go to see any doctor she wanted. The copay for an emergency room visit was just $15. She had three kids over the years, and health care was one thing Salfia didn't feel like she had to worry about.

"The one thing about being a public schoolteacher was you knew that was taken care of," Salfia, a teacher of 16 years, tells me. "But in the last four to six years, it's been death by a thousand cuts."

The state legislature kept cutting taxes, and copays for teachers kept going up — eventually costing Salfia and her family $100 just to show up at the emergency room or urgent care. On top of that, their health plan started to restrict which specialists they could see. Suddenly, some teachers had to travel as far as five or six hours to see a doctor.

Salfia's daughter's sore throat quickly spiraled into a $650 bill, as the rest of the family got sick. "My husband and I had to sit down and decide what bills we're gonna pay or what bills we're not gonna pay," Salfia says.

The West Virginia teachers went on strike over rising health care costs, eventually securing a pay bump and a freeze on insurance premiums. But their plight reveals the cracks, increasingly difficult to ignore, in the bedrock of American health care: employer-sponsored insurance.....