Former Michigan U.S. Rep. Bart Stupak talks about health care Saturday at the Peter White Public Library. He recently released his book, “For All Americans,” which addresses this topic and Stupak’s role in the passage of the Affordable Care Act in 2010. Inset, the book is shown. (Journal photos by Christie Bleck)

MARQUETTE — The state of health care in the United States and how to pay for it is a topic that won’t go away.

Bart Stupak, a nine-term Democratic congressman from Michigan’s 1st District, focused a good share of his time in office on health care. His efforts are the premise behind his recently released book, “For All Americans: The Dramatic Story Behind the Stupak Amendment and the Historic Passage of Obamacare.”

Stupak talked about the book, as well as health coverage in general, Saturday at the Peter White Public Library.

The description of the book an Amazon reads: “Bart Stupak, a nine-term Democratic Congressman from Michigan’s First District, brought two unshakable principles with him to Capitol Hill in 1992: a firm belief in the sanctity of life, and the conviction that health care was a right for all Americans and not a privilege for the fortunate few.

“Studies indicating that 45,000 Americans died needlessly every year for lack of access to health care inspired Congressman Stupak’s tireless efforts, often at great personal cost, to pass lifesaving legislation while remaining true to his right-to-life principles.”

The book is a first-person account of the inner workings and behind-the-scenes dealmaking in the U.S. House of Representatives and of the collaboration between then-President Barack Obama and Stupak’s team of legislators to pass the Affordable Care Act, also known as Obamacare, in 2010.

Stupak, though, went beyond that specific topic in his Saturday talk, noting he was an advocate for health care throughout his years in elected office.

“I always believed that it was a right and not a privilege for those who could afford it,” Stupak said.

Stupak was co-author of a proposed amendment to what was then called the Affordable Health Care for America Act, which would prohibit the use of federal funds to pay for abortion or cover any part of the costs of any health plan that includes abortion coverage except in the cases of rape, incest or danger to the mother’s life.

Ultimately, Stupak made a deal with President Obama in which he and a group of Democratic legislators would vote for the final bill if Obama signed an executive order barring federal funding of abortion under the bill.

Stupak said his book appears to be selling pretty well, stressing it’s not really a novel.

“It’s very, very factual,” he said.

Some of those facts aren’t pleasant.

Stupak said health insurance companies, which use computer programs, approved people after they applied for individual policies.

“They never look at your application,” Stupak said. “Never. They wait, and when you send a medical record or a prescription in, they run it through their computers. They have between 1,400 to 2,000 keywords that will trigger a review of your application.”

Anything that indicated a person might have a condition that would require an expensive treatment was a trigger.

“If that shows up, or there’s even an indication you might have it, they’ll find a reason to kick you off their insurance policy, even though you have a contract with them,” said Stupak, who noted an appeal would have to go to the insurance company.

That was changed with the Affordable Care Act, he said.

Recently, Sens. Lindsey Graham, R-South Carolina, and Bill Cassidy, R-Louisiana, released a new Obamacare repeal bill. However, the Graham-Cassidy Bill died when some Senate Republicans announced they opposed it.

Stupak acknowledged the current political climate presents challenges when it comes to change in health care, with both the Republican and Democratic parties being extreme.

“There’s no more middle in either party,” he said.

There is a third party, if you will.

“I think you still have a powerful voice in the American people,” Stupak said. “Otherwise they would have repealed and replaced Obamacare by now, and since they can’t repeal and replace it, they’re starving it, cutting all funding for it so it falls on its own weight.”

Stupak predicts the United States will be in the single-payer system within 10 to 20 years.

Single-payer health care is a system in which a single fund pays for health care costs instead of private insurers.

“I just think it’s the way to do it,” Stupak said.

He also discussed Medicare for All, pointing out that Medicare administration costs would be 2 percent compared with 17 to 20 percent for regular health insurance.

“You save billions and billions of dollars, and everybody then would have an equal plan, and if you wanted to enhance your plan, you just buy supplemental that’s more attractive,” he said.

Stupak prefers the U.S. House of Representatives’ public option plan in which the public’s collective monthly premiums pay for the plan.

However, he also expressed frustration over the lack of discussion on health care in Congress.

“There’s not been an honest discussion for health care policy since we passed the Affordable Care Act,” Stupak said. “None. I’ve had so many discussions — Democrats and Republicans — and asked them about it, and they have no idea what they’re talking about.

“Why? I don’t know. I can’t figure out why they didn’t have a backup plan. They had seven years.”

Even President Donald Trump acknowledged it’s a complicated issue, he said.

Larry Buege of Harvey, a retired physicians assistant, said at the presentation that what Republicans and Democrats don’t understand is that people want health care, not health insurance.

“Nobody’s working to make health care more efficient and cheaper,” Buege said.

For example, he noted medication costs are expensive because of the advertising costs for drug companies.

“You don’t have access to health care just because you have insurance,” Buege said.

Stupak said there’s no reason why the U.S. federal government can’t use its purchasing power to negotiate lower drug prices.

“Everybody else does,” Stupak said. “Every big company does. We can’t.”

Regardless of the plethora of challenges health care presents to the public, the Affordable Care Act, Stupak said, is a good start.

“No matter what they do, Americans now have an expectation they’ll have access to health care,” he said. “That will be the legacy of Obamacare, even if they repeal it tomorrow. You’re going to insist upon something, and even President Trump admitted he had to have something to replace it. He just never thought what it might be.”

Obviously, more attention needs to be paid on the issue, and Stupak said that involves legislators willing to address health care and public access to it.

It also means a continuation of what’s already been accomplished with the ACA.

“We’ve got to build on it,” Stupak said. “Make sure all Americans have quality health care.”

Christie Bleck can be reached at 906-228-2500, ext. 250. Her email address is cbleck@miningjournal.net.