by Aidan Stretch '20
The state of healthcare in the United States is unfortunate. Unfortunate because exorbitant deductibles and copays leave millions of Americans reluctant to seek insurance. Unfortunate because trillions of annual taxpayer dollars are apportioned to inefficient and ineffective Medicare and Medicaid plans. Unfortunate because pharmaceutical products are priced so high as to be an extravagance to those in dire need of them. This reality of the American healthcare system thwarts any appeal, any reasoning, to the idea that the status quo is somehow an imperfect inevitability in the realm of health insurance. So pair this abhorrent reality with another one: this same basic system of healthcare has persisted in the U.S. since the 1850’s. It seems outrageous that this standard of poor coverage and ineffectiveness has passed for normalcy over the course of the last decades. Yet, despite its apparent flaws and injustices, the reason for its persistence is quite simple: Healthcare is a business and like all other businesses in the U.S., its legal obligation is not the well-being of every single American, but rather to produce a profit for its shareholders.
In corporate or business terms, the healthcare industry is not broken, nor is it ineffective. Instead, it is thriving with companies making nearly $5 billion in quarterly net earnings and their CEO’s making $20 million per year. This is precisely the problem. It is not the health insurance companies that are swindling millions of Americans each year but the U.S. healthcare model itself. These health insurance companies seek not to cheat citizens out of basic needs, but instead to simply turn a profit like all companies aim to do. Attacking the isolated incidents of high-deductibles, co-pays, and pharmaceutical prices, will get reformists nowhere. They must instead dismantle the very system that allows and even encourages them to occur. These problems, so deeply imbedded in the healthcare system, lend themselves to only one viable solution: scrap the healthcare business model altogether and adopt a single-payer, “Medicare for All” plan.
The initiative, supported by Bernie Sanders as well as other 2020 Democratic presidential hopefuls, would establish a universal health care system, funded by the federal government and operated by the private sector, in which all persons living in the U.S., regardless of citizenship, are insured. In making the federal government the “single payer” of health insurance, the profit motive basis of healthcare would be annulled, while a necessity for improving care would assume its place as the driver of most macro health insurance decisions. At first glance, or after hearing Senator Sanders describe it, the single-payer method is the savior of the underinsured or the champion of those with looming medical debt, but in practice, the plan is far from perfect and has raised some very serious concerns.
The leading caveat with the plan is its monetary implications. According to George Mason University, Medicare for All would lead to a $32.6 trillion increase in federal spending, which would be mirrored in a similarly scaled increase in taxes. Not to mention, doctors and other medical practitioners’ salaries would be expected to decrease by 10% (Mercatus Center). A second quite practical issue that has been raised is that the government is notoriously inefficient in handling both the allocation of money and supervision of everyday operations—two essential functions that would be required of them as the “single payer” of American healthcare. “Trust the market, not the government, in operating a system such as this,” skeptics say. “What’s to say that the government will be any more effective than the health insurance agencies in managing these challenging issues?”
These are undoubtedly valid concerns, but the weight of this debate lies not with money or efficiency or politics, but instead with what I believe should be the primary purpose of healthcare in the United States. It is difficult to arrive at absolutes and ultimatums within a controversy as nuanced as health insurance, but if there is a single weight in this discussion it is the notion that every American should have the luxury of basic accessibility and use of healthcare. For this reason and no other, “Medicare for all” deserves, at the very least, the right to be heard and considered by the people of the United States.