Why do 70 percent of Americans support the single payer, universal healthcare system known as Medicare for All (Reuters–Ipsos survey, August 2018)? Partly because the current system is broken, but also because a growing number of people see healthcare as a human right.
Few would argue that our healthcare system works well. Even though the number of people without insurance has been cut in half since the Affordable Care Act, there are still millions of Americans who are uninsured.
Others don’t access care because of high deductibles, and health care costs are still the primary reason for over 65 percent of family bankruptcies (American Journal of Public Health, March 2019). Premiums, co-pays and costs to employers continue to rise relentlessly.
According to The Commonwealth Fund research (November 2016), we spend more on healthcare than 10 other high-income nations, but rank last on a variety of quality measures. And, we are the only one without universal coverage. People in these countries love their healthcare systems. When President Donald Trump said he was sure the U.S. and Great Britain could make great trade deals when or if the UK leaves the European Union, Boris Johnson agreed but said the only thing that was off the table is their National Health Service.
Our current system is the result of a mistaken belief that healthcare is best distributed through the “free market.” As Wendell Potter, former vice president for corporate communications at Cigna, points out in an Oct. 16, 2019, NBC News article, this is insurance company propaganda, and the entire system is actually a classic example of a market failure (see http://wendellpotter.com/ for more information).
Free markets require that consumers know how much a good or service will cost them, and they decide whether to make a purchase. Our healthcare system has little to no price transparency and consumers have little freedom to choose services and providers. Most of us have heard of people who got large surprise medical bills after emergency treatment.
Nevertheless, the main reason the market can’t solve our healthcare problems is because a market economy simply isn’t a mechanism for ensuring universal access to a basic human right.
In a market economy, competition determines prices, and access is based on the customer’s ability to pay.
Under a “Medicare for All” system with privately delivered services that are publicly paid for, access would be universal. There would be true competition between providers, as prices would be transparent and patients would freely choose providers.
Right now, about half of U.S. medical spending is from government and half is from patients and employers. Medicare for All would shift nearly all of that spending to the government. If you believe that everyone deserves access to healthcare and no one should go bankrupt due to illness, you will agree that change is needed and the time is now.
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