A Case for Single-Payer Health Care: Rejecting the Greed of Health Insurance in the Private Market
(An essay from my Persuasive Writing class at Temple University)
In 2018, America spent 3.6 trillion dollars on health care, by far the highest number per capita in the world (CMS.gov). However, in that same year, 37 million Americans were uninsured (Galvani), hundreds of thousands went bankrupt due to medical bills, and tens of thousands died from lack of health insurance. This is the grim truth of living in the only first-world nation not to guarantee health care, where private companies prioritize profits over human lives. In America, health care is treated as a commodity to be bought and sold, netting a profit. This is a distinctive attribute to America that has allowed insurance companies to rake in profits of 35.7 billion dollars a year (Minemyer). For comparison, across Western Europe and Canada, most notably, civilians are guaranteed free at the point of service care where privatized insurance is beyond an anomaly. Bluntly put, the current system prioritizes mega-profits over the health of its civilians. To combat the conflict of interest of the for-profit health care industry, America should implement a single-payer health care system, better known as Medicare for All, because it would save lives, guarantee health care to everyone, and save hundreds of billions of dollars a year in the process. Through the deconstruction of biases and easy to understand populist rhetoric, the solution to America’s health care disparities is clear that Medicare for All is a winner for working people.
The goal of a single-payer health care system is “to establish a Medicare-for-all national health insurance program,” according to Bernie Sanders (I-VT) in the overview of his bill, the Medicare for All Act of 2019 (Sanders). At face value, a single-payer system such as that proposed by Bernie Sanders is a brilliant solution to all of America’s health care disparities. It represents a health care system similar to those that have thrived in countless countries across the western world, expanding health care to include dental, hearing, and vision care (Sanders). However, in such a hyper-polarized political landscape, terms such as “Medicare for All” can easily fall victim to society’s culture wars, fueled by corporate media pundits and social media misinformation. Making Medicare for All a reality is even more complicated when the gatekeepers that decide and influence legislative policy such as corporate media outlets, lobbied members of congress, the sitting president, and the president-elect have all shut down Medicare for All. These prominent figures have cited costs and are frightened of alienating voters outside the progressive wing. What these high-ranking individuals fail to acknowledge, though, is the roughly 22 highly accredited studies of differing ideologies supportive of Medicare for All or the overwhelmingly favorable public opinion of universal health care among Americans.
Before I further make a case for a single-payer system, one must understand that universal health care isn’t a new idea to America, but one pushed for by some of the most accomplished Presidents in U.S. history and, to some extent, already in place today. Perhaps the most brushed aside advocate of universal health care in mainstream American politics was the 35th U.S. President, John F. Kennedy. In May of 1962, Kennedy spoke in front of a packed Madison Square Garden, saying, “We are behind every country pretty nearly in Europe in this matter of medical care for our citizens’’ and later railed against big pharma’s greed, urging the need for alert and progressive citizens (Kennedy). A few years later, after that Madison Square Garden speech, his successor, President Lyndon B. Johnson, passed The Medicare and Medicaid Act of 1965. While the bill didn’t go as far as President John F. Kennedy advocated, The Medicare and Medicaid Act of 1965 made health care a right for those 65 and older, guaranteeing health care to America’s seniors. Since then, the Medicare and Medicaid program, funded primarily through payroll taxes, has consistently been one of the U.S. government’s most praised institutions, with a favorability rating of 75% among the American public (Kaiser Family Foundation). The passing of a single-payer health care bill today would be similar to how Medicare and Medicaid have been working for roughly 55 years, just on a much larger scale. Instead of making health care a right to the exclusive age bracket of 65 and older, the same framework would become a right to every American with zero out-of-pocket expenses. For Americans, this would mean no more insurance premiums, deductibles, copayments, etc., that stand in the way of seeing their doctor.
John F. Kennedy’s stance on universal health care can be heard here.
As mentioned earlier, terms such as “Medicare for All” can get lost in the culture wars, but when deconstructed, the single-payer system is a brilliant idea rooted in America’s most respected political figures. It’s a long-standing idea with numerous vital benefits that would increase the American people’s material well being. Out of the numerous benefits of Medicare for All, perhaps the greatest motive is that tens of thousands of human lives would be saved each year. Medical researchers first brought to attention in a 2009 Harvard study that 45,000 American deaths per year were linked to lacking adequate health insurance. Since that shocking 2009 study, other top-tier institutes have only reported bleaker findings, such as a study released in February from Yale University that found the number of deaths due to lack of adequate health insurance to be 68,000 (Galvani). For perspective, in the U.S., there were roughly 16,000 homicides and 48,000 suicides in 2018. Yet, the tens of thousands of disenfranchised Americans dying from lack of health care are never discussed as a pressing issue in the mainstream landscape.
For people who go without or can’t afford to get the proper treatment and medications, the primary reason for not seeking the treatment they need is fear of medical debt. Last year, a study found that 137 million Americans struggled to pay off medical debt (Yabroff). Due to these outrageous costs, many Americans put off the treatment they need to live a healthy life. For the most at-risk Americans, this decision is deciding between paying rent, groceries, or proper health treatment, among other life-dependent expenses. An example of the outrageous costs of health care in America made headlines in June; a 70-year-old Seattle man was billed 1.1 million dollars after spending 62 days in the hospital after his battle with COVID-19 (Westneat). While this man was lucky to have insurance that will cover the “vast majority” of costs, someone under the age of 65 could’ve been on the hook for the entire cost if they were one of the tens of millions uninsured in a global pandemic. Medicare for All would eliminate the fear Americans have of deciding between health or going into medical bankruptcy, ruining lives forever.
As if saving human lives isn’t enough to make the switch, a Medicare for All system will save Americans billions of dollars a year, according to numerous studies on both sides of the ideological divide. Twenty-two accredited studies agree that Medicare for All would save money, citing the reduction of administrative costs as a critical factor (Cai). Citing the Yale study again, Medicare for All would save $5 trillion over the next decade in what has been one of the most convincing and optimistic studies regarding Medicare for All to date (Galvani). The primary reason health insurance prices would decrease is that instead of thousands of insurance companies negotiating with doctors, hospitals, and manufacturers, under the Sanders plan, that would become just one. Similar to how unions negotiate health care plans, among other benefits, the leverage of a single national program negotiating its prices allows for healthcare-related expenses to plummet, which means more money back in the pockets of your average American. It’s not just left-leaning elite research institutions that agree with the efficiency of a Sanders plan either; take the Mercatus Center, for example. The Mercatus Center is a right-wing research center at George Mason University that emphasizes the free market. They found that Bernie Sanders’s proposed Medicare for All Act of 2019 would save trillions of dollars over the next decade (Blahous). Breaking with talking points in the media and Washington, The Mercatus Center report communicates the Medicare for All system’s viability to its targeted audience of fiscally conservative moderates and right-leaning individuals. This study demonstrates the universal appeal of Medicare for All, regardless of political ideology, debunking the progressive pipedream portrayed by the opposition.
Other than affordability, the most significant concerns regarding a Sanders plan have to do with Americans fearing that they will be kicked off their current health care plan, paying into something inferior. In reality, the prospect of getting kicked off your current provider is nothing more than a fear-mongering lie. For starters, in section 103 of the Medicare for All Act of 2019, Bernie Sanders states, “any individual entitled to benefits under this Act may obtain health services from any institution, agency, or individual qualified to participate under this act” (Sanders). This means that providers that meet the standards for enrollment in section 301–401 of the Medicare for All Act of 2019 will be eligible to participate. These standards are simple as being non-discriminatory, never charging a dime out of pocket for services covered under the act, adhering to quality standards by designated entities, and certified by the Department of Health and Human Service, among others laid out in straightforward language in the sections of the bill (Sanders). In other words, every current provider will be eligible to enroll in the Sanders plan so you can continue to see your preferred doctor. However, this greater freedom of choice would allow for the ability to choose outside your network of providers limited by the current system. For individuals who have health care but unsatisfied with their doctor or provider, the Medicare for All Act of 2019 would strip away any boundaries that stand in the way of seeing someone else outside your network.
An enormous flaw under the current system is that employer-based insurance is the most common type of health care in America. Sixty-nine percent of workers in America have health care tied to their job and are potentially one layoff away from losing those insurance benefits (Fronstin). In a pandemic that had seen the official U-3 unemployment peak at 14.7%, at least 12 million people lost their insurance in the ongoing pandemic. Under the current system, the working American’s access to health care is as equally secure as the economy (Bivens). Amid the worst economic crash since the Great Depression, COVID-19 has pulled back the curtains of just how flawed our current system is, overwhelmingly relying on employers whose number one priority is to turn a profit for health care access. Nobody deserves to have the burden of job security tied to accessing health care, which Medicare for All separates. Not to mention, Medicare for All would give workers more leverage by making health care an inevitable right, ridding employer-based insurance as an incentive, and having to offer other incentives such as higher wages to attract and retain employees. In similar rhetoric, entrepreneur and 2020 presidential candidate Andrew Yang paints Medicare for All in a manner that even the most staunch free-market capitalist couldn’t disagree with: “On the worker side, tons of people hang on to jobs that they do not want to be in just for the health insurance. Economists refer to this as “job lock;” it makes the labor market much less dynamic, which is bad in particular for young workers” (Yang). The separation of employer and health insurance allows for more risk and innovation regarding entrepreneurship; an aspect overlooked when those in support of Medicare for All make the pitch for a single-payer system.
A frequent argument against Medicare for All is that legislation should be passed to build upon the current system instead of entirely revamping our health care system. For context, the current system is called The Affordable Care Act, better known as “Obamacare.” Passed by President Barack Obama in 2010, the system has been a definite improvement, insuring more people than ever before. However, The Affordable Care Act has managed to allow tens of millions to go uninsured in a global pandemic, demonstrating that profits will need to be made long as private insurance exists, leaving too many people disenfranchised. Another misconception of the Affordable Care Act is that the U.S. has the most advanced healthcare system globally. According to the Organisation for Economic Co-operation and Development (often referred to as OECD) data, the U.S. has higher rates of pregnancy-related deaths, mortality rates, medical errors, and premature deaths among other than Western European nations (Kurani). Even though the U.S. pays by far the most globally for health care, the doctors and medications trail single-payer countries such as France, Sweden, the United Kingdom, and other prosperous nations in Europe. This is because of the for-profit nature of health care in America; when turning a profit is the primary motive, human life is susceptible to cutting corners. In a study from NORC at the University of Chicago, one in five Americans say they have experienced a medical error while receiving health care in America; however, many minor instances go unreported. The majority of these people believe that a lack of attention to detail and or poorly trained providers contributed to the medical errors (NORC at the University of Chicago).
An example of a private health care provider providing poor care is Corizon. In 2015, Corizon, the largest for-profit prison health care provider in America, terminated a 1.2 billion dollar contract over “lack of contract flexibility.” In reality, this “lack of flexibility” was hundreds of lawsuits filed because of poor service quality and on the heels of 346 prison deaths the year before with no immediate cause of death (Mohler). All too common in America, your status in society dictates the level of care you’ll receive. If you’re well off, you’ll be fine, but for those with unsatisfactory health insurance, even though you may be able to access care, receiving error-free treatment is far from a guarantee. Throughout Europe, where health care is free at the point of service, money doesn’t buy care better than another, but courteous care to all from the very top of society to the most at-risk.
To restate, Medicare for All would save lives and save money, a more than favorable prospect to make the transition away from privatized health care insurance. Unfortunately, the greed of elected officials in Washington, D.C., and the pockets of the big pharma industry stands in the way. The latter has so much influence in American politics that they contributed 29 million dollars to politicians to do their bidding of protecting the privatized status quo during the 2018 midterm election cycle (Wouters). Pennsylvania Senator Bob Casey (D-PA), who took the most during the 2018 cycle at a clip of $540,192, represents the lengths big pharma will go to shut down the idea of Medicare for All. Like other top big pharma recipients, Senator Casey opposes The Medicare for All Act of 2019 (OpenSecrets.org). To summarize, lobbying from the wealthiest individuals of society exert influence on elected officials in Washington, keeping the most at-risk Americans from accessing the health care they need to live healthy lives.
In America, a small percentage of the elite have enough wealth to dictate and influence policymaking. This is why it can seem so intimidating to confront the big money interests standing in the way of Medicare for All. As millions get kicked off of their health care, big pharma has seen its profits, in some cases, double in the second quarter of 2020. Anthem’s net income was 2.3 billion in the second quarter of 2020, up from 1.1 billion in net income at the same time last year (Abelson). As the material well-being for your average American in the pandemic has diminished, the wealthiest continue to see their net worth increase in a private sector that doesn’t exist in a system that guarantees health care to its people. In America, access to affordable health care is the only industrialized place on Earth where this is a class issue, as it affects every working American. Even in a hyper-politicized society, people understand that they are being taken advantage of, losing health care in a pandemic as the wealthiest members of society see enormous gains. In particular, those profiting off of life-saving care in the private sector see their net worths balloon, a key rationale for the growing support of single-payer health care.
As the middle-class continues to shrink, the support for Medicare for All has seen a significant rise in popularity, especially since the beginning of the pandemic. This has led to the overwhelming majority of American people to support a Medicare for All system, making it a bipartisan solution with strong support from all walks of life. In April, a Hill-HarrisX poll found 69% of voters favor Medicare for All. Broken down by party affiliation, 88% of Democrats, 68% of Independents, and 46% of Republicans are in favor of Senator Sanders’s bill (Schulte). This same poll broken down by region reveals 70% of people in the rustbelt/midwest support Medicare for All, a place where states such as Ohio and Iowa have increasingly voted Republican in recent elections. For a region that suffers the brunt of outsourcing, economic disparity, and job loss due to greed in Washington D.C, the blue-collar rustbelt and midwest desperately need guaranteed health care. With the current status quo of employer-based insurance, these people will lose access to health care the moment a job is shipped outside of America (Tausche). If globalization is indeed inevitable, the U.S. must act to provide guaranteed health care, especially for the sectors that have been hit the hardest by outsourcing and COVID-19.
Again, America should implement a single-payer health care system because it would save lives, guarantee health care to everyone, and save hundreds of billions of dollars a year in the process. Nobody deserves to suffer due to insufficient or lack of health care in the wealthiest country in the world. Instead, flourish without having to be tied down to an unsatisfactory job or career because of employer insurance used as leverage instead of a right. Having the safety net of guaranteed health care allows the American people to take greater ventures into the world of start-up entrepreneurship, follow passions, and live without the fear of medical bankruptcy or getting kicked off their employer’s health care. The hundreds of billions of dollars a year saved would be put towards programs such as tuition-free college, guaranteed housing, combating climate change, and rebuilding infrastructure that would improve working American’s material well-being. All that stands in the way of a single-payer Medicare for All system is the greed in Washington, D.C., and the big pharma industry. To quote John F. Kennedy from his same 1962 speech advocating for universal health care, “between an alert and progressive citizen and a progressive government is what has made this country great” (Kennedy). All of these decades later, that spirit and message emphasized by President Kennedy are as relevant as ever where millions of people continue to lose private employer-based insurance in a global pandemic. At face value, it can be easy to deflect the idea of overhauling America’s entire health care system. However, once you distance from the talking points of politicians funded by billionaires and corporate media outlets, the decision becomes much easier. The Medicare for All Act of 2019 is a winner for the working people.
Works Cited
Abelson, R. (2009, September 17). Harvard Medical Study Links Lack of Insurance to 45,000 U.S. Deaths a Year. Retrieved September 30, 2020, from https://prescriptions.blogs.nytimes.com/2009/09/17/harvard-medical-study-links-lack-of-insurance-to-45000-us-deaths-a-year/?scp=2
Abelson, R. (2020, August 05). Major U.S. Health Insurers Report Big Profits, Benefiting From the Pandemic. Retrieved from https://www.nytimes.com/2020/08/05/health/covid-insurance-profits.html
Bivens, J., Zipperer, B. (2020, August 26). Health insurance and the COVID-19 shock: What we know so far about health insurance losses and what it means for policy. Retrieved October 13, 2020, from https://www.epi.org/publication/health-insurance-and-the-covid-19-shock/
Blahous, C. (2018). The Costs of a National Single-Payer Healthcare System. Retrieved September 30, 2020, from https://www.mercatus.org/system/files/blahous-costs-medicare-mercatus-working-paper-v1_1.pdf
Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Kahn, J. (2020, January 15). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. Retrieved September 30, 2020, from https://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1003013
CMS.gov. (2019, December 17). National Health Expenditure Data. Retrieved October 13, 2020, from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData
Galvani, A. P., Parpia, A. S., Foster, E. M., Singer, B. H., & Fitzpatrick, M. C. (2020). Improving the prognosis of health care in the USA. The Lancet, 395(10223). doi:10.1016/s0140–6736(19)33019–3
Kaiser Family Foundation (2020, February 28). Data Note: 5 Charts About Public Opinion on Medicaid. Retrieved November 10, 2020, from www.kff.org/medicaid/poll-finding/data-note-5-charts-about-public-opinion-on-medicaid/
Kennedy, J. F. (1962, May 20). Madison Square Garden, Senior Citizens Rally, 4:00 PM. Speech presented in Madison Square Garden, New York City.
Kurani, N. (2020, August 20). How does the quality of the U.S. healthcare system compare to other countries? Retrieved September 30, 2020, from https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/
Minemyer, P. (2020, February 24). Health insurers’ profits topped $35B last year. Medicare Advantage is the common thread. Retrieved October 13, 2020, from https://www.fiercehealthcare.com/payer/big-name-payers-earned-35-7-billion-2019-here-s-one-common-thread-their-reports
Mohler, J. (2015, December 03). Cutting Corners on Health Care Hurts Us All. Retrieved October 22, 2020, from https://www.inthepublicinterest.org/cutting-corners-on-health-care-hurts-us-all/
NORC at the University of Chicago and IHI/NPSF Lucian Leape Institute. (2017). Americans’ Experiences with Medical Errors and Views on Patient Safety. Retrieved November 22, 2020, from http://www.ihi.org/about/news/Documents/IHI_NPSF_NORC_Patient_Safety_Survey_2017_Final_Report.pdf
OpenSecrets.org. (2019, June 10). Pharmaceuticals / Health Products. Retrieved October 20, 2020, from https://www.opensecrets.org/industries/indus.php?cycle=2018
Sanders, B. (n.d.). Medicare for All. Retrieved September 30, 2020, from https://berniesanders.com/issues/medicare-for-all/
Sanders, B. (2019, April 10). Text — S.1129–116th Congress (2019–2020): Medicare for All Act of 2019. Retrieved September 30, 2020, from https://www.congress.gov/bill/116th-congress/senate-bill/1129/text
Schulte, G. (2020, April 24). Poll: 69 percent of voters support Medicare for All. Retrieved September 30, 2020, from https://thehill.com/hilltv/what-americas-thinking/494602-poll-69-percent-of-voters-support-medicare-for-all
Tausche, K. “Ahead of 2020, Manufacturers Are Struggling in Rust Belt Regions That Helped Trump Win Last Time.” CNBC, CNBC, 7 Nov. 2019, www.cnbc.com/2019/11/05/manufacturers-struggle-in-rust-belt-regions-that-helped-trump-win.html.
Westneat, D. (2020, June 13). Coronavirus survival comes with a $1.1 million, 181-page price tag. Retrieved October 19, 2020, from https://www.seattletimes.com/seattle-news/inspiring-story-of-seattle-mans-coronavirus-survival-comes-with-a-1-1-million-dollar-hospital-bill/
Wouters, O. (2020, May 1). Lobbying Expenditures and Campaign Contributions by the Pharmaceutical and Health Product Industry in the United States, 1999–2018. Retrieved October 13, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054854/
Yabroff, R., Zhao, J., Han, X., & Zheng, Z. (2019, January 01). Prevalence and Correlates of Medical Financial Hardship in the USA. Retrieved October 13, 2020, from https://link.springer.com/article/10.1007/s11606-019-05002-w
Yang, A. (2019). Medicare for All — Yang2020 — Andrew Yang for President. Retrieved October 20, 2020, from https://www.yang2020.com/policies/medicare-for-all/
