The United States already has universal health care for some. The government should expand the system to protect everyone.
A national health insurance is a universal health care that “uses public insurance to pay for private-practice care. Every citizen pays into the national insurance plan. Administrative costs are lower because there is one insurance company. The government also has a lot of leverage to force medical costs down,” according to economic expert Kimberly Amadeo. Canada, Taiwan, and South Korea all have national health insurance. In the United States, Medicare, Medicaid, and TRICARE function similarly. [178]
Medicare is the “federal health insurance program for: people who are 65 or older, certain younger people with disabilities, [and] people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).” Patients pay a monthly premium for Medicare Part B (general health coverage). The 2023 standard Part B monthly premium is $164.90. Patients also contribute to drug costs via Medicare Part D. Most people do not pay a premium for Medicare Part A (“inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care”). More than 65.3 million people were enrolled in Medicare according to Feb. 2023 government data. [180] [181]
Medicaid “provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.” More than 84.8 million people were enrolled in Medicaid as of Nov. 2022. [181] [182] [[182] [[[186]
If the government can successfully provide universal health care for 36% to almost 50% of the population, then the government can provide univeral health care for the rest of the population who are just as in need and deserving of leading healthy lives.
Pro 2
Universal health care would lower costs and prevent medical bankruptcy.
A June 2022 study found the United States could have saved $105.6 billion in COVID-19 (coronavirus) hospitalization costs with single-payer universal health care during the pandemic. That potential savings is on top of the estimated $438 billion the researchers estimated could be saved annually with universal health care in a non-pandemic year. [198]
“Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations. This shift to single-payer health care would provide the greatest relief to lower-income households,” conclude researchers from the Yale School of Public Health and colleagues. [201]
According to the National Bankruptcy Forum, medical debt is the number one reason people file for bankruptcy in the United States. In 2017, about 33% of all Americans with medical bills reported that they “were unable to pay for basic necessities like food, heat, or housing.” If all Americans were provided health care under a single-payer system medical bankruptcy would no longer exist, because the government, not private citizens, would pay all medical bills. [131]
Further, prescription drug costs would drop between 4% and 31%, according to five cost estimates gathered by New York Times reporters. 24% of people taking prescription drugs reported difficulty affording the drugs, according to a Kaiser Family Foundation (KFF) poll. 58% of people whose drugs cost more than $100 a month, 49% of people in fair or poor health, 35% of those with annual incomes of less than $40,000, and 35% of those taking four or more drugs monthly all reported affordability issues. [197] [199] [200]
Additionally, 30% of people aged 50 to 64 reported cost issues because they generally take more drugs than younger people but are not old enough to qualify for Medicare drug benefits. With 79% of Americans saying prescription drug costs are “unreasonable,” and 70% reporting lowering prescription drug costs as their highest healthcare priority, lowering the cost of prescription drugs would lead to more drug-compliance and lives not only bettered, but saved as a result. [197] [199] [200]
Pro 3
Universal health care would improve individual and national health outcomes.
Since 2020, the COVID-19 pandemic has underscored the public health, economic and moral repercussions of widespread dependence on employer-sponsored insurance, the most common source of coverage for working-age Americans…. Business closures and restrictions led to unemployment for more than 9 million individuals following the emergence of COVID-19. Consequently, many Americans lost their healthcare precisely at a time when COVID-19 sharply heightened the need for medical services,” argue researchers from the Yale School of Public Health and colleagues. The researchers estimated more than 131,000 COVID-19 (coronavirus) deaths and almost 78,000 non-COVID-19 deaths could have been prevented with universal health care in 2020 alone. [198]
Another study finds a change to “single-payer health care would… save more than 68,000 lives and 1.73 million life-years every year compared with the status quo.” [201]
Meanwhile, more people would be able to access much-needed health care. A Jan. 2021 study concludes that universal health care would increase outpatient visits by 7% to 10% and hospital visits by 0% to 3%, which are modest increases when compared to saved and lengthened lives. [202]
Other studies find that universal health coverage is linked to longer life expectancy, lower child mortality rates, higher smoking cessation rates, lower depression rates, and a higher general sense of well-being, with more people reporting being in “excellent health.” Further, universal health care leads to appropriate use of health care facilities, including lower rates of emergency room visits for non-emergencies and a higher use of preventative doctors’ visits to manage chronic conditions. [203] [204] [205]
An American Hospital Association report argues, the “high rate of uninsured [patients] puts stress on the broader health care system. People without insurance put off needed care and rely more heavily on hospital emergency departments, resulting in scarce resources being directed to treat conditions that often could have been prevented or managed in a lower-cost setting. Being uninsured also has serious financial implications for individuals, communities and the health care system.”