Healthcare has been a hot topic of debate, especially since Bernie Sanders announced his intentions to lower the qualifying age of Medicare to 55 from 65, so now is a great time to talk about public healthcare and medicine. I first took an interest in the topic after taking actuarial and insurance classes and finding out that single-payer/universal healthcare options would be over 25% cheaper than the public-private options we have in the U.S. today. Government healthcare should stretch beyond coverage for visits to the doctor’s office and cover everyone equitably including physical, mental, dental, and all medically necessary products like wheelchairs and prescriptions. There are multiple types of government-sponsored health insurance plans with varying degrees of social and economic equity involved.
The current healthcare marketplace is a disaster for individuals uncovered by plans hosted by their employer or as a dependent under another family plan. Unsubsidized plans start around $400 out of pocket per person per month, and the cheapest plans usually have the highest deductibles. In other words, policyholders of cheap plans always pay a higher upfront cost at the doctor’s office or hospital than those with more expensive options. Even if you are fortunate enough to be classified as a dependent on a parent’s insurance or be on a plan provided by your employer, the employer might cover some cost of the plan, but the policyholder is still on the hook for hundreds of dollars a month to maintain coverage. As a result of exuberant expenses, over 20 million Americans rely on government assistance through the Affordable Care Act for coverage and another 25 million are uninsured altogether.
The sheer fact that government-assisted insurance exists doesn’t imply any degree of fairness between public and private coverage. Private insurers negotiate and agree upon prices for procedures and products by provider, meaning coverage and cost vary widely depending on the insurer. In true American fashion, insurance provided by the federal government is void of adequacy and leaves policyholders with copays/deductibles so high that they often elect to forego treatment because they still can’t afford it. The lack of adequacy in public healthcare is necessitated and perpetuated by private healthcare industry participants that spend billions annually lobbying for inferior public options.
While competition sounds good and ‘BrEeDs InNoVaTiOn’ as the capitalists say, the reality is the healthcare industry relies on product scarcity and necessity to make money more than innovation. Creating a government-sponsored, single-payer healthcare system eliminates the need for countless dollars in healthcare to go towards lobbying, administrative expenses, and profits for shareholders. There are three types of government healthcare systems: mandatory private coverage (Obamacare), public insurance to cover private practitioners (Medicare For All), and nationalized healthcare (the government owns/operates/provides all care and care facilities provided to people).
Funding any government insurance/healthcare scheme undoubtedly comes with a tax increase, especially for top earners, but that’s not to say there will be less money in your pocket at the end of the day. It is possible to create a cash flow model to fund government healthcare, but because that’s far too intricate for you or me to understand (and much too long to include in an Ethanomics piece), trust me on this one. According to the Bureau of Labor Statistics, employers pay an average of 67% of premiums for the health insurance provided to employees, or $13,717 per full-time employee per year and the employee pays the other $6–7k per year out of pocket. Introducing universal healthcare increases taxes but would eliminate $20,000 of expenses annually between employee and employer to invest, spend, or create more jobs.
Healthcare is a fundamental human right and more clearly than others because without it we literally CAN NOT live. Tying insurance (and other healthcare services) to some capitalistic measurement like the ability to hold a job or wealth implies people who don’t have jobs or adequate wealth are undeserving of the same right to life as wealthy counterparts. It is essentially the same as saying someone deserves an expensive procedure because they can make money but another person deserves suffering/death because their capitalistic value is less. Advocating for universal healthcare is a social good that won’t undermine the quality of care but provide top care to everyone regardless of their ability to pay.