Why Single-Payer Universal Health Care Should Be Adopted in the United States
The Numbers Don’t Lie
Health care coverage and costs have become a hot button political issue in the United States recently, and with good reason. In 2019, nearly 23 million people in American were uninsured for health care, and another 64 million were underinsured (Bivens, 2020). Lack of affordability of coverage is one of the most common reasons for being uninsured. Health care costs, in general, are higher in the United States; the United States spends more per capita than other wealthy countries on health care, with nearly 17% of the country’s gross domestic product in 2016 utilized for health care (Doherty et al., 2020).
An often proposed alternative to today’s private, multi-payer health care system in the United States is a single-payer health care system, also referred to as Medicare for All. Key elements of a single-payer system include government financing, universal coverage with a comprehensive benefits package, elimination of private insurers, and negotiation of provider service and drug pricing. Two-thirds of Americans support universal health coverage through a national plan like Medicare for All. As of November 2019, there were two Medicare for All Act of 2019 legislative proposals in the US Congress: Senate Bill 1129 and House of Representatives Bill 1384 (Cai et al., 2020).
Though universal health care programs exist in 117 other countries around the world (World Population Review Countries with Universal Healthcare, 2020), many American politicians argue that such programs are either unnecessary or would be ineffective or economically unfeasible in the United States. This paper will review how adopting a single-payer universal health care system is economically feasible and would benefit the United States, by expanding health care coverage and access to all Americans, improving health outcomes, reducing health care costs, and supporting economic growth.
Single-payer universal health care would expand health care coverage and access to all Americans.
One of the most important benefits of adopting a universal health care policy in the United States would be the expansion of health care coverage and access to all Americans. The definition of universal health care from the World Health Organization’s world health report 2010 includes a health care system that enables all people to obtain the health services they need, and that the services are of sufficient quality to be effective, while also offering protection from financial hardship to those who need them. The goals of achieving effective health care coverage include reducing the gap between those in a country who need health services and usage of those services, and that services are of high enough quality to likely improve the health of those who use them (Kutzin, 2013).
With nearly 23 million Americans uninsured, and another 64 million underinsured in 2019 (Bivens, 2020), nearly one in three people in the United States either don’t have access to or can’t afford health care services they may need to survive and thrive. To combat this challenge, the American College of Physicians recommends the implementation of “a health care system where everyone has coverage for and access to the care they need, at a cost they and the country can afford.” This would include a health care system that eliminates social factors that contribute to inequitable health care, provides coverage for underserved populations, and ensures that no one is discriminated against based on personal identities, such as national origin, ethnicity, race, gender, sexual orientation, or religion (Doherty et al., 2020). By adopting a universal health care policy, the United States could expand health care coverage and access to everyone in the country, regardless of income or ability to pay for coverage. This would cover tens of millions of Americans who don’t have sufficient access to affordable health care today and greatly benefit everyone in the country by affecting health outcomes.
Single-payer universal health care would improve health outcomes for Americans.
Adopting a universal health care policy in the United States would significantly improve the health outcomes of millions of Americans. One of the ways this improvement can be measured is by evaluating life expectancy at birth. In 2018, a study was published by Frontiers in Pharmacology that explored the relationship between Universal Health Coverage (UHC) and life expectancy across 193 UN member countries. The analysis found that universal health coverage was associated with significantly increased life expectancy at birth across all member countries evaluated. According to the study, “There have been significant gains in life expectancy worldwide, with global life expectancy at birth (LEAB) increasing by 6 years (65–71) since 1990…Life expectancy at birth for low-income countries is now 62 years, compared to 79 years in high-income countries, and there is a 34 year gap between the lowest country (Lesotho, 50 years) and the highest (Japan, 84 years).” (Ranabhat et al., 2018). This means the average life expectancy at birth is 17 years higher in high-income countries with universal health coverage than in lower income countries without it.
Single-payer universal health care would reduce overall U.S. health care costs.
Another way that a single-payer, universal health care system would benefit the United States is that it would reduce health care expenses overall in the country. According to the Centers for Medicare and Medicaid Services, “U.S. health care spending grew 4.6 percent in 2019, reaching $3.8 trillion or $11,582 per person. As a share of the nation’s Gross Domestic Product, health spending accounted for 17.7 percent,” (Centers for Medicare & Medicaid Services Historical, 2020). Health care spending in the United States was also 25 percent higher than the second-highest health care spender, Switzerland, in 2016 (Johns Hopkins Bloomberg School of Public Health U.S. Health Care Spending, 2019). And those costs are only continuing to rise. “Insurance premiums, for example, rose 20% in 2019. Overall spending on prescription drugs rose more than 9% between the fourth quarter of 2018 and the fourth quarter of 2019 — the largest year-over-year change since 2015,” (Bivens, 2020).
Key takeaways:
In conclusion, adopting a single-payer universal health care system is both economically feasible, and would benefit the United States, by expanding health care coverage and access to all Americans, improving health outcomes, reducing health care costs, and supporting economic growth in the country. Many reputable organizations support the adoption of universal health care systems, including the World Health Organization, the Organization for Economic Co-operation and Development (OECD), and the American College of Physicians.
Beyond all of these compelling data-driven and economic arguments, adopting a single-payer universal health care system in the U.S., such as Medicare for All, is also the right thing to do morally. The question should not be whether or not to adopt such a policy in the U.S., but rather how. It won’t be easy. Overhauling a very complex health care system and radically changing the way it operates will require extensive research, experimentation, and solid, sustainable policy development. It will also require strong political support to be successful.
More than 100 countries already have universal health care systems and their citizens enjoy the benefits today. With millions of Americans uninsured and underinsured, and feeling the pressures and stresses of soaring health care costs, poor health outcomes, job insecurity, poverty, and even early death, implementing a single-payer universal health care system in the U.S. is long overdue.