This article was a winner of the Medicare for All scholarship opportunity. It contains one essay arguing for the implementation of Medicare For All.
Medicare for All is a public health insurance plan that has been put forward in the United States by notable Democratic senators including Bernie Sanders but the concept of a tax-financed single payer healthcare scheme is nothing novel and exists in many forms around the world. The question of free public healthcare is not just an economic one, but a moral and social obligation that should be an integral part of society similar to the police or army. This essay will aim to deconstruct the flaws with the current system and how Medicare for All could address these problems and illuminate a brighter future for America.
The current US healthcare system is globally regarded as one of dysfunction with per capita healthcare government spending at $8160, nearly twice as much as other industrialised countries. Despite this immense spending in a private system nearly 51 million Americans are uninsured and many others are inadequately covered. Estimates from the US National Library of Medicine suggest that over 26,000 Americans die every year due to a lack of health insurance. The COVID-19 pandemic has further illustrated the systemic issues that permeate the US healthcare system with some of the poorest handling of cases and vaccination rollout in the developing world. Evidently, there is a major issue with the current system and Medicare for All could help to majorly reduce inequality in treatment and vast differences in treatment quality from hospital to hospital.
The major issue that a single payer system would solve is that it will bring badly-needed coverage to low income families and will help sustain an increasingly ageing population. The poorest members of our society are not any less human and have the same right to live and be treated equally. Especially when those that are disadvantaged tend to be racially oppressed minorities. Relieving the economic and mental stress of medical insurance would alleviate the 66.5% of bankruptcies in the U.S. were due to medical issues such as high fees and time lost from work. There is also the indirect effect of reducing risk and encouraging spending and innovation by individuals without worrying that a broken bone could make them homeless.
Another issue that Medicare for All helps to tackle are exorbitant drug prices. The government could use significant leveraging powers to reduce drug price by up to 80%. The development of the Covid vaccine is a perfect demonstration of how public investment and pressure can help provide astonishing results with development of a vaccine in record times. A common argument against Medicare for All is the suggestion that a public system would curtail innovation but if we examine the current situation of pharmaceutical companies there is a flaw in incentives. Why would private companies invest in helping people, and making drugs cheaper if they are directly profiting off the illness. Why cure diabetes, if you can make insulin tablets that generate $350 per bottle. In fact there is a developed foundation of theoretical work that shows the faults of a private healthcare system. The argument stated that it is insurance that is inefficient and inherently regressive due to adverse selection. The lowest income households are most likely to have healthcare problems and are forced to pay much higher insurance premiums than those who can afford to pay for it and this leads to a cycle of poverty and wealth inequality. Or in some cases people choose not to use healthcare and end up using the emergency ward as their only treatment.
Having established some of the social arguments for Medicare for All, what would the economic cost be of such an undertaking? Currently US’s private insurers spend nearly one third of every dollar on administrative costs such as underwriting, marketing and huge executive salaries. A single payer health insurance scheme would drastically reduce this cost by an estimated $400 billion every year. In terms of overall cost, the most recent analysis from the Urban Institute estimated it would require $59 trillion in funding over a decade. Under the current system the equivalent figure would be just less at $52 trillion. The figures are debatable but consistently show that the cost is not an astronomical difference and if there is an increase in tax to fund this over 60% of Americans say they would not mind if it gave them free healthcare and peace of mind. Medicare for All would also bring plenty of positive externalities. It is estimated that the increased demand for healthcare would create 2.6 million jobs and infuse $100 billion in wages into the US economy.
To conclude, the Medicare for All system is by no means perfect, and there is the serious risk that the quality of healthcare will fall significantly if there is a too sudden change in systems. However, if these issues are appropriately dealt with by management and government budgeting early on, the country should be able to pivot like the other 32 developed countries that have universal healthcare. Overall Medicare for All will drastically reduce wealth and health inequality, reduce unnecessary bureaucratic costs and promote medical innovation.
Bibliography (cited sources):
Falan, S.L., Han, B., Zoeller, L.H., Tarn, J.M. and Roach, D.M. (2011). Sustaining Healthcare Through Waste Elimination. International Journal of Healthcare Information Systems and Informatics, 6(4), pp.1–22.
UKEssays. November 2018. Single Payer Healthcare System In The Us Economics Essay. [online]. Available from: https://www.ukessays.com/essays/economics/single-payer-healthcare-system-in-the-us-economics-essay.php [Accessed 2 February 2021].
Tanne, J.H. (2008). More than 26 000 Americans die each year because of lack of health insurance. BMJ, [online] 336(7649), pp.855.2-855. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323087/#:~:text=PMID%3A%2018420687-,More%20than%2026%20000%20Americans%20die%20each,of%20lack%20of%20health%20insurance [Accessed 2 Feb. 2021].
Konish, L. (2019). This is the real reason most Americans file for bankruptcy. [online] CNBC. Available at: https://www.cnbc.com/2019/02/11/this-is-the-real-reason-most-americans-file-for-bankruptcy.html#:~:text=A%20new%20study%20from%20academic,and%20bills%2C%20the%20research%20found. [Accessed 31 Jan. 2021].
Natap.org. (2016). “The absurdly high cost of insulin” - as high as $350 a bottle, often 2 bottles per month needed by diabetics. [online] Available at: https://www.natap.org/2019/HIV/052819_02.htm [Accessed 2 Feb. 2021].
BBC News (2019). Medicare for All: Can Bernie Sanders overhaul US healthcare? [online] BBC News. Available at: https://www.bbc.co.uk/news/world-us-canada-47821997 [Accessed 1 Feb. 2021].
Holahan, J. and Blumberg, L. (2018). Estimating the Cost of a Single-Payer Plan. [online] . Available at: https://www.urban.org/sites/default/files/publication/99151/estimating_the_cost_of_a_single-payer_plan_0.pdf.
Kiley, J. (2018). Most continue to say ensuring health care coverage is government’s responsibility. [online] Pew Research Center. Available at: https://www.pewresearch.org/fact-tank/2018/10/03/most-continue-to-say-ensuring-health-care-coverage-is-governments-responsibility/ [Accessed 3 Feb. 2021].
https://www.thenation.com/authors (2009). Single-Payer Health Care Would Stimulate Economy. [online] The Nation. Available at: https://www.thenation.com/article/archive/single-payer-health-care-would-stimulate-economy/ [Accessed 4 Feb. 2021].
Bibliography (Other sources):
Oecd-ilibrary.org. (2019). Health expenditure per capita | Health at a Glance 2019 : OECD Indicators | OECD iLibrary. [online] Available at: https://www.oecd-ilibrary.org/sites/876d99c3-en/index.html?itemId=/content/component/876d99c3-en [Accessed 1 Feb. 2021].
Institute for Health & Socio-Economic Policy (IHSP) (2009). Single Payer/Medicare for All: An Economic Stimulus Plan for the Nation
Medicare for All: Pros and Cons — The Thread (2020). The Thread. [online] The Thread. Available at: https://www.thethreadweekly.com/news/medicare-for-all-pros-and-cons [Accessed 31 Jan. 2021].
Healthcare-NOW (2020). Free Market Arguments against Medicare for All – Healthcare-NOW! [online] Healthcare-now.org. Available at: https://www.healthcare-now.org/blog/free-market-arguments-against-medicare-for-all/ [Accessed 1 Feb. 2021].
Weedston, L. (2020). Medicare For All: Common Arguments Against And Rebuttals. [online] Medium. Available at: https://lindseyweedston.medium.com/medicare-for-all-common-arguments-against-and-rebuttals-16384a8dfb43 [Accessed 2 Feb. 2021].
Rothchild, A. (2020). Coronavirus: A good argument for Medicare for All. [online] The Seattle Times. Available at: https://www.seattletimes.com/opinion/coronavirus-a-good-argument-for-medicare-for-all/ [Accessed 30 Jan. 2021].
Golshan, T. (2019). The 4 fights that make up the Medicare-for-all debate. [online] Vox. Available at: https://www.vox.com/policy-and-politics/2019/11/4/20948117/warren-sanders-medicare-for-all-cost-voxcare [Accessed 4 Feb. 2021].
Comments