Sen. Bernie Sanders, an independent from Vermont, has presented a replacement to our nation’s fundamentally flawed health care system that would result in a radical change. Sanders has openly expressed healthcare is a moral and economic issue. In his “Medicare-for-All” proposal, all Americans would be covered by a publicly funded, single-payer health care system. Instead of having thousands of health care payers paying different prices for the same treatment at play, the government as a single-payer entity would be responsible for all medical expenditures.
Under Sanders’ “Medical-For-All” initiative, patients would no longer have to pay rising insurance premiums and would be exempt from being charged co-pays at doctor appointments. Sanders’ all-inclusive health care plan would cover doctor visits with your primary care physician, hospital stays, lab work, medical devices, maternity and newborn care. Theoretically, Sanders’ proposal would depreciate the uninsured rate from 8.8 percent to just over zero. A single-payer system would dramatically decrease administrative and advertising, which would relatively decrease the cost of health care. While the enactment of Sanders’ “Medicare for All” health care legislation is highly unlikely to even pass in the Senate, due to a 52 to 48 political party divide, Sanders has remained resolute that his proposed health care plan would mend our broken system in time by expanding coverage, providing a beyond satisfactory health benefits package and lowering costs.
The United States spends around 18 percent of our total GDP on healthcare- that is about $10,000 per person. As a nation, we spend twice as much of our economic output than any other industrialized country on medical care, and yet we continually yield health outcomes below standard in many metrics including infant mortality, life expectancy and overall efficiency. Our country’s systemic healthcare failures raises the question of how can we continue to invest trillions of dollars into health care and still not provide universal access to premium quality medical treatment? Morally, it would be more efficient to place funds into a single payer healthcare system and ensure all in the U.S. have access to a good quality of life.
Kevin Thompson, a philosophy professor at DePaul, said, “I believe that single-payer healthcare is morally obligatory because, unlike market-based or other multi-payer systems, only single-payer healthcare genuinely meets the moral burden of guaranteeing access to healthcare for all.”
Thompson’s ethical perspective upholds the United State’s moral obligation to adopt a universal healthcare plan. Quality healthcare must shift from the current, flawed system to one that supports quality healthcare for all.
Sanders’ comprehensive universal health care proposal would fulfill the moral obligation we have to providing universal access to medical services and ensuring all our citizens’ needs are met, but at what cost?
Sanders has not clearly defined how the Medicare expansion would be financed. Under a publicly funded insurance entity, however, we could expect an increase in taxes as compensation for universal coverage.
In 2014, Sanders’ home state of Vermont attempted to implement a single-payer system. However, the government-funded local health care plan collapsed when they had to increase payroll taxes to a rate of 11.5 percent and income taxes to a rate of 9 percent. For a single-payer system to work, we need to accept the possibility of higher taxation if we want to prioritize universal coverage.
“Anything that provides more coverage to more people is a good thing in my book,” said political science professor Molly Andolina. “But it is not without its tradeoffs and we need to have an open and frank discussion about what they are.”
Sanders holds a firm belief that adopting a single-payer system is a cost-effective approach to expanding healthcare coverage and eliminating profiting private insurance companies. Countries like Canada and the United Kingdom work under a single-payer system, providing universal healthcare coverage at a minimal cost. Their publicly funded and government-sponsored insurance are documented successes, despite their inefficiencies.
The U.K.’s government-funded insurance covers all of its citizens, however, at the cost of higher taxes to finance their single-payer system. Canada’s health care system is identical to our Medicare program that provides coverage to U.S. citizens over the age 65, but provides health insurance to all of its citizens at the expense of timely health care treatment reflected in significantly longer wait times. When it comes to health care reform, not everyone comes out victorious. Unfortunately, sacrifices must be made in order to provide universal access to quality medical treatment.
“At this time, a single-payer system is not a step in the right direction. The vreason I am against single-payer system is that there are not enough resources and capital at this point to take care of 325 million citizens,” said professor and co-director of MS program in economics Robert Kallen. “There are only so many hospitals, adequately trained healthcare providers and finite number of resources. Those healthcare facilities are at their max and cannot handle anymore inputs.”
As a nation, how do we decide what care 325 million Americans are entitled to? How do we decide who receives the kidney transplant that would save their life? How do we make life-altering decisions under scarce resources? If the U.S. were to adopt a single-payer health care system offering universal access, Andolina said, “we have to decide that we pay more via taxes or we cover less in terms of what kind of care is covered.”
A single-payer system entrusts the government with the power to decide what medical care would be covered and accessible to all citizens. With limited resources available, elected leaders would be forced to cut corners and provide minimal basic coverage. Consequently, citizens who once were covered under employee-based insurance would be forced to shop elsewhere (for-profit private insurers) for complete coverage and peace of mind. On paper, a single-payer system seems like a quick fix to our systemic structure inefficiencies. However, if implemented, we need to fully acknowledge and address access, quality and cost in order to make any progress.
To truly fix health care in the U.S., the government must consider all options.
“We should take the Affordable Care Act and amend it incrementally. It is far from perfect, but a good platform to start from,” Kallen said. “As a nation, we need to divide and conquer incrementally.”
GOP senate leaders, Bill Cassidy and Lindsey O. Graham, have introduced their own piece of legislation coined as the Cassidy-Graham Health care Bill to repeal and replace Obamacare. The Senators proposed that funds financially supporting Obamacare expansion be reallocated and distributed across states in the form of “blocked grants” to subsidize the dire healthcare demands of their state population.
With the state aid provided by the government, it grants states the freedom and flexibility to adopted market-based or government-centered healthcare structures tailored to their state population. However, their proposal grants states immunity that eliminates government regulations and withdraws from price protection for American’s with pre-existing conditions.
While the GOP health care legislation appears as a practical and plausible solution to our health care’s systemic failures, there are obvious tradeoffs that may cause us to reconsider its effectiveness. Health care has forever been a contentious issue among Democrats and Republicans, however there is a sense of urgency to repeal and replace Obamacare in the White House. We are already seeing health care legislation set to replace Obamacare sooner rather than later.
Adopting the purest form of socialized medicine, single-payer health care and replacing Obamacare entirely is not a simple solution to our current inefficient and bureaucratic system. As a united front, we need to accept that tradeoffs are an inevitable element of health care reform.