Why Medicare Should Be Provided to All Citizens at an Affordable Price

For decades, the world has looked to The United States of America as a beacon of hope, liberty, and prosperity. As a global powerhouse, the citizens of our nation have enjoyed the privileges of living in a place where most can purchase both what they want and need to live an at least semi-comfortable life. On measure after measure, the U.S. is near the top of the pack on it’s citizens’ living standards and financial well-being. But where we fail terribly is our method of health insurance coverage. The United States’ healthcare system is inefficient, overly expensive, and in need of an overhaul. And so, I am proposing that the federal government provide a public option to most American’s health care plans by opening Medicare up to all citizens of the country.

First of all, we must take a look at a few of the reasons that the United States system of health insurance coverage is so very flawed. According to a 2014 study reported upon by Lenny Bernstein of the Washington Post, “the problems of our health-care system remain so pervasive that it will take more than better access and equity to resolve them” (2014). This assessment of the quality of the United States’ health insurance market can be viewed as a result of a number of factors. Now, it should be noted that the report cited in the Washington Post’s article was conducted before President Barack Obama’s Patient Protection and Affordable Care Act, also more commonly known as Obamacare, came fully into effect, therefore it is possible that the United States may finally begin playing catchup to the other modern nations that precede it in terms of overall coverage. Nevertheless, the report concludes that the U.S. “ranks behind most countries on many measures of health outcomes, quality, and efficiency. U.S. physicians face particular difficulties receiving timely information, coordinating care, and dealing with administrative hassles," (Bernstein, 2014). Furthermore, the United States places “26th out of 34 Organization for Economic Cooperation and Development member countries” in terms of Life Expectancy (Brodwin, 2014). This places the U.S, firmly viewed as western civilization’s economic powerhouse behind the likes of poorer nations such as Korea and Slovenia. Race plays a major role in determining the life expectancy of Americans, as African Americans can expect to live to the ripe age of 75, which is “the same life expectancy [that] white Americans enjoyed 30 years earlier in 1979” (Brodwin, 2014). Race and socio-economic status have been intertwined in the United States since its inception, and as such this statistic should not be surprising to many. But what should be surprising, is that the U.S lags behind many other developed countries, “ranking 29th globally in infant mortality, with the same rate of infant death as Slovakia and Poland” (Brodwin, 2014). America also spends the most on healthcare than any other developed nation, spending “[n]early a fifth of [it]’s gross domestic product [on] healthcare,” (Brodwin, 2014). One of the more alarming statistics noted in Erin Brodwin’s article is the fact that more Americans are dying from treatable diseases like Asthma than in nations such as Costa Rica and Brazil while also simultaneously sending more adults to be treated for the disease than any other developed country, with what Brodwin views as “the soaring cost of asthma medication in the US (a Qvar brand inhaler, for example, costs 18 times more in the US than it does in Greece) [to be] partially to blame for this problem (2014). Prescription drugs are exceptionally expensive in the United States, which spends a great percentage of it’s budget on pharmaceutical drugs. This stands in stark contrast to other developed nations “whose governments regularly haggle with pharmaceutical companies to reduce drug prices,” but which “Medicare is forbidden to do” (Brodwin, 2014). That is not even to mention the huge amount of money spent as a percentage of the United States’ GDP, with “[d]ata from the OECD show[ing] that the U.S. spent 17.1 percent of its gross domestic product (GDP) on health care in 2013.” Now, this chunk is reportedly “almost 50 percent more than the next-highest spender (France, 11.6% of GDP) and almost double what was spent in the U.K. (8.8%). U.S. spending per person was equivalent to $9,086” (Squires and Anderson, 2015). The absence of preventable care to a majority of the population is also a major issue in the consistent low-ranking of the U.S health care system. Brodwin asserts that “it has become to easy for Americans to opt out of vaccinations” which has in turn led to new outbreaks of preventable diseases such as “measles and Hepatitis B, especially among susceptible populations such as the young and the elderly” (2014). Doctors also fail to spend enough time with their patients “[i]n comparison to physicians in the Czech Republic, New Zealand, France and Israel, doctors in the US spend far less time consulting with patients and do a far worse job explaining to them what’s wrong” (Brodwin, 2014). As you can see from the many issues present in the system, the United States is far from successful in providing quality health care to it’s people. But it does not have to be this way, as there are other systems that have proven to work toward that goal.

There are various health insurance systems in many nations across the globe, with most resembling either that of Canada or the United States. For instance, most Americans are “insured through their employer, some are enrolled in a public insurance program whilst others buy insurance direct” (Limerick, 2012). These public run health insurance programs are owned by the government, with the two largest public insurance companies being Medicare and Medicaid, which provide coverage to the “elderly, poor, people with disabilities, end-stage renal disease and ALS – a form of motor neuron disease” (Limerick, 2012). In regards to private health insurance in the United States, the vast majority is provided through employer sponsored programs in which “the employer makes a contribution towards costs (around 85%) and the employee pays the rest” (Limerick, 2012). Limerick further explains that self-employed Americans such as business owners are provided with incentives and tax deductions in order to purchase their own health insurance” (2012). When it comes to hospitals, Mr. Limerick expounds on the fact that hospitals are either non-profits, government owned facilities, or privately owned. There are also “specialized medical centers and clinics in every state such as the John Hopkins Hospital which specializes in neurosurgery, pediatrics, cardiac surgery, urology, endocrinology and child psychiatry” (Limerick, 2012). Now, due to the disconnect between the different ways health care is provided in the United States, split between government and employer-based plans, there are millions of Americans that slip through the cracks. Most developed nations in the world, to combat this problem, have transitioned to single-payer systems such as in the United Kingdom, Norway, and Canada. Singe-payer health care “refers to a system in which one entity (usually the government) pays all the medical bills for a specific population and usually (though, again, not always) that entity sets the prices for medical procedures (Rovner, 2016). In one of his articles, Zeesham Aleem, who covers public policy and politics as Mic’s senior staff writer, explains the intricacies of the Canadian health insurance system in a relatively understandable way and contrasts it with that of the United States’ as well as a plan put forward by Democratic Presidential hopeful Bernie Sanders. He delves into how a single payer health care system could work in the United States and provides evidence as to why it would work in the form of Canada. Aleem asserts that single-payer is “a proven model for delivering universal coverage” with Canada having had “a single-payer system since the 1960s, [which] has proven to be an effective way to provide universal, high-quality health care for the population at nearly half the cost per person of the same care in the United States” (2016). He explains that [i]n the Canadian system, medical bills from physician and hospital services are covered entirely by the government” and also that “[h]ospitals are publicly funded, but doctors generally remain in the private sector — they're technically private independent contractors” (Aleem, 2012). It is this streamlining of the system by having a single entity pay for all insurance bills that “cuts down on administrative costs associated with the messy complex of profit-oriented insurance companies,” which could save you “at least 10% in terms of the total amount you spend on health care” just based on these administrative costs (Aleem, 2012). But perhaps the key feature of the Canadian health insurance system is its requirement of fixed prices, which means a standardization of services ranging from “[t]he amount doctors are paid, hospital stays, expensive diagnostic tests like MRIs and the cost of drugs” (Aleem, 2012). Aleem goes on to explain that these services are all on a government regulated price schedule, where “not only are those prices fixed, they're also set low” (2012). It is all but a forgone conclusion that the Canadian system is cheaper, provides better care, and is far more efficient than that of the United States. But can it be done in the U.S? As Aleem notes, “on a level of policy, it is entirely possible” (2012). It is within the realm of political plausibility that the problems emerge. This could be solved by the election of a Democratic President as well as supermajorities in both house of Congress reminiscent of the 111th Congress.

The United States has struggled with attempts to reform its health care system going all the way back to the second administration of President Harry Truman in the late 1940s, and has just recently undergone slight changes made by President Obama’s Affordable Care Act. But many, myself among them, feel that the ACA does not go far enough and so have proposed a different idea. My plan would be to convert the United States’ system to one that is roughly the equivalent of Canada’s. First of all, my plan would expand Medicare to include all individuals under the age of 65 under a plan that includes dental care, preventative, long-term, and emergency care, as well as prescription drugs. I call for the phasing out of private health insurance companies, as I feel that their very existence is counterintuitive to the very meaning of insurance. You are required to buy insurance to cover things that could happen within the realm of possibility, such as car accidents, fires, earthquakes, and floods. If there is one certainty in life, it is that eventually you will get sick and die. People deserve health care, not health insurance. My plan allows for nonprofit health maintenance organizations, also known as HMOs, that deliver care in their own facilities, but private insurance companies would mostly be replaced with a nationalized system for basic care. In regard to paying for the system, a bill proposed in every Congress since 2003 known as the United States National Heath Care Act would establish a trust fund to finance the program with amounts deposited:

(1) from existing sources of government revenues for health care; (2) by increasing personal income taxes on the top 5% of income earners; (3) by instituting a progressive excise tax on payroll and self-employment income; and (4) by instituting a small tax on stock and bond transactions. Transfers and appropriates amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the State Children's Health Insurance Program. These taxes would be paid instead of insurance premiums, as the government (instead of private insurance companies) would be paying for the care under this single-payer system (Conyers, 2009)

My plan would adopt such a system of payment, as well as call for the creation of a national board of physicians and administrators to provide advice on the quality and affordability of health care in the country. In a nutshell, what I am proposing would be a vast expansion of the federal Medicare program, paid for by 5% surtax on those Americans in the top 1% income bracket as well as a small increase in payroll taxes.

The United States is in need of a major overhaul of its present health care system, and what I am proposing does just that. The current health insurance industry is over expensive and inefficient. We as a nation can do a better job, and my plan does a better job by providing health insurance to every man, woman, and child in the United States.