The United States consistently ranks as one of the least effective healthcare systems in the developed world. When almost every other developed nation has some form of a national healthcare system, one will logically question the reasons why the United States has not taken steps to implement a similar system. When 27.9 million non-elderly Americans are uninsured in the nation that spends more money per-capita on healthcare than any other nation, there is clearly a problem with the current system (Cai et al. 2020). Comparatively, countries such as Germany spend drastically less per-capita and still ensure universal coverage to their citizens. Due to the absurd lobbying powers that pharmaceutical companies have, our current for-profit system has reigned supreme despite 56% of Americans favoring a national healthcare system (KFF 2020).
Within the last decade, policies such as Bernie Sanders’ Medicare for all have become increasingly prominent in American political dialogue. This conversation has been amplified in 2020 due to the upcoming election as well as the COVID-19 pandemic. As the pandemic has left millions of Americans out of work, studies have estimated that 5.4 million Americans lost their health insurance this year (Rummler 2020). Around 57% of Americans have employer-sponsored health insurance (Sonfield et al). This is a fundamental flaw in the American healthcare system that was exposed by the pandemic.
It has also become evident that racial capitalism has shaped many of the issues that minority groups face as a result of the pandemic (Laster 2020). Racial segregation, higher chances of contracting compounding illnesses that are affected by COVID-19, and limited access to additional resources have all negatively impacted the black and brown American communities. Health care is not only a human right but a necessity especially during a pandemic when Americans need access to it the most.
Prominent politicians such as President Trump have criticized a national healthcare system by stating that the cost would be significantly greater under a single-payer system than our current system. The media has also played a role in portraying universal healthcare as economically impractical. Christopher Cai and his research team wanted to assess whether a single-payer approach would be fiscally viable in their study published in January 2020 titled, “Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses.” Analyzing this study will give insight as to whether Trump and the media’s claims are accurate and whether advocating for a national healthcare system is worthwhile.
Cai and his team conducted a literature search between June and December of 2018. They gathered their research from surveying an expert panel and using web sources such as PubMed, Google, and Google Scholar. The researchers reviewed ninety studies and included analysis from government agencies, business consultants, research organizations, and academics. These sources analyzed the economic impact of twenty-two single-payer plans within the last thirty years. Through analysis of these studies, they found that the total savings of system costs when switching to a single-payer system ranged from 3.3% to 26.5%, with a median of 12.1%. They also found that there is nearly a consensus that a single-payer system would reduce healthcare expenditures while also providing quality healthcare to all Americans.
Of these economic systems analyzed, the largest savings occurred when plans included reductions in drug costs. Per capita, the United States spends more money on drugs than any other country, spending $1,011 annually compared to an average of $422 (Cai et al 2020). An example of this is Truvada, an HIV drug where Americans spend roughly $2000 per month while Sweden’s citizens pay only $20 (Salzman 2019).
Cai was careful with their methodology as they explained explicitly why the studies they looked at were used and why some information was excluded. Some of the limitations that they listed may have impacted the accuracy of the results. For example, they state that they did not apply quality rating scores to the economic studies that were included. They also state that there is no empirical data to support their results as the United States has never implemented a single-payer system. This study could be improved in the future by analyzing a single-payer system if it were to be implemented in the coming years. Cai and his team could have done more extensive research to ensure that the methodology of every study they include is appropriate and yields accurate results.
Health care is a human right. When the wealthiest nation in the world fails to provide all of its citizens with a human right, there is a problem that must be solved. When citizens have access to the care that they need and deserve, quality of life improves drastically. Stripping away the financial strain of medical bills would keep more Americans out of poverty and allow them to pursue interests and careers. Democratic candidate Joe Biden claims that he will protect and expand upon the Affordable Care Act, yet has also stated that he would veto a national healthcare bill. Until all Americans are guaranteed their right to healthcare, it is critical that Americans put pressure upon their politicians and continue to fight for the good of the people, not profits.
Cai C, Runte J, Ostrer I, Berry K, Ponce N, Rodriguez M, Bertozzi S, White JS, Kahn JG. 2020. Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine. [accessed 2020 Aug 31] https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003013#sec014. doi:https://doi.org/10.1371/journal.pmed.1003013
[KFF] Kaiser Family Foundation. 2020. Public opinion on single-payer, national health plans, and expanding access to medicare coverage. [accessed 2020 Sep 16] https://www.kff.org/slideshow/public-opinion-on-single-payer-national-health-plans-and-expanding-access-to-medicare-coverage/
Laster Pirtle WN. 2020. Racial capitalism: A fundamental cause of novel Coronavirus (COVID-19) Pandemic Inequities in the United States[PB1] . SAGE Public Health Emergency Collection. [accessed 2020 Aug 31] doi:10.1177/1090198120922942
Rummler O. 2020. Study: 5.4 million Americans lost health insurance this year. US: Axios. [accessed 2020 Sept 8] https://www.axios.com/coronavirus-health-insurance-south-b6ddcea8-837d-42e6-ae2f-0370da0c1b4e.html
Salzman S. 2019. What does PrEP cost outside the United States? TheBody. [accessed 2020 Sept 16] https://www.thebody.com/article/what-does-prep-cost-outside-the-united-states
Sonfield A, Frost J, Dawson R, Lindberg L. 2020. COVID-19 job losses threaten insurance coverage and access to reproductive health care for millions. HealthAffairs. [accessed 2020 Sept 8] https://www.healthaffairs.org/do/10.1377/hblog20200728.779022/full/
Stolberg S. 2020. Millions have lost health insurance in pandemic-driven recession. New York Times. [accessed 2020 Aug 31] https://www.nytimes.com/2020/07/13/us/politics/coronavirus-health-insurancetrump.html
Second Thought. 2020. Why American Healthcare Is The Worst In The Developed World. YouTube. https://www.youtube.com/watch?v=wO1IoKN0AkY