Why the US needs a single payer health care system

As we near 5 months into this on-going pandemic, COVID-19 has truly exposed the cracks in the foundation of many of our infrastructures, especially our health care system in the US. Now more than ever you may be hearing for more calls for single payer health care, or the catch all phrase “Medicare-4-All”. So what is a single payer health care system? What does it look like in other countries, and why has it not been implemented in the US?

Single payer health care, very plainly, is having one public agency in charge of providing health care coverage to all its citizens. This eliminates the issues that arise in our health care system with billing, insurance, deductibles, and the astronomical administrative costs we see with our current health care system. Although several countries have a single payer system (South Korea, Canada, the UK, etc), it can look different in each place. For example, Canada’s single payer system covers all hospital and doctor visits, but does not include dental or vision. In South Korea, the single payer system is funded both through public and private means. Finally, the UK has the National Health Service, which lets the government provide health care to its citizens, while also employing doctors and hospitals.

So this sounds pretty great…why aren’t we doing this in the US already?

To put it quite plainly again, it all comes down to politics. The health care industry has become extremely politicized in the US, where a person’s coverage is usually tied to their place of employment. Because of the competitive nature of our health care system, this creates many moving parts with hundreds of different insurance companies offering (and lacking) many services. The biggest players, including pharmaceutical companies and insurance agencies, have immense lobbying power, thus making it very difficult to transition away from the current system. This sort of piece-meal way of offering health care is partially why Americans end up paying so much out of pocket, compared to other developed nations. A recent study found that of Americans who filed for bankruptcy in 2018, ~66% of bankruptcies were related to medical problems.

What would a single payer health care system actually look like in the US?

Ideally, having a single payer system here would allow much of our health care initiatives to be financed towards preventative public health causes, such as funding programs to prevent diabetes or heart disease very early on. The US spends more than any other developed nation on health care, yet does not provide universal coverage. With a single payer system, not only would the costs be reduced, but we would ensure a much healthier nation. The healthier we are, the more productive we will be, thus making room for more economic growth (and, of course, less people dying unnecessarily as they will no longer have to be denied coverage). Researchers from UCSF found that a single payer system would save us in costs, even in the long-run.

The researchers were able to estimate longer-term savings by using cost projections made in 10 of the models, which looked as far as 11 years into the future. These studies assumed that savings would grow over time, as the increases in healthcare utilization by the newly insured leveled off, and the global budgets adopted by single-payer systems helped to constrain costs. By the 10th year, all modeled single payer systems would save money, even those that projected costs would initially increase.

https://www.ucsf.edu/news/2020/01/416416/single-payer-systems-likely-save-money-us-analysis-finds

So as COVID-19 continues to plague our health care system, we must seriously consider alternative options to how we provide health care to begin with. No one should have to declare bankruptcy or die because they are not able to afford health care in the wealthiest nation in the world. By pushing our elected officials to vote in favor of a single payer system, the US may one day become a healthier nation where health care is seen as a civil right, and not as a privilege for the wealthy.

What are your thoughts on the US health care system and/or single payer health care? Leave a comment below!