America’s Broken and Politicized Healthcare
America spends nearly twice as much per person on healthcare as our peer nations, such as the European Union, Australia, and Japan. This spending gets us fewer doctor visits, shorter life expectancies, higher maternal and infant mortality rates, higher rates of death from preventable causes, and, contrary to the never-ending stream of misinformation, longer wait times for care as well.
We continue to act like the debate over healthcare is whether to have it under the control of corporations or the government. Not only has that debate been had, but solutions have been enacted around the world, and the results are in: Universal healthcare provides the highest accessibility, the lowest costs, and the best outcomes. And again, contrary to the myth, the average wait time in our peer nations with universal healthcare is lower than in the US.
Universal healthcare does not mean it has to be a single-payer system, that everything is free, or that everything is covered. It means that every citizen has access to a standard level of care, the government sets or negotiates prices for services and prescriptions, insurance companies are regulated, and profit-making is limited for basic and necessary care.
Universal healthcare is the understanding that accessible healthcare is for the public good. The only debate remaining is which approach to universal healthcare is right for the United States.
The current government shutdown highlights the differing views of the two parties on healthcare.
Expiring Affordable Care Act subsidies for premiums will cause healthcare costs to skyrocket for over 20 million Americans, and cuts to Medicaid in the Republican “One Big Beautiful Bill,” which will cause another 14 million to lose coverage over the next decade.
Democrats want to reverse the cuts and extend the subsidies. As a party, they’ve given up on pursuing the single-payer system they once championed and have instead focused on incremental improvements to Medicaid and Medicare, as well as making increased ACA subsidies permanent to make healthcare more affordable.
Republicans made the cuts to Medicaid and do not want to extend the ACA subsidies, despite more Republican voters than Democratic voters relying on them. They blame the current issues on the ACA, which they attempted to repeal in the past but now admit is no longer an option due to how many Americans rely on it.
While the ACA did not go far enough, it did improve many aspects of healthcare:
It stopped companies from denying insurance for people with preexisting conditions.
It mandated a standard level of care for all insurance plans.
It eliminated annual and lifetime caps for healthcare insurance.
It requires preventative care coverage, often at no cost, which reduces overall healthcare costs by detecting issues earlier when they are easier and less expensive to treat.
It reduced the uninsured rate from 14.5% in 2013, the year before it took effect, to 7.9% in 2023.
It achieved all of that while causing premiums to increase at a slower rate than before the ACA was enacted.
Any politician attempting to blame the ACA for our current healthcare issues is either woefully misinformed or is shamelessly trying to play partisan politics to distract from their own failings on healthcare. The ACA didn’t create the problems; it solved some, reduced others, and delayed the inevitable need for a better, more comprehensive solution. The time is up. We need to take the next step.
Which approach will we take?
Single-Payer
Canada and the United Kingdom are two examples of single-payer systems and are routinely ranked among the top 10 nations for healthcare.
Single-payer means that the government uses taxes to cover healthcare for all of its citizens. The government sets the rates and pays the bills. Those payments can go to private hospitals and doctors, or, as in the UK and Canada, the government also runs hospitals to administer the care it pays for.
Both Canada and the UK allow people to purchase private insurance, which grants them access to private hospitals that help them bypass wait times or provide services not covered by the public healthcare system, such as elective surgeries.
Multipayer
Germany and the Netherlands are examples of multipayer healthcare systems that are also ranked among the top 10 nations for healthcare.
Germany mandates that all citizens have healthcare and uses a system of highly regulated sickness funds paid for by personal and corporate taxes. High-income earners can opt out of the system to use private insurance instead.
The Netherlands also requires all citizens to purchase healthcare through private insurers, which must accept all applicants and compete for customers. The healthcare system is regulated by the government, which also pays subsidies to make insurance more affordable.
Germany typically has lower out-of-pocket costs for routine care, while the Netherlands has an annual deductible similar to many American health insurance plans.
Hopefully, you can see how these healthcare systems are not drastically different from what the US uses today. They do have key aspects missing from America’s approach, such as government regulation of healthcare costs, limiting profit-making on necessary care, and requiring or providing healthcare for all citizens.
So why do we act like Universal Healthcare is some alien system so foreign to our own that would be catastrophic to implement?
The over $1 billion in lobbying from healthcare companies every year is a big reason. $155 million is from health insurance companies, with Blue Cross/Blue Shield spending over $20 million in 2024 alone.
Politicians from both sides also see heavy investment from healthcare companies into their campaigns, particularly once they run for President.
The only way this situation changes and America finally gets an accessible, affordable, quality healthcare system is for voters to make the midterms and next presidential election a referendum on healthcare. The politicians who promise to back a realistic healthcare plan with details are elected and held accountable in the next election if they fail to deliver.
It is time to vote for our best interests.
https://www.opensecrets.org/political-action-committees-pacs/industry-detail/H/2024
Redirect Your Anger
Americans are frustrated at the difficulty of making ends meet. Campaign promises about tackling inflation, lowering prices, mass deporting migrants, and using tariffs to solve our problems likely won one of the closest presidential elections in US history.