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Single payer health care is a contentious issue in America. However, many people do not fully understand what a single-payer health care system would entail. This guide will present both the single-payer health care pros and cons so you can draw your own conclusion about this complex and divisive topic.
Understanding Single-Payer Health Care
In the recent election, Bernie Sanders coined the phrase, “Medicare for all.” But what does it mean?
If you are familiar with our health care system, you know that it relies heavily on the private sector. Even the Affordable Care Act, popularly known as Obamacare, uses private health insurance companies to offer government-regulated plans through a marketplace. However, there are still federally sponsored programs like Medicaid, CHIP, and Medicare that provide subsidized or free health care to those who qualify using taxpayer dollars. Bernie’s plan is to make these government programs available to everyone, not just those who are eligible under current laws.
Medicare for all and single-payer are synonymous. The end goal of both is to have the healthcare industry run and regulated by the government and take private health insurance companies out of the mix. This would be achieved by using taxpayer money to completely fund all medical costs in the US, giving everyone access to health care. It’s a controversial topic in the US, but this single-payer health care system has already been adopted by most developed nations. So the question remains,
"If so many other developed nations have adopted the single-payer health care system, then why is the US so hesitant to follow suit?"
To answer that question, let’s take a look at the pros and cons of a single-payer health care system.
Pros And Cons Of Single-Payer Health Care
Completely shifting the health care system in the US is no easy task. There are so many moving parts under the current system that even the slightest change in policy can set off a chain reaction, which is something we saw with the Affordable Care Act. There are valid arguments on both sides of this debate, so let’s take a look at what changing the makeup of health care in the US would mean.
Pro: Everyone Is Covered
Today, health care is not considered a right in the US (which is a debate within itself). The single biggest benefit of switching over to Medicare for all is that everyone has health coverage and access to the coverage they need without having to worry about the costs. According to Bankrate, a study from 2017 showed that more and more Americans are putting money ahead of medical attention. The study showed,"
“Older Millennials (ages 27-36) are most likely to forgo care due to cost, the survey shows. About 1 in 3 Americans in that age group say they’ve chosen not to seek needed medical attention because they couldn’t afford it.”
This highlights the current problem with health care in the US and is a fairly strong argument in favor of a single-payer system.
Pro: Healthier Population
According to a recent Gallup poll, just over 11% of the US population still doesn’t have health coverage. While the number may not seem significant, compare it with the 0% people without coverage in most other developed nations. When people don’t have coverage or access to quality coverage, they lose out on many benefits. Most importantly, preventive services.
When you are able to schedule appointments for preventive services regularly, your health will reap the benefits. Physicians, doctors, and most medical providers have the ability to catch unhealthy behaviors or conditions that may be coming on. It’s easier and more affordable to take measures to prevent a health condition than it is to treat one.
Pro: Better For Business
The majority of Americans have health insurance through their employer. Employer-sponsored coverage is actually mandatory under the Affordable Care Act if a company has 50 or more employees. For larger corporations, these additional costs may be feasible, but for many smaller companies, it can lead to financial ruins.
Under a single payer system, companies would not have to worry about providing costly benefits. Instead, businesses can focus on paying their employees more fairly.
Pro: Reduced Spending Per Capita
This one is argued on both sides, but let’s take a look at the US spending on health care per capita and compare it to other countries with a single-payer system.
|Country||Health Care Spending Per Capita||Ranking|
Right off the bat, you can see that the US spends significantly more on health care per capita than any other nation in the world. Granted the US has a larger population that is not as healthy as many other countries, so take this one with a grain of salt. Still, Most other countries with a single-payer system have found ways to spend less on health care than the US, so maybe there is something there.
Con: Significant Tax Hikes
The money has to come from somewhere, right? If you think you pay too much in taxes now, just imagine how much it would cost the government to provide health coverage to the entire population of the US.
Under the Medicare for all proposal, Bernie Sanders would be implementing a 2.2% tax on individuals who earn $200,000 or less per year, and families that earn $250,000 or less each year. The tax rate would increase for the higher earners, as well as bring on a 6.7% payroll tax for employers. Even though we mentioned single-payer health care may be beneficial for small businesses, under Bernie’s proposed health care plan, businesses big and small may find themselves struggling with these higher taxes, which could lead to a higher unemployment rate.
Con: Longer Wait Times
This is one of the main points of contention for opponents of a single-payer health care system. The Fraiser Institute conducted a study, spanning over two decades, to see how wait times are affected by a single-payer system. They took a look at Canada and found that in 2017, the average wait time after getting referred from your general practitioner to a specialist was about 21.2 weeks. That’s an increase from the 20 weeks it took in 2016, the previous year.
It’s going to be difficult, if even possible, to avoid long wait times under a single-payer health care system. Right now, the US has a pay to play system, unless you qualify for government assistance. If everyone had access to the same coverage, there would inevitably be more people seeking medical attention that there are now, which would create longer wait times.
Con: Reduced Government Funding
A single-payer health care system would be financially draining on the government. Not only would more money be distributed, but there would be additional costs and positions needed within the government to run and manage the healthcare sector. This would take funds away from other important programs like education and infrastructure.
Con: Eliminating Competition
A single-payer health care system doesn’t necessarily mean the death of competition, but it would definitely hurt it. Competition drives innovation, it’s the sole reason that the US has come so far in terms of science and technology. Every medical provider wants to have the newest and best medical technology to increase their profits, but what if there were no profits to drive competition?
The private sector has been behind some of the most innovative medical breakthroughs in recent history, and it’s likely we may not see similar advancements without it.
Whether you are for or against a single-payer health care system, it’s important to understand why people argue both sides. Both sides of the spectrum have valid pros and cons that need to be addressed. Hopefully, after reading this you are a bit more informed on the subject and are able to dig a little deeper to draw your own conclusion.