Since President Truman’s administration, Americans have wrestled with an essential question: How large a role should the government play in the American healthcare market? Though the fundamental issues are no different than 60 years ago, political rhetoric has clouded debate. Now more than ever, it is important to cut through the ideation and see how real people are affected by policies debated in Congress.
I grew up in a military family. One of the benefits the Department of Defense provides military families is Tricare, which gives them access to wide-ranging healthcare coverage– essentially comprehensive, government-provided insurance.
This coverage became critical in 2014 when my mom was diagnosed with cancer. The first medical procedure my mom underwent was a robotic surgery with a da Vinci robot, which costs around $400,000. Had my family been uninsured, we could have only afforded the necessary surgery if we had dipped into my college fund. I will forever be grateful my family never had to make the choice between healthcare and higher education.
Americans have an immutable right to “Life, Liberty, and the Pursuit of Happiness.” Our founders swore this country would protect basic rights, including the right to life. As America has evolved, this right to life has become a right to healthcare. When people are stranded without care, they live in an eternal state of hope. They hope there is not a stroke in the family; they hope they do not get cancer they cannot afford to treat; they hope that they never have to make the choice between treating a relative’s heart disease and paying for essentials.
Today, roughly fifty percent of Americans receive health insurance through their employer. In a society built on the free market, this seems like a reasonable solution to health insurance: firms compete for labor by offering benefits to their employees such as quality healthcare. Republicans increasingly support this plan: leave healthcare coverage to employers, keep the government uninvolved. Our tax policy has further encouraged employer-based healthcare. Through employer-sponsored insurance exclusion, employer-paid premiums are exempt from state and federal taxes. The Tax Policy Center estimates that the employer-sponsored insurance exclusion costs the federal government $260 billion a year. Thus, it is sensible for firms to provide their employees with health insurance.
However, this system has significant flaws. When millions lose their jobs, insurance, and livelihood, the government increases its presence. According to the Federal Reserve, there was a dramatic increase in spending for Medicare and Medicaid during the Great Recession. As businesses cut costs, jobs, and benefits, the federal government acted as a backstop for Americans who were employed, but were let go through no fault of their own. An estimated $260 billion in tax breaks for healthcare that only works when the economy is booming. That cannot be the system America entrusts to keep its citizens healthy.
There is a solution that draws from my own experiences with Tricare: “Medicare for all.” Americans’ access to insurance should not be tied to the business cycle, where a simple downturn leads to millions more uninsured. The government should not have to foot the bill for millions of Americans’ healthcare after already doling out billions in tax breaks to firms who were supposed to cover that healthcare in the first place. The answer is simple: cut out businesses.
Inefficiency dominates American healthcare because of the piece-meal nature of the system. Fifty percent of Americans receive coverage through their employer while another forty percent receive it through Medicare and Medicaid. Ten percent have absolutely no coverage. So imagine a young person enters the job market and receives insurance through his employer. Then he is laid off and goes on Medicaid. He decides to start his own business, so he buys his own insurance and pays his own premiums. Finally, he retires and is eligible for Medicare. Throughout this person’s life, he maneuvers through various facets of the healthcare system, but moving creates inefficiency. With “Medicare for All”, regardless of occupation or station in life, the government provides healthcare. Data show this centralized system costs less: while Canada spends eleven percent of its GDP on healthcare costs, the US spends seventeen percent. With a more uniform system, healthcare costs per capita decrease in the long run.
In private healthcare systems, young, healthy people must enter insurance markets to offset the cost of older, sicker people. The Affordable Care Act attempted to address this issue through the individual mandate: either buy insurance or pay a fine. This sought to encourage previously uninsured young people to enter the insurance market. However, according to the New York Times, many young people elected to simply pay the fine rather than purchase a healthcare plan, citing cost as the primary reason.
Government-sponsored healthcare solves the question of young people. With “Medicare for All,” every American citizen will be in the insurance market, including young, healthy people. Having these individuals in the market helps drive down costs because they pay upfront premiums, but are inexpensive to cover. A “Medicare for All” system would expand the amount of Americans in the health insurance market, but since most sick and elderly Americans are already in the insurance market, this expansion would bring in the young, healthy people that serve as the lynchpin of any healthcare market.
Another critique of “Medicare for All” is the sheer cost of total government involvement in healthcare. However, the biggest change would be the reallocation of funding, not the dramatic increase in expenditure. Working-age Americans pay thousands of dollars to insurance companies in exchange for coverage. With a government-funded plan, Americans would pay that money in taxes rather than as premiums. Additionally, the government would recoup the annual $260 billion in business tax breaks that fund employer-sponsored healthcare. At the same time, businesses would cut costs since they would no longer be responsible for providing healthcare to their employees. Many people equate “Medicare for All” with a total government takeover of the healthcare industry. Rather, Medicare for All would combine the private sector’s ability to provide care with the government’s ability to provide insurance.
This fact cannot be overstated: All Americans have a right to affordable healthcare, and “Medicare for all” is the best policy to realize that goal. As a civilized society, we cannot tolerate millions of our own citizens living unprotected from simple injuries or innocuous diseases. Any plan that leaves an additional twenty-two (or twenty-three) million Americans uninsured cannot be accepted in our society. An individual or politician who supports the idea of leaving millions uninsured is denying Americans their right to life, liberty, and the pursuit of happiness.
We, as Americans, must not allow ourselves to be content with the system that currently governs the healthcare of our country. A governmental program should be measured by the way it operates under drastic circumstances. We expect our military to protect us even in the midst of a recession; our government’s healthcare policy should work the exact same way. It is time for the government to play an active role in providing healthcare for Americans. If government healthcare helped my family cope with a disease as insidious as cancer, imagine what it can do for every other American.