The implementation of a single-payer healthcare system in the United States has been discussed for several years. It is a hotly-debated issue that aims at addressing the problem of inequity. The US healthcare system is flawed as it does not offer universal healthcare. The Affordable Care Act has played a key role in the improvement of the health insurance industry. However, it excludes more than 30 million Americans. A single-payer healthcare system involves the provision of insurance services for everyone by a single entity. This means that every citizen receives health coverage under a common insurance plan. All the necessary services, including doctor visits, prescription drugs, and vision care, are provided. Opponents of the system have argued that it will increase wait time and lead to massive job losses. On the contrary, proponents argue that it will provide preventive care to all, decrease health care spending, and enhance positive health outcomes as observed in countries like Norway, Sweden, France, and Denmark. America should switch to universal single-payer healthcare because it will stop medical bankruptcies, guarantee better and more affordable care to everyone, and improve the overall health of the entire nation.
Benefits
Stop Medical Bankruptcy
Statistics have shown that the number one cause for bankruptcies in the United States is medical bills, accounting for about 62.1% of all cases. Additionally, more than 2 million people are under severe financial pressure owing to their huge medical expenses (Levitt, 2018). A 2019 study conducted by the Kaiser Family Foundation (KFF) revealed that 9% of the participants had declared bankruptcy because of their medical expenses while 20% had disputes with collection agencies (Sainato, 2019). The researchers also found out that, even though wages were increasing, people were unable to keep up with the rising costs of health care. Medical insurance premiums have doubled while wages have increased by a paltry 26%. A 2019 study showed that approximately 530,000 cases of bankruptcy emanating from accrued medical debt are reported annually (Schumaker, 2020). The Affordable Care Act has been insufficient in mitigating the problem because of poor health insurance. The most effective way of addressing the issue is the adoption of a single-payer system.
Enhance Equality
One of the major challenges of the current healthcare system is the pervasive inequality with regard to access to quality health care. More than 30 million Americans lack access to health insurance because they cannot afford it (Levitt, 2018). The system is comprised of a complex network of both public and private insurance providers that take advantage of applicable laws to deny coverage to individuals from poor socioeconomic backgrounds. The US spends more on funding the healthcare system compared to other developed countries. However, the World Health Organization (WHO) has noted that it has the lowest life expectancy (Donnelly et al., 2019). Moreover, it performs poorly with regard to the attainment of specific health outcomes. In that regard, the current system is ineffective due to a lack of centralized administration.
The implementation of a single-payer healthcare system would mitigate the challenge of inequity. As mentioned earlier, the Affordable Care Act plays a significant role in enhancing health insurance coverage (Liu & Brook, 2017). However, millions of Americans have little to no access to quality health care. A single insurance provider will promote the provision of health cover to everyone because of the elimination of the competition that exists between public and private insurance agencies (Donnelly et al., 2019). In that regard, administrative costs will decrease, and the cost of medical services will be easily regulated. Moreover, it would curtail wasteful spending and lower expenses (Glassman et al., 2017). Case studies from other developed countries have shown that the system is effective. Experts have argued that the system would encourage more spending in order to enhance positive outcomes with regard to public health (Levitt, 2018). For instance, funding obesity prevention programs would be cheaper and more effective than paying for visits to physicians.
Provide Cheaper Health Care
An important argument in support of a single-payer system is the reduction of the cost of medical care. The program would be operated by merging the current sources of funding, such as Medicaid and Medicare, with affordable taxes predicated on an individual’s economic status (Schumaker, 2020). Surveys have projected that more than $500 billion in administrative costs would be avoided because the operations of the single provider would be streamlined (Glassman et al., 2017). Moreover, premiums would be eliminated, and all individuals would save money. Barriers to quality medical care, such as deductibles and co-pays, would disappear, and patients would enjoy the freedom to choose their doctor and hospital (Donnelly et al., 2019). The system would allow doctors to take full control over patient care, and, as a result, provide the best care possible.
Individuals who cannot afford health insurance cover usually encounter the challenge of choosing between taking care of their health and accruing medical debts. A 2017 survey conducted by Bankrate, a financial services company, revealed that about 31%, 25%, and 23% of Millennial Americans, Gen X, and Baby Boomers, respectively, had declined medical treatment because they could not afford to pay for the services. These findings are an indication of how ineffective the current healthcare system is, and this could be mitigated by implementing a single-payer system. Obamacare has several limitations that can be addressed by creating a single health insurance provider. The law renders the control of costs impossible and supports the imbalanced funding of health care (Glassman et al., 2017). Insurance providers will continue the unethical practices of increasing deductibles and co-pays, limiting care and maintaining restrictive networks to their advantage and at the expense of patients.
Hospital care is one of the most expensive services that contribute significantly to the high healthcare costs in the US. Many adults rely on the emergency room for their primary care physician, primarily due to the lack of access to other providers. Uninsured and underinsured Americans have limited healthcare options (Glassman et al., 2017). Therefore, they are highly likely to use the emergency room to obtain key medical services. The cost of emergency room care is high for individuals without insurance coverage. Therefore, the costs are usually added to Medicaid and health insurance premiums, making health care costly (Heitkamp, 2018). A single-payer healthcare system would create a playing level field in which all individuals would have equal access to all medical services while saving money.
Promote Public Health
One of the major benefits of a single-payer system is increased access to preventative care services. Preventive care refers to any service that is aimed at preventing health emergencies and keeping people healthy. It comprises dental cleanings, annual physicals, immunizations, screenings, and contraception (Heitkamp, 2018). The main goal is to stop a disease from spreading among the population and becoming catastrophic. Preventive care is beneficial because it keeps people productive and lowers health care costs. Government statistics show that heart disease, stroke, chronic lower respiratory disease, and cancer are the leading causes of death in America (Levitt, 2018). They are expensive to treat and cause complications that have serious health implications. The four illnesses can be managed through the provision of quality preventive care, which can be achieved by a single-payer healthcare system. 90% of the health care expenses are incurred from the treatment of chronic diseases and the management of mental health conditions (Levitt, 2018). Overreliance on Medicare, Medicaid, and insurance agencies to provide free preventive services could be mitigated by implementing the aforementioned system.
A single-payer system would be pivotal in averting serious health issues before they require the intervention of a physician, or before they progress to stages that are expensive to treat. For example, the administration of vaccines prevents the spread of diseases while screenings for cancer improve health outcomes by identifying and treating illnesses through the implementation of cost-effective measures (Heitkamp, 2018). The aforementioned system would ensure that every individual has access to screening services that are unavailable to millions of Americans (Liu & Brook, 2017). Many cases of such illnesses as cancer and diabetes could have been avoided had the patients undergone doctor checkups early enough.
Disadvantages
There are three main disadvantages of implementing a single-payer healthcare system in the US: it could increase wait time, cause political divisions, and lead to job losses among private health insurance firms. A single-payer system could be ineffective because in, the US, health care is a political issue that is hotly debated (Krahn, 2016). Current surveys have shown that more than 50 % of Americans support a shift to a single-payer system. However, the percentages are different among members of political parties as 39% and 64% of Republicans and Democrats support the shift, respectively (Levitt, 2018).
The abolishment of the private health care system would lead to massive loss of jobs and the uncertainty of careers rooted in health care. Health care providers would be the least affected individuals. However, employees who work in privately-owned entities would either encounter destabilization or the outright loss of their jobs. An increase in wait time is one of the main reasons presented by opponents of the proposed system (Levitt, 2018). They argue that the program will overwhelm the health care system, and increase the number of days that a patient would wait before seeing a doctor (Krahn, 2016). Moreover, the restricted availability of core healthcare services renders the system a poor fit that could replace the current system. Opponents argue that despite its numerous benefits, the system will not mitigate the challenge of balancing access, cost, and quality in healthcare.
Rebuttal
The arguments presented by opponents of the single-payer system are baseless as surveys conducted in countries that have adopted the program reveal otherwise results. For example, the aforementioned issues are much smaller in France, Norway, and Denmark when compared to the current American system. The main hindrance to adopting the proposed system is political interference rather than challenges within the program’s structure (Levitt, 2018). Stakeholders who will be affected the most, including health insurers and pharmaceutical companies, are the major obstacles. The argument that the transition from the old to the new system is costly is informed by unsubstantiated ideologies because, in the long term, it would save billions of dollars. As mentioned, the government would save $500 billion in administrative costs if a single-payer healthcare system were to be adopted. The losses that would be incurred as a result of job instability or losses are negligible when compared to the amount of money that would be saved and the improvements in public health that would be achieved.
Conclusion
The current healthcare system is characterized by dependence on employer-based, for-profit health insurance that has left millions of Americans without coverage. Although Obamacare was implemented to mitigate the problem, the premiums are still high, and more than 30 million individuals lack access to quality medical care. The prevalence of expensive and unequal insurance plans has resulted in numerous negative outcomes that include bankruptcies, death, and an increase in cases of preventable diseases. In that regard, America should switch to universal single-payer healthcare because it will stop medical bankruptcies, guarantee better and more affordable care to everyone, and improve the overall health of the entire nation. A single-payer system would enhance the health of everyone because people would seek medical care early enough before diseases progress to more critical stages. People who lack insurance are less productive because they suffer more from injuries and report higher cases of illnesses than people with insurance coverage. The possibility of having a wider choice of doctors would ensure continuity of care in case an individual changes employers or careers.
References
Donnelly, P. D., Erwin, P. C., Fox, D. M., & Grogan, C. (2019). Single-payer, multiple-payer, and state-based financing of health care: Introduction to the special section. American Journal of Public Health 109(11), 1482-1483. Web.
Glassman, A., Giedion, U., & Smith P. C. (Eds.). (2017). What’s in, what’s out: Designing benefits for universal health coverage. Brookings Institution Press.
Heitkamp, K. L. (Ed.). (2018). Universal health care. Greenhaven Publishing.
Krahn, H. P. (2016). The single-payer healthcare system: Faults and fixes. Friesen Press.
Levitt, L. (2018). Single-payer health care: Opportunities and vulnerabilities. The Journal of the American Medical Association 319(16), 1646-1647. Web.
Liu, J. L., & Brook, R. H. (2017). What is single-payer health care? A review of definitions and proposals in the U.S. Journal of General Internal Medicine 32(7), 822-831. Web.
Sainato, M. (2019). “I live on the street now”: How Americans fall into medical bankruptcy. The Guardian. Web.
Schumaker, E. (2020). Health care spending decreases under single-payer systems: Study. ABC News. Web.