We’ve heard a lot about “universal healthcare” pros and cons over the last few years, with discussion on key points ranging from “Medicare for All” to a single-payer system. Universal healthcare would do away with private health insurance and replace it with a government-run healthcare service, providing “free” access to medical services to every citizen, albeit taxes would likely go up for middle- and upper-class Americans. From politics to think pieces and the medical community, this hot-button issue has supporters and dissenters on all sides.
Let’s dive into all the different universal healthcare pros and cons and what they would mean for patients and providers.
For Universal Healthcare
The United States already spends more on healthcare than any other country in the world. U.S. healthcare spending grew 3.9% in 2017, reaching $3.5 trillion or $10,739 per person. Healthcare spending accounted for 17.9% of the country’s Gross Domestic Product. These numbers include U.S. expenditures for healthcare goods and services, public health activities, government administration, the net cost of health insurance, and all investments related to healthcare. With the high cost of care, nearly 45 million Americans, including illegal immigrants, are under- or uninsured.
Proponents of universal healthcare argue that doing away with private healthcare would reduce costs. Universal healthcare would also give coverage to every American. Individuals would no longer have to pay for care out of pocket. They could see a doctor without worrying about co-pays, insurance, deductibles and other surprise expenses. The government controls the system and it would be paid for using taxpayer money.
According to several studies from across the political spectrum, universal healthcare would reduce the many costs of healthcare by trillions of dollars over the next decade by getting rid of inflation and inefficient practices such as private insurance, claims approval, payment systems, and record keeping. While taxes will go up for many Americans, total costs would go down for most households and individuals across the country.
Proponents point to the success of other universal healthcare systems, such as those in the United Kingdom, France, and Germany. These nations don’t pay as much for healthcare as the U.S. and their residents tend to be healthier.
A Healthier America?
Proponents also argue that Americans would use more healthcare with a single-payer system. If individuals and families were guaranteed healthcare under the law, they may be more willing to schedule regular screenings with doctors, find a primary care provider, or take their medication without worrying about inflated costs.
Increasing access to healthcare services may increase the cost of healthcare, but it could also reduce overall costs by reducing the rate of preventable chronic diseases, such as liver disease and heart disease, while also increasing the rate of early detection for cancer patients.
Reducing Income Inequality
Under a single-payer system, total costs would go down by doing away with all private healthcare charges. Large corporations and the richest Americans would see a major increase in their taxes, while small businesses and middle-class Americans would see a modest increase. Once the new system goes into place, every American would have access to the same healthcare services, reducing income inequality across the board.
Lower-income Americans would be able to access life-saving services without worrying about co-pays, premiums, and the cost of medications, while upper-class Americans, many of whom already access medical services, would pick up the bill by paying more in income taxes.
Creating a National Healthcare Database
Proponents also argue that universal healthcare would lead to the formation of a centralized national healthcare database, easing the flow of information between doctors and care providers. In today’s system, facilities, doctors and providers each have their own record-keeping systems. Patients need to fill out a new form every time they visit a new facility or provider. Separate record systems inflate the cost of care and can lead to poor data collection. Patients may forget to add important information that could affect their diagnosis.
With a centralized database, providers could keep an ongoing record of a patient’s health information. Providers could also analyze the country’s healthcare information to glean new insights about treating and preventing certain conditions and diseases, spurring innovation across the industry.
At the end of the day, proponents argue that providers could focus more on healing patients and less time dealing with insurance procedures and worrying about making a profit.
Against Universal Healthcare
Opponents of universal healthcare argue that it would raise taxes on most Americans without reducing the total cost of healthcare. Estimates for a universal healthcare program vary from $1.3 trillion to nearly $3 trillion annually. To make up for these added costs, opponents say the national debt would spiral out of control, while raising taxes and reducing funding for other federal programs, such as defense or education.
Opponents also argue that the wealthiest Americans and businesses would have to pay for the bulk of these added costs. To pay for the program, some have suggested implementing a wealth tax, taxing capital gains as regular income, and raising income taxes on most American households. Opponents say a universal healthcare system would put an unfair burden on the richest people and businesses in the country. Why should these individuals pay to care for the poorest and sickest individuals in the country?
Universal healthcare could also leave the country vulnerable to costly malpractice lawsuits. If a patient sues a provider for malpractice, the federal government may have to pick up the tab.
Opponents of universal healthcare tend to be proponents of the free market. Taking economic competition and the freedom of choice out of the equation would hinder innovation in the medical field. Companies and providers would no longer compete against each other for patients and funding. Without this competition, facilities, institutions and companies would have less incentive to improve the quality of care and explore new treatment options.
Others warn that a government-run system would dissuade the next generation from pursuing careers in medicine. Without the option to go into private practice, those considering a career in medicine may take their talents elsewhere and look for careers in the private sector where they can make more money.
Reducing Patient Flexibility
Some fear that switching to a single-payer system would also reduce patient flexibility. Patients will still be able to see the provider of their choice, but cost limitations may go in place that would prevent patients from accessing certain procedures or expensive tests. Some argue this may lead to longer wait times and other potentially dangerous delays. Patients may have to seek government approval before accessing these services or prove that they are medically necessary, reducing individual autonomy in the healthcare industry. However, there’s no guarantee that such cost limitations would go into place or that the government would ration certain services or medications to lower costs.
A Painful Transition
Those against universal coverage also tend to be wary of the federal government’s ability to handle such a massive undertaking. The entire country would have to switch over to a new system during the first 10 years after launch, leading to widespread unemployment and massive confusion among consumers and businesses. Opponents often point to the launch of the Affordable Care Act website, which crashed just a short while after going public back in 2013.
The transition to a single-payer system could turn out to be costly and may drag on for many years, dramatically reshaping the American economy and medical billing as we know it today.
Switching to a universal healthcare system won’t be easy, but it could dramatically improve, or harm, the country’s current system, depending on your point of view. There are many potential universal healthcare pros and cons to consider, regardless of where you stand on the issue. In any case, Medicare for All will continue to be a hot-button issue in politics and the medical community for years to come. Learn more about this issue as it continues to dominate the headlines.