Let’s Cover the Basics: Single Payer Healthcare
Single Payer Healthcare is a system in which the state covers healthcare costs, including but not limited to visits to the doctor or the hospital, preventative care, long-term care, dental, vision, prescriptions, mental health, and reproductive health for all citizens no matter their income or health status. Canada’s healthcare system, for instance, is socialized and entirely state funded. Canadians do not pay out of pocket for any of their necessary hospital and physician services — meaning a ride in the ambulance does not get a Canadian a $300 bill in the mail, and lifesaving surgery does not leave them in debt. Private health insurance plans are still a possibility, but if one cannot afford it, the socialized healthcare system is available. Canada can attribute their high life expectancy and lowest-child-mortality rate of all industrialized countries to this system.
The US’s healthcare system is unique, as it is a hybrid of many systems. Despite spending more money on healthcare than almost any other country, we do not have a uniform health system, nor do we have universal health care coverage. It was only with the passing of the Affordable Care Act, also known as Obamacare, that healthcare coverage became mandatory for everyone. We do not have a national health service like the UK or a single-payer healthcare like Canada, or multi-payer healthcare like the Netherlands.
The difference between the US health care system and the Canadian one is price. Health care is incredibly expensive in the US. Cancer treatment can leave a patient in debt for decades. About 59% of physicians admit that their patients have “difficulty” paying for care. People will often go without medical attention, endangering their lives to avoid medical debt. If they do visit the doctor, many won’t go for further treatment or fill their prescription.
Senator Sanders is proposing “Medicare for All.” This is his attempt at a single-payer health care system and it is creating quite a bit of buzz. He’s proposed it several times before, but it has never generated such support. According to Senator Sanders’ plan, the US will move, over the course of four years, towards a system where every US citizens would be covered, meaning no more people having to risk their lives in order to afford rent. Lower income families can get the same care as higher income families. Everyone gets treated and everyone pays the same price.
While this sounds amazing, it is highly unlikely that it will pass Congress. It does not have a chance with a Republican majority for a lot of reasons. People who support a smaller federal government definitely won’t support the federal government controlling all heath care. And the cost is a doozy. The Urban Institute estimates that it would cost $32 trillion over 10 years. How would that money be raised? By raising taxes— largely on the wealthiest of Americans, which Republicans will definitely not support. Additionally, many Democratic Congressmen and women are reluctant to support Sanders’ cause. However, Kamala Harris, Elizabeth Warren, Cory Booker, and Kirsten Gillibrand—influential members of the Democratic Party and possibly the Presidential candidates for 2020— are all co-sponsoring the bill.
The downside with a single-payer health care, however, is the potential for long wait times. While the government would eventually start paying less for health care, it would start as very expensive. In addition, some people theorize that the reason the United States is the center of so much medical innovation is because of how much money doctors and medical companies can make. If you can make millions off of a new procedure, you are encouraged to design that next procedure, but if you are paid the same as everyone else, you may not be so tempted to put in all that work. Lastly, while Sanders only wants to tax the wealthiest of Americans and the larger corporations, some of the tax burden could be passed onto families with lower incomes.
In addition to the mentioned issues, there may be countless more possible snags in the system. However, due to the reluctance of Democrats and refusal of the Republican majority to cooperate, it will not be a reality for a long time, if ever.