Societal Loss Reclaimed via Medicare for All
Senator Bernie Sanders characterizes the United States health care system as “dysfunctional and cruel.” He declared “Today, there are millions of people who would like to go to a doctor but cannot afford to do so. This is an outrage. In America, your health and your longevity should not be dependent on your wealth. Health care is a human right that all Americans, regardless of income, are entitled to and they deserve the best health care that our country can provide” (2025, April 29, para 3).
The Medicare for All legislation (introduced to Congress in April 2025 by Senator Bernie Sanders and Representatives Pramila Jayapal and Debbie Dingell) is anchored by the core philosophy that “healthcare is a human right, not a privilege” (2025). Senator Bernie Sanders has been the leading Senate advocate for Medicare for All since introducing the first modern Senate Medicare for All bill in 2017. During the 119th Congress Sanders sponsored the Medicare for All Act of 2025 (S. 1506), while Representative Pramila Jayapal sponsored the companion House legislation (Medicare for All Act of 2025, H.R. 3069, 2025).
During the press conference following the Medicare for All Act of 2025 introduction, Representative Pramila Jayapal proclaimed “It is a travesty when 85 million people are uninsured or underinsured and millions more are drowning in medical debt in the richest nation on Earth” (2025, April 29, para 4).
Representative Dingell asserted “A health care system that ties coverage to employment will always leave patients vulnerable. It’s flat-out wrong and Medicare for All would put a stop to it. We’ve been fighting this fight since the 1940s, when my father-in-law helped author the first universal health care bill. It’s time to get this done” (2025, April 29, para 5).
While the moral arguments are compelling, policy change is more likely when driven by clear economic incentives. Greater public awareness of the potential economic benefits could significantly increase support to move this legislation forward.
To this end, Genichi Taguchi’s loss to society metric (1986) is used to delineate how a Medicare for All system would recoup these losses, transforming preventable suffering and economic waste into measurable public savings. Genichi Taguchi wrote that the true measure of product or service quality is the negative impact it has on society. Those costs include waste, inefficiency, harm, and downstream economic burdens. This Taguchi metric is an inverse measure of quality: increasing societal loss denotes declining quality.
The lack of healthcare access for uninsured individuals creates profound societal losses. Universal healthcare would significantly reduce suffering and enhance quality of life.
· Avoidable mortality. Research indicates that approximately 26,000 to 45,000 Americans die prematurely each year due to a lack of health insurance. Studies show that uninsured working-age adults face up to a 40% higher risk of death compared to their insured counterparts, largely due to delayed care, undiagnosed conditions, and unmanaged chronic illnesses.
· Preventable chronic conditions. Diabetes and other avoidable chronic conditions stem from a lack of routine preventive care. Medicare for All offers zero-cost annual wellness exams, screenings for diabetes, cardiovascular disease, depression, and various cancers (including mammograms and colonoscopies), immunizations, and counselling on lifestyle changes to improve overall health and wellbeing.
· Severe illness. Earlier diagnosis and treatment can prevent diseases from progressing to more severe and costly stages. Universal healthcare access ensures individuals can seek medical attention without financial hesitation. Thereby, patients are far more likely to visit healthcare providers for minor or ambiguous symptoms, rather than delaying care until symptoms become debilitating.
The Center for Medicare and Medicaid Services NHE Fact Sheet (2026) reports that health care expenditures per capita in 2024 was $15,474 per person and accounted for 18.0% of Gross Domestic Product (GDP). The United States spends double that of comparable countries — yet has significantly worse health outcomes. In the second of his 14 Points for Management, “Adopt the new philosophy” (1986, p. 24), Deming urged all individuals to reject the notion that inefficiencies and wastes are an unavoidable aspect of life.
The U.S. health care system is highly fragmented, with thousands of insurance plans, billing systems, and coverage rules. A single-payer system could substantially reduce administrative expenses associated with claims processing, prior authorizations, provider credentialing, and insurance marketing. The financial losses that can be reclaimed through universal healthcare include:
· Administrative. Studies have found that our federal government could save up to $500 billion per year on administrative costs by moving to a single-payer health care system, by eliminating the administrative burden costs arising from multiple payers and insurance companies with differing rules and coverage criteria. Furthermore, fewer administrative tasks for nurses and other staff members would allow more time for patient care.
· Reliance on the Emergency Room for non-emergency visits. Emergency rooms across the country regularly treat patients whose conditions could have been managed safely and affordably in a primary care setting. Uninsured individuals often rely on emergency departments as a last resort when unable to afford other options. This generates substantial financial waste because ER care is one of the most expensive healthcare settings. So, from a health economics perspective, the “waste” is the excess cost difference between ER care and lower-cost alternatives for conditions that are not true emergencies. Each avoidable non-emergency ER visit can cost approximately $1,000–$2,500 in potentially avoidable spending. Estimates suggest roughly 30% of ER visits could potentially be treated in primary or urgent care settings.
· Prescription drugs. People in the U.S. pay more money for prescription drugs than people anywhere else in the world. During a press conference, Pramila Jayapal noted that “We don’t suffer from scarcity in America, we suffer from greed” (2025). While nearly one out of four Americans cannot afford the life-saving medicine their doctors prescribe, ten top pharma companies made $102 billion in profits in 2024. Nancy Hagans remarked “In the richest country on earth, nobody should be forced to choose between taking their medications and putting food on the table.”
The World Health Organization (WHO) defines Universal health coverage (UHC) as “all people have access to the full range of quality health services they need, when and where they need them, without financial hardship” (2026).
The Medicare for All represents the most comprehensive path to universal health care because it guarantees coverage for all residents, eliminates financial barriers to medically necessary care, reduces administrative waste, and promotes greater equity in access to health services while leveraging national purchasing power to control costs It would also expand Medicare to include dental, hearing, and vision care, and it would give every American the freedom to choose their doctors without endless paperwork or fighting their insurance company (H.R. 3069, 2025; S. 1506, 2025).
Gene Marks wrote “I’m as capitalist as they get. But I’ve learned that government has a significant role in our lives, from providing defense to funding needed infrastructure. Providing healthcare to all through a national insurance system strengthens our economy’s infrastructure. It’s a better, easier system for small businesses that employ more than half of the country’s workers and fund half of our GDP. It makes it possible for workers to be healthier, come to work more often and be more productive.” (2025)
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Today, the traditional Medicare program only spends two percent of its costs on administration. That’s less than one-sixth the administrative costs of private health insurance companies.
Medicare actively negotiates lower drug prices directly with pharmaceutical companies on many high-cost, widely used drugs under the Inflation Reduction Act. A single national insurer will have more leverage and bargaining power to negotiate substantial discounts for additional drugs, medical devices, and high-cost treatments.
Furthermore, Medicare spearheaded solutions to reduce healthcare costs. The predecessor (Health Care Financing Administration) to the Centers for Medicare and Medicaid Services (CMS) conceptualized and developed the first Prospective Payment System (PPS) to pay hospitals a fixed rate per discharge adjusted for severity of illness (1983). In essence, this system groups standard costs related to a specific diagnosis. These Diagnosis-Related Groups (DRG) codes are used by insurers, hospitals, and the government to standardize the process of reimbursement.
Research regarding the early years of PPS found that it substantially slowed the growth of hospital spending and reduced hospital lengths of stay, achieving many of its intended cost-containment goals (1988).
Medicare for All could reduce long-term healthcare expenditures by removing financial barriers to preventive care, enabling earlier diagnosis and treatment of chronic diseases.
Call to Action
Public support for a single-payer healthcare system is substantial. In a poll conducted by the Medicare for All PAC, 54 percent of voters expressed support for a Medicare for All healthcare system. (2026). In addition, survey responses revealed that 65% believe the federal government is doing too little to help people afford health care, and bipartisan majorities reported unfavorable views of prescription drug companies (69%) and for-profit health insurance companies.
A recent KFF Health Tracking Poll discovered that health is the top voter concern, and lawmakers face intense public disapproval over the lack of legislative action to prevent rising healthcare costs (Kearney et al., 2026). These findings suggest that supporting the Medicare for All Act may be a politically advantageous strategy for congressional candidates. because it addresses key voter concerns, including escalating healthcare costs, the expiration of Affordable Care Act subsidies, and growing frustration with the private insurance system.
References
Center for Medicare and Medicaid Services (2026) Health Care Expenditure (NHE) Fact Sheet. https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet
Deming, W. E. (1986). Out of the crisis. Massachusetts Institute of Technology, Center for Advanced Engineering Study.
Gutterman, S., Eggers, P., Riley, G. Greene, T. and Terrell, S. (1988). The first 3 years of Medicare prospective payment: An overview. Center for Medicare & Medicaid Services. https://www.cms.gov/research-statistics-data-and-systems/research/healthcarefinancingreview/list-of-past-articles-items/cms1192039
Julija A. (2026). Key Statistics & Facts About Uninsured Americans. Fortunly. https://fortunly.com/statistics/uninsured-americans/
Kearney, A., Mulugeta, M., Montero, A., Valdes, I., Lopes, L., & Kirzinger, A. (2026, April 29). KFF health tracking poll: Health care costs and the midterms. KFF. https://www.kff.org/public-opinion/kff-health-tracking-poll-health-care-costs-and-the-midterms/
Medicare for All Act of 2025, H.R.3069–119th Congress (2025–2026): Medicare for All Act. (2025, April 29). https://www.congress.gov/bill/119th-congress/house-bill/3069
Medicare for All Act of 2025, S.1506–119th Congress (2025–2026): Medicare for All Act. (2025, April 29). https://www.congress.gov/bill/119th-congress/senate-bill/1506
Sanders, B. (2017, September 13). 17 senators introduce Medicare for All Act. U.S. Senate. https://www.sanders.senate.gov/press-releases/17-senators-introduce-medicare-for-all-act/
Sanders, B. (2025, April 29). NEWS: Sanders, Jayapal, Dingell, hundreds of health care workers introduce Medicare for All. Bernie Sanders U.S. Senate. https://www.sanders.senate.gov/press-releases/news-sanders-jayapal-dingell-hundreds-of-health-care-workers-introduce-medicare-for-all/
Taguchi, G. (1986). Introduction to Quality Engineering: Designing Quality into Products and Processes. Asian Productivity Organization.
The Union for Everyone. (2026, February 9). New poll finds majority support for Medicare for All. https://www.ueunion.org/political-action/2026/new-poll-finds-majority-support-for-medicare-for-all/
The World Health Organization (2026). Universal health coverage. https://www.who.int/health-topics/universal-health-coverage#tab=tab_1
