Possible Impacts If US Switched To Single-Payer Healthcare
One of the consistent weaknesses and challenges in our political system is that rarely does a relevant issue get reviewed and discussed thoroughly, both from the positive as well as the negative perspectives. Rather, we generally witness empty rhetoric, incomplete and/or false facts, and oversimplistic fear-based responses from both sides of any issue! Perhaps as much or more than any other issue, for decades, the discussions related to US healthcare, especially how it is delivered, have ended-up being less than a thorough one, and even what some believe should be a basic guideline, whether quality, affordable, accessible healthcare is and/or should be considered a basic right! How can anyone have the ability to truly enjoy life, liberty and the pursuit of justice, if we can’t even actually, thoroughly address both the pros and cons of the entirety of the considerations?
Those supporting switching to universal healthcare in the USA state doing so would guarantee medical coverage for all Americans, eliminate medical bankrupcies (only in the US do we witness so many of these), and potentially, lower overall national healthcare spending. Opponents proclaim this would also result in a significant increase in federal taxes and the need to cerate massive administrative shifts, while proponents state the amount taxes would increase would be far-less and more fair than the current system!
With Universal Access, everyone would have health insurance, and would remove the potentially dangerous gap which often leaves millions uninsured or underinsured. Studies such as the one at Yale School of Public Health suggest a single-payer system could reduce total annual US help expenditures by hundreds of billions to perhaps-trillions of dollars, by eliminating private insurance overhead and profit markups, while being better positioned to negotiate lower drug and service prices. Mark Cuban strongly suggests he has proven it can be done, through vehicles similar to his online site which dramatically lowers costs to consumers. It would also transform society by eliminating bankruptcies which are driven by medical debt. At present, the US is the only developed nation which does not use some form of single-payer system, and it is interesting we are also the only country where medical expense-driven bankruptcies are so widespread! Interestingly, under our current system, although we spend much more than others, the US currently ranks close to last in many key medical health categories!
Because of efficiencies experts would expect, it is most likely, preventive care access would improve, which many studies estimate could potentially save tens of thousands of lives annually, while boosting national productivity. No longer would workers be somewhat-tied to their jobs, solely or predomiantly for health insurance benefits, which would probably also encouarge greater entrepeneurship, and job mobility. However, there are also potential major drawbacks and challenges, which would need to be addressed thoroughly, to make doing this more efficient, effective and better! Federal income or payroll taxes would increase substantially to fund the public programs, and private premiums would be mostly replaced with government ones! However, one important caveat which unfortunately would need to be fully considered and addressed, from the onset, is how could this be done and ensure doctors, in discussion with patients, and not the government would make health decisions and choices! We have seen how Medicare is far-from exceptionally managed, and that costs continue rising, so what assurances can be made that changing healthcare delivery systems and how they are paid for, will be protected, for the greater good?
One challenge is whether this would increase potential wait times, especially for basic non-emergency care! Some other nations have seen that as an undesirable impact/ramification. Most likely, doctors and hospitals would face reduced provider reimbursement, which potentially would adversely affect physician pay, and/or hospital resources, especially in rural areas. However, as a result of provisions and impacts from last years OBBB, as well as HHS current policies, we have already witnessed too much of this impact, anyway! Another consideration would have to be how to proactively address and be prepared for significant disruptions in private health insurance and corporate billing departments, which would probably create significant displacement or require massive workforce retraining, since the Health Insurance system employs so many workers, and what would happen to them. Some might suggest this change would have to be a phased-in one, or perhaps, some sort of public-option, to address indidividual differencies, needs and priorities.
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How might a Universal Healthcare system be less expensive? Firstly, and significantly, as currently exists, private insurance companies spend lots of money on paperwork, processing, billing, advertising and marketing, and profits. Proponents of doing this claim a single payer government system would cut the waste, yet how can this be ensured to eliminate the typical government waste. Clearly, Medicare and Medicaid are far-from flawless or seamless, so a better approach should be designed to address these types of concerns! One of the weaknesses of our current system is we pay far-more in the USA for the same drugs/pharmaceuticals than nearly every other country does! In theory, making this type of change would create a path for a large public system to negotiate lower prices for prescription drugs abd other medical services. However, we must be aware and vigilant, to ensure the typical government inefficiences don’t ruin even-the-best intentions!
Ideally, this system would encouarge more prventive care, so people could see a doctor earlier, and treat minor health issues before they get worse, and also stops the expensive, inefficient emergency room visits later. The Yale School of Public Health study, mentioned earlier in this article, dound that a universal system could save $1 trillion and prevent thousands of deaths, each year.
However, making such a major change would most likely, have challenges and potential trade-offs! Since the government would pay for care instead of private insurance, taxes would go up, yet nearly every study indicates, it would be less than the current system, and how government bureaucracy and inefficiencies might impact this, would need to proactively be considered and addressed. Although, there would probably be significant improvements in the longer-term, there would most likely be signficant costs initially to get this set-up and running properly. Most pragamatists would say any significant change such as this, would need to be phased in. In addition, certain concerns and questions would need to be addressed, such as: 1) What happens to hard-fought union benefits, and how might this corporate cost be reallocated?; 2) Who would make medical decisions, and how can the public be protected against radicalization, from either side?; 3) How can doctors and hospitals make-up for the anticipated lost revenues, while also realizing, even in the current system, private insurance often reimburses and pays at a low rate, anyway?; 4) Do we consider quality, affordable, accessible healthcare to be an essential right, regardless of one’s socioeconomic situation?; 5) Who and how would people and their medical providers and institutions be prepared, trained, and fully understand, how to proceed, and what quality control would be in-place?; 6) Is it possible to keep partisan politics out of the ongoing process, and protect Americans healthcare? It should be remembered these are only a few of the considerations, from the onset?
In addition, making such a significant transition and change, and changing the entire national system, is both difficult/challenging, and expensive to start! Who would design it, and how well? It’s far-easier to use catchphrase such as Medicare-for-all, and Single Payer, and Universal healthcare, than to create the best path forward! How might potentially concerning wait times be proactively addressed, for the greater good? How would this be done, and administered, in urban, large urban, suburban, and rural communities? Is equal quality, accessible, affordable healthcare possible, on a national basis?
This is both a significant as well as a complex subject. Who would coordinate and design it? How can we ensure we don’t nearly create Change for Change-sake, and rather introduce significant differences for the better? How can we ensure more efficiency and effectiveness, and protect segregated funds so our political system doesn’t destroy it before it might make a difference for the better?
And, perhaps, most significantly, do we as a nation, believe quality, affordable healthcare which is accessible and efficient, should be a basic right, or one which favors the elite? How hard might certain industries, such as the Health Insurance, and Big Pharm industries. resist any similar efforts, and with the current political atmosphere where money has so much power, and with recent SCOTUS decisions, where lobbying and PAC groups have even-less reporting accountability? As we have seen in other political and partisan battles in recent years, actual facts as opposed to empty rhetoric and misstatements, often create less-than-stellar results! No doubt, this is a complex issue, yet perhaps one of the most significant and compelling ones, in recent memory! What might be the best path forward, and is it viable to get it done?
