Why single payer health care

Almost all have a role for the private health insurance sector Tikkanen, In contrast, the United States, spent This spending represents almost twice the average among the 12 nations listed, with the poorest health outcomes including lowest life expectancy, highest suicide rate, highest prevalence of chronic diseases, highest number of preventable hospitalizations and highest rate of avoidable deaths Tikkanen and Abrams, In countries with cost sharing the United States still demonstrates poor health status indicators related to expenditures.

Life expectancy in years is lowest Switzerland, Suicide rates is highest per , population U. Chronic disease burden percentage in the population is highest U. Although these statistics were stark, in the initial months of the COVID pandemic the results were attributed to prolonged wait times and allocation of life sustaining treatments to health care professionals. The fatality rate belies the fact that countries with UHC had lower case numbers of patients. Recent literature illustrates the public health benefit of UHC to primary care; particularly vaccination.

An uncoordinated effort in the U. Their UHC is funded through taxes and as the other aforementioned UHC health systems have public options with supplementary private coverage.

Although the size of the nation is comparable to New York State, hospitals remain government owned and costs are constrained by governmental control. Taiwan with an increased population density and close proximity to Wuhan China experienced an incident rate of In the United States, in the midst of the COVID pandemic health outcomes diminished for those with co-morbid and underlying conditions without health insurance. Despite the ACA, an estimated additional 5. Yet as discussed, comparable health systems with federally mandated systems expand access to all through supplementary private health insurance and cost-sharing.

To strategically improve the American health system, foundational ethical and moral philosophies have implications to aid the adoption of universal health care.

There are positive duties, which include actions we are commanded to take and there are negative actions which are prohibited. Kant assumes that people are rational and have choices, which selected are to be based on rationality and duty Yudanin, In true sense the moral worth of a person is revealed only when he acts from duty. Actions qualify as moral when they are worthy and enacted upon for the sake of duty Mulia et al. Actions should be taken because they are inherently good onto themselves and not a means to achieve something else Foot, According to a deontological philosophy actions are morally acceptable when consistent with relevant moral norms.

In the case of universal health care in America, strategically adopting the norms of health systems with equitable health outcomes should be the duty of legislators. What should serve as the moral norms; what is right and what is wrong; what is a duty and obligation? Consider their connectivity to foundational values:. Craig King, considered health care to be a social good, based on the tenets of religion, American ideals, morality and ethics for the foundations for the health system. The author challenges Americans to get away from looking in the mirror as the wicked witch did in Snow White.

Friedberg Friedberg, points to the Jewish philosopher Maimonides who wrote about the mitsvat aseh, representing an absolute obligation. The term mitzvah refers to such an obligation or commandment in Hebrew writings.

While we are commanded or are obliged to perform mitzvot, when done we are blessed. Performing mitzvot provides the performer with recompense which should not be viewed as monetary reward. Biblical references to the blessings that will accrue if mitzvot are performed can be found for example in Leviticus 3—12; Deuteronomy 7: 12—24; Deuteronomy 22—25; and Matthew 7: Tzedakah, is a related Hebrew term for the commandment associated with charity, which has the literal meaning of righteousness or justice.

Consider the following capturing the essence of this mitzvah of tzedakah from Rabbenu Bachya Ben Asher, a 13th century Torah commentator:.

Hence we are not to wait for the right opportunity, the right time, and the right place to come along, but instead we are to actively seek the opportunity to practice justice. Taitz, Inherent in such a model are values contained within the Golden Rule, a sense of community and responsibilities for those within the community, a responsibility to help those in need, compassion, justice and doing the right things. A single payer system embodies these values. The United States could achieve universal coverage relatively promptly if it were willing to adopt these 2 principles.

Unfortunately, as political polarity is reality, opposing sides ascribe mean-spirited attributes to their opponents. ACA, as first envisioned, supported an expansion of Medicaid financial eligibility in all states. However, opposition to this goal led to opposition and eventual change to permit states to opt out of expansion. While there was a nation-wide sharp reduction in the uninsured population, the reduction in the uninsured could have been higher with all states agreeing to the expansion.

Those in the coverage gap who remained uninsured most often had income too low to qualify for tax credits but too high to receive Medicaid because their states did not expand financial eligibility Texas Health Institute, Perhaps the barrier to policy change is that some believe in a Social Darwinism approach of survival of the fittest. Click here to send an editable letter in support to your representative.

For other steps you can take in support of single payer, check out our Take Action page. Over the past two decades, peer-reviewed research by PNHP leaders framed the debate on health care and focused it on the need for fundamental reform.

Our proposals detail what a single-payer system in the U. A single-payer plan would shift the financing of health care from premiums paid by employers and individuals to taxes. Tax-based financing is key to true universal coverage, since it means that everyone is automatically insured.

But it also could be quite disruptive. The overall amount spent on health care could decrease under a single-payer plan, but some people would end up paying much less while others would pay much more. Cost Containment. A single-payer plan has the potential to push down health costs in 3 ways: by lowering the prices paid for health care higher prices are the main reason the United States spends so much more than other countries , by cutting out administrative costs for billing and insurance sales, and by reducing profits.

While no 2 countries have approached their health systems in the same way, those with universal coverage generally have a much bigger role for government in regulating prices and a much smaller role for for-profit insurance companies. Other elements of a single-payer plan that could push health spending up include covering more people and reducing or eliminating deductibles and copays. The net effect on health spending would depend significantly on the details of how a single-payer system was designed and implemented.

That simplicity in some ways obscures tradeoffs, which are inevitable in any comprehensive health reform. A bigger government role in the health system could bring down prices, but those prices represent income to hospitals, physicians, and drug companies, which they will fiercely resist reducing.

People may not have to pay premiums or anything at the point of service, but they will pay higher taxes. The absence of deductibles or copays would remove financial barriers to accessing needed care but could also result in more unnecessary care.

Polling from the Kaiser Family Foundation informs how public opinion might be swayed in a revved-up debate over a single-payer health care system. However, when presented with arguments that opponents might use in a heated political debate—that taxes would increase, that the government would have too much control over health care, or that a single-payer system would eliminate the role of employers in health care—majority support turns to majority opposition.

On the other hand, arguments from supporters of a single-payer plan—that it would ensure universal coverage, reduce administrative costs, or decrease the role of private insurers—increase support. Thus, despite its advantages, single payer will not ease the constant tension of balancing access, quality and cost in healthcare. However, Oberlander suggests these issues are much smaller in countries with single payer healthcare when compared to the current U.

Oberlander implies the major obstacles to adopting Medicare-for-all are political, rather than actual practical problems within the single payer structure. Stakeholders who stand to lose — such as health insurers, organized medicine, and pharmaceutical companies — represent a powerful opposition lobby.

Public opinion needs to be redirected to focus on how the net benefits of a single payer system outweigh the tradeoffs discussed above. Furthermore, despite the individual level savings, behavioral economics predicts the general public will wince at the notion of transferring healthcare spending from employers to higher taxes managed by the federal government.

Additionally, despite long term savings projected from moving to a single payer system, the upfront costs of the transition are also politically unpopular. If the major barrier to implementing single payer healthcare in the U. Interestingly, whereas a majority of physicians support transitioning to single payer, they are less likely to believe their colleagues share this opinion.

Multiple strategies to continue to push for Medicare-for-all have been proposed. An alternative proposes implementing a single payer system on a federal level by lowering the Medicare qualifying age every few years. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. Insurers add only one advantage, cost containment. That is, they say no. They look for the cheap way out.

But do they improve outcomes? And is their cost containment exceeded by the amount of money they take out of the system. We pay much more for healthcare and have less favorable outcomes than our other developed nation cohorts.

We should do the smartest thing, without any need to make profitable insurance companies. Who could still sell the same products they offer to Medicare members. We have the best health care in the world for a reason. Have you seen our crusted out mail trucks and Amtrak trains?

They look third world. Congress has raided SS and the highway improvement fund. The government, money and management are just a bad combo all the way around. Accurately naming what we have in health care is vital to understanding and ameliorating our problem.

Thus, correctly labeling the American health care chaos as chaos—for that is surely what we have, not a health care system—will assist Americans in coping with our problem. Similarly, if we begin talking about our American health care chaos, and refrain from incorrectly speaking or writing about it as something as logical as a system, we will be doing ourselves a favor by using a term which more precisely reminds us of the problem plaguing us.

Our health care chaos does not deserve the dignity of being thought of or talked about as a respectable system.