As we continue to struggle with healthcare in the United States, a preeminent discussion point has been universal coverage within a single-payer structure. We, as well as other countries, have grappled with this dilemma for decades.
One of the leading arguments for such a model is insuring the uninsured. Undoubtedly, a single-payer system is a solution. In moving forward, two main points require agreement. Subsidies for individuals that do not have the means to pay are necessitated, and everyone must contribute to the subsidies. Though this sounds intuitive, a recent Pew study revealed that a modest majority of those surveyed favored subsidies only, and a modest majority favored approved compulsion only. Furthermore, there was not a majority who supported both. Hence, we are at an impasse that requires further social conversations.
Improved health outcomes are another goal that is aspirational. As a country, we lag behind many others in most metrics. Though we spend more on healthcare, we spend less on social services. If we focused on the causes of poverty, healthcare spending would decrease. A single-payer system or a more aggressive social model would be more straightforward and would have a positive impact on coordinated social services at the governmental level.
Undeniably, costs are a significant concern. Our present insurance model has dollars that are needed for administrative functions, investor returns, and marketing. All these dollars are not going towards caring for those that require service. Our present healthcare financing system is fragmented and relies on employment-based health insurance, payroll taxes, income taxes, other taxes, payment by consumers, individual coverage, and governmental insurance. The administrative overhead to manage such a disparate conglomeration is staggering. When you layer on the cost being borne by providers that ultimately is passed back through to payers, one can quickly see the wasted resources on the administrative side of delivery. When we factor in all that we are paying for healthcare through our present governmental model, fiscal responsibility will dictate us viewing our situation through a different lens.
This country is better positioned to solve these issues than any other. We are reflective, caring, and innovative. We also spend more money than any other, so lack of funds is not an issue. Our goal should be to move toward a fairer and more efficient healthcare system. For us to succeed, we will need to change our definition of fair. Equality and equity are not the same words. Equity and fairness will require us to value the social good of caring for those that are vulnerable, especially when their health is at risk. Whether it be universal health coverage or less-comprehensive reforms based on agreed upon principles, let’s get going.