BY ALISON NEAL | Guest Columnist | You have heard the arguments before: the U.S. spends nearly twice as much per capita as any other country on health care. That equates to greater than 17 percent of the gross domestic product, yet we have worse health outcomes than many developed nations.
The Affordable Care Act was merely a start to the overhaul that our health care system so desperately needs. It provided coverage to individuals with pre-existing conditions, allowed children to remain on their parents’ insurance until age 26, determined minimum standards of coverage and made insurance more affordable for those in lower income brackets.
Still, the bill fell short of addressing health care equity and spending.
Under a single-payer system, the entire population is covered, benefits are uniform for all, no out-of-pocket expenses are incurred for basic medical services and private insurance for hospital and medical services is not permitted. The method of financing may be a combination of income taxes and other sources of funds such as payroll taxes on the employer and employee, Medicare and Medicaid payments, taxes on alcohol and tobacco or even sales tax.
The major advantage of a single-payer system is its simplicity in achieving universal coverage. Access to care by those with low incomes and the uninsured would be improved and less would be spent per capita on medical services by allowing individuals to seek care earlier. Placing greater emphasis on prevention is more cost effective and directly enhances quality of life. From an educational standpoint, such a system is more replicable, teachable and easy-to-navigate.
This proposal is not meant to ignore legitimate reasons for increased medical expenditures. We are an aging population with more chronic illness and new diseases. The cultural shift toward preventable illness combined with our ability to pay means the U.S. accounts for 37.5 percent of the world pharmaceutical market. Such increased demand for health care has created shortages of personnel which has ultimately increased wages.
But there are also unjustifiable explanations for our rising health care costs. A complete lack of transparency in cost has distorted consumer choices and diminished consumer incentives to be concerned with cost of medical services. Our health care administration costs are the highest in the world, where serious discrepancy exists between the private sector insurance industry versus non-profit companies and public options Medicare and Medicaid. Perhaps of most notoriety, our assorted coverage provides little bargaining power to reduce the price of prescription drugs.
In reflecting on the implications of a single-payer system, I cannot help but think of the freedom it would impart on individuals and families. We would be free to seek care at any facility with any provider. We would be free to seek employment at any firm for any number of hours. This would have had stark implications for my family growing up. My dad would have better care for his chronic respiratory issues, allowing him to work until he could accrue full retirement benefits and my mom could have sought employment she enjoyed rather than worrying about carrying health benefits for our family. So many people I know have a story like this and I encourage you to share yours.