The Healthcare Conundrum By Samuel HoDman

Universal Healthcare. It is an idea that has floated in and out of the national conversation in the past. During the 2016 Presidential Race, however, it became one of the most hotly debated topics of the national discussion. Democratic contender Bernie Sanders became the leading proponent of universal healthcare, proposing a 'single payer system' in which the government provides health insurance and care to all its citizens. His ideas found broad support amongst young people, who have helped maintain momentum in the movement to implement single payer in the U.S.

SandErs brought the idea of Universal Healthcare back into the forefront of American politics.

Sanders’ proposal attempts to treat the many ailments within our current system, ailments which are increasingly hard to ignore. Around 30 million people remain uninsured in the U.S. According to the US Government Center for Medicare and Medicaid, U.S health care spending per person is also the highest in the Western world. The United States has consistently ranked last amongst 11 industrialized nations from 2004 to 2013 based on access, quality, efficiency, equity, and health, according to the Commonwealth Fund, even though we have consistently spent more than any of those other countries.

Despite spending half the money per person that the U.K does, we lag far behind them in safe and efficient care, access, and equity.

The vast inadequacies of U.S. healthcare, along with a growing discontent with our current system, has left many people actively looking for solutions more than ever before. When we look overseas and see single payer systems in much of the Western world, it seems like the best option that is available. Yet full single payer healthcare is not the right medication for America’s ailments.

Single Payer Health Care in Action

An example that single payer advocates like to point out is Canada. Canadian healthcare is, admittedly, much more efficient than America's. Canada spends about 9% of their GDP on Healthcare, about half of America's costs, yet the insurance provided is more comprehensive and reaches a larger percentage of its population. According to the University of Colorado at Boulder, "there is no alternative program, such as private health insurance, to which Canadians can turn for basic health care.” Costs are controlled and insurance is public in the Canadian system, while both hospitals and doctors are privately managed. Most funding and administration is done on a local level, and as a result, Canadian healthcare takes less people to administer than the Blue Cross Blue Shield of Massachusetts.

Canadian Health Care, while costing less and covering more, still has major flaws and many factors worKing in it's favor.

However, this system isn't nearly as perfect as it may seem, and is heavily assisted by many outside factors. First of all, the total population of Canada is only about 36 million, nearly one tenth of the American population. Canadian citizens do not make significantly less than the average American citizen, and according to The Economist, Canada is the fifth largest producer of crude oil, which provides an economic boost to the country. The small population and large wealth of Canada make it possible for their single payer system to run as well as it does. But it still doesn't run perfectly: according to a survey by the Fraser Institute, the median wait time for medically necessary procedures in Canada is 20 weeks. Even in Ontario, the capital of the country as well as its most populous province, the average wait only drops to about 15 weeks.

The Large-Scale Failures of Single Payer

The issues with single payer systems only become more blatant as the population size and income inequality gets larger and less manageable. Brazil, like Canada, has also implemented single-payer health care. They have a population of 200 million, and, according to the CIA, an income-inequality ratio between the top and bottom ten percents of 25. Similarly, the U.S has a population of 325 million and income-inequality ratio of about 16. Because of this, The Atlantic describes Brazil as ¨not unlike a slightly smaller, warmer America, except with soccer.¨ Brazil does not have the small population size and wealth that Canada does, and is far more similar to the United States in that it is diverse both ethnically and geographically.

There are only about two hospital beds for every 1,000 people. It can take months to get an X-ray in Sao Paulo.

As a result, the Brazilian single payer system functions far worse than Canada’s. "There is an ongoing shortage of essential healthcare infrastructure, such as beds and x-ray machines,” according to The Atlantic, and there are only 2 hospital beds for every 1,000 people. Waiting times can be months and months long, even in urban areas like Sao Paulo, either due to shortages of equipment or the wealthier patients who crowd out the poor. The wealthy often abuse the system, using private insurance for most of their needs while using public health care to get the costliest procedures or to obtain expensive experimental drugs for free.

While Brazil may provide health insurance for everyone, the quality and equality of that care is poor. While it’s true that the lower classes in Brazil have some coverage as opposed to none at all, the single payer system used to achieve this end causes more issues and does not effectively provide care to larger populations. Brazil is a good example of what single payer could look like in the United States, and we shouldn't go down the same path as Brazil if it is only in return for mediocre gains.

America Has options, and Single payer isnt the best or only one that we have to provide universal healthcare.

Plus, we have choices: single payer is not the best or only option for providing universal healthcare that exists. Supporters of single payer often point to European systems as examples, yet most liberal European democracies “have achieved true universal coverage with hybrid public/private models,” according to The Guardian. “When compared to single-payer Canada, the hybrid models in general rank better in quality and efficiency and are as or more equitable.” Not only is single payer less effective than a hybrid system, it is less feasible as well -- to implement single payer healthcare in the modern-day United States, we would have to not only nationalize the insurance industry, but also severely reduce “payments to doctors, hospitals, and other areas of the healthcare industry if it were to bring any cost savings,” according to The Guardian. It would never be “politically viable even if it was desirable as policy.”

So let’s not rush towards single payer health care. While the U.S has its ailments, single payer won't magically alleviate them. Let’s take a page from Sanders’ book and look to the other Western nations for better, hybrid solutions - the solutions that will actually work for America.

Created By
Samuel Hodman
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