My hyper-idealistic proposition of a single-payer healthcare coverage system

America is among the wealthiest nations, hailing as one of the 8 superpowers of the world. We have the largest economy, we have one of the largest populations, and we have one of the largest land masses (specifically important because it means we are more spread out). Despite all of these accomplishments, we are lagging behind every other developed nation in regards to quality of healthcare system, which is ranked according to a composition of outcomes, quality of care, and access to services. My proposal for an immense improvement of our current healthcare system would be a government run single-payer system  where all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Where my proposal stems away from those of other developed nations is how they pay for what would be considered luxuries such as dental, or vision care. They offer separate private plans for those luxuries, while I propose to include the luxuries with my plan (with purely cosmetic surgery paid out of pocket) because I believe we will be able to afford it by cutting administrative costs to the bare minimum. In this blog, I will be reviewing why this proposition is superior to our current system with the help of comparisons between other nations’ and our own systems.

One of the problems with our current system is that too many citizens are unqualified for coverage or they can’t realistically pay for the care with their income. What’s happening here is that they either make too much money to qualify for Medicaid, and they aren’t granted coverage through their jobs.With this list, it may not sound like a lot of people could fall through the cracks, but yet 27.4 million Americans are left uninsured. My single-payer system proposal would cover all citizens, and as opposed to the system that we have at the present, mines wouldn’t leave our citizens with crippling debt or un-access to treatment. It would be similar to France and Canada in that at least the basics are covered, although my proposal will stretch a bit more, with a more encompassing coverage. That source reveals that it is possible for other nations to effectively provide coverage ti their citizens through a multitude of different means. My proposal is actually pretty close to Canada’s from the source, except I cut out private insurers completely and instead expand what is provided to the public insurance ( vision, dental, and prescription drug benefits).

Another problem with our current healthcare system is that our current healthcare expenditure vastly surpasses those of other developed nations. This means that we spend a lot more on healthcare as a nation than that of other nations. As I established on one of my previous blogs, one of the heaviest burdens contributing to our much greater expenditure are the provider and insurer administration costs, which have to deal with all of the different insurance companies (900+) to ensure everything is set. With my proposal, there will be one single payer (the government) rather than multiple different insurance companies. My proposal would save $200 billion alone annually, just from by eliminating overhead costs and reducing the billing and paperwork expenses. This is money saved from eliminating the middle man (insurer and provider) administration, which as established in the source a massive cut which will be effectively directed towards the healthcare of our citizens rather than the pockets of the insurers and their unit.

Another problem with our current healthcare system is that our primary care is underdeveloped and underfunded. People who cannot afford healthcare avoid hospitals until their conditions can no longer be ignored or until it is too late. More resources will be spent trying to treat the condition when it gets serious than treating the condition when it is only budding, racking up the net cost of the condition. My proposal would allow people to not fear the costs of hospital visits, so our citizens would willingly attend frequent checkups and we would be able to catch and diagnose ailments before they get too bad and require costly specialist work. With a focus on early diagnosis, the primary care field will  logically receive more funding, furthermore improving their effectiveness and ultimately reducing the costs we spend as a nation. The source is important because it will be the motor that keep our healthcare system cheaper than what it is at the present. People get sick and/or old eventually, but to allow it to get to bad enough to where it bleeds so many resources to sometimes no avail is a common reality in our current system because of the required cost for basic checkups. My solution intends to seal the bleeding before we lose too much proverbial blood.

 

So in summary, my healthcare coverage proposal is a single-payer system of government-run public insurance that covers all medically necessary services
The reasons why my proposal is superior to our current system is that my healthcare expenditure stemming from completely unnecessary spending (that stemming from administration and the like) will be drastically reduced, our citizens will be happier and healthier as they can afford checkups without stressing about the bill, and that no citizens are left unable to pay for treatment, as they are universally covered by my proposal. My proposal is paid for by businesses and the individual, with there being a percent tax for both parties.

 

This diagram covers what I was talking about, in which a single payer universal healthcare would be mroe cost-effective than our current model. 98% of current NYers would pay less for healthcare under my proposed plan and every single one will be covered (unlike now where 3/10 are either uninsured or underinsured). This diagram also cleanly demonstrates where exactly the funding is coming from and the path it takes towards the doctor’s office for your insured healthcare coverage.

 

Universal Healthcare gets yeeted by Legislature 2019 in 4khdr

Despite the increased rallying by Americans for universal healthcare, we have made seemingly negligible progress towards such a system. Considering that most other developed nations have some form of universal healthcare, it feels like a simple problem that should have a simple solution, but that the people in power just don’t want to afford us universal healthcare. That is unfortunately not the case, as there are too many seats at the table, too many conflicting interests, and too many systems and subsystems in place for universal healthcare to be implemented with a simple signature or with relative ease. The only institution that can realistically prompt the implementation of universal healthcare system nationally is Congress, the legislative branch of government, through creating the laws that will usher in the framework for universal healthcare. In this blog, I will further be discussing why and how Congress impedes progress towards Universal Healthcare ranging from composition of opposing factions to some of the economics.

 

Congress as a whole unit is extremely powerful, arguably more powerful than the other branches of government, as Congress create the laws which all Americans must follow. Owing to the fact that Congress is so powerful, it is justly divided into two factions, one being the Senate (2 representatives per state) and the other being the House of Representatives (number of representatives based on size of each state’s population), which constitutes to a total of 535 members of Congress. Parties, interest groups, and voters/citizens all influence members of Congress in their vote choices, and members also compromise and negotiate with one another to reach agreements. Every decision made affects some group, so naturally every group wants their voice heard. In short, for a bill to be passed, it must go through a committee and subcommittee, and then it’s voted on, then repeats the cycle in the other chamber, then a final conference between both chambers to solidify a proposal. (Genome.gov.)
Universal healthcare is convoluted as it is, as there can be multiple ways of going about attaining it with multiple possible forms. Having every single component being agreed upon by a majority in every single step of the proposal becoming a law is incredibly difficult, so must be tactfully crafted at the start. Conclusively, the reason any form of universal is having trouble being passed is because there are too many hoops and opposition to go through because of all of the different interest groups represented in Congress and all of the stages.

One of the reasons that no significant progress is being made is because of the inadequate allocation of funding and taxation by Congress. Another ability of Congress is to appropriate spending for any fiscal policy measures, meaning that “Congress can raise and provide public money and oversee its proper expenditure”. (Casey.senate.gov)  Specifically,  Article I, Section 8 is what gives Congress the power to “lay and collect axes, duties, imports, and excises.” The Constitution allows Congress to tax in order to “provide for the common defense and general welfare. Congress has the power to set the stage for universal healthcare by increasing taxes on the wealthy, regulating drug prices (through taxation), and redistribution of wasted expenditure towards a universal healthcare (Here is a breakdown of our 2018 expenditure, nearly 50% towards defense). As suggested in my source, Congress has the power to influence the spending of the government, so I am advocating for us to allocate some of the defense budget towards healthcare along with the added taxes from the uber rich because as it stands now, prioritizing the interests of the wealthy is a massive roadblock for universal healthcare.

Another of the reasons no progress is being made is because congress members generally have to stick with what their constituents voted them in for. So even if bills are proposed that would benefit the majority of citizens, congress members are still generally tied to their constituents’ will. ( Openstax, TYPES OF REPRESENTATION: LOOKING OUT FOR CONSTITUENTS)It should be noted that it is not absolute; it is just a trend that if not followed risks losing standing after term. Because of each respective member’s insistence to get their way on behalf of their represented, mostly simple laws are likely to get passed, as complicated ones might rub too many shoulders wrongly. The point being made here is that congress people are usually firm to their base, and it is related to stopping the implementation of Universal healthcare because too many congress people are firm in their rejection of anything progressive in regards to UH, as their base generally is(earlier we established that Americans are anti-intellectual, so they view “handouts” poorly).

 

So in summary, Universal Healthcare is held back by the fact there are so many hands (conflict of interest at the table) coupled with so many hoops, the fact that Congress is putting too little pressure on the wealthy, and the fact that representatives in Congress generally have to stick with what their constituents voted them in for. My first source stresses the lengthiness of the legislative process and all of the checks “yes” it has to go through, it would fall under social of our group concept map, as we are working on how the system of legislation is run(all the steps listed in source 1). My second source digs into the power that Congress has over our economics, and I supplement it with my 3rd source to suggest an improved allocation of their funding. They would fall under resources of our group concept map, as we determine how we pay for it with source 3(reallocation of funding) and who pays for it(prompting the wealthy to pay through taxes). The final source has to do with both mental and social, as both constituents and their representatives believe that they generally have to meet eye to eye, effectively being a political culture.  And although the abilities of congress are pivotal to the implementation of universal healthcare, but other factions both regional and local also fall into play and can’t be overlooked.

 

As demonstrated in the graphic, significant reform of the Healthcare system is more bipartisan than we would hope for change to be made in Congress(assuming reps are in tune with their voters). The saving grace in the graphic would be the independents, and their general consensus would depend on how Congress proposed the reform(assuming that congressmen were completely in tune with their constituents’ desires.

The US Healthcare System as it is now

In this project, I will be proposing a different model or ideal outcome for the US healthcare system. Before that, here is a quick overview of the way our healthcare system currently works and why:

In the American system as it stand today, we have what is known as a direct-fee system, in which patients under 65 (those 65 and older are covered by Medicare) are expected to pay for medical costs themselves(out-of-pocket), aided by private health insurance (usually through one’s employer.) (Saylordotorg.github.io) So in this current model, healthcare is essentially reserved for patients 65+, smaller public programs (like CHIP, VA benefits, etc) for specific demographics, citizens with a decent employee benefits, Medicaid (for the dirt poor), and the wealthy/financially stable. It sounds like pretty much everyone is covered someway somehow under this system with so many programs available, yet millions of Americans still go into debt paying for their care, and the seemingly all-encompassing social nets are far from perfect with too many hoops to jump through for coverage.

America is currently the largest economy in the world, yet the U.S. healthcare system is characterized as the world’s most expensive yet least effective compared with other nations. There are many issues that contribute the abnormally high cost of spending including the use of expensive new diagnostic tests and treatments, increased costs of health care goods and services, overuse of specialists, high administrative costs, and defensive medicine (malpractice insurance as well as tests and procedures done to protect against being sued for malpractice, rather than to ensure the health of the person.) (Merckmanuals.) One of the major economic drains from the aforementioned is the high administrative cost, which, if you look at the graphic, makes up an unreasonably large percentage of our health care expenditure. The reason is because of private insurance companies, as “having to deal with many different private insurance plans typically increases administrative costs for health care providers by making processes (such as claim submission and coding) more complicated and time-consuming and companies that provide private insurance spend money on marketing and evaluation of applicants to identify those with preexisting disorders or the potential for developing a disorder.”

The current US model for healthcare holds healthcare in the hands of private entities, which leave too many Americans without healthcare insurance(nearly 14%) (Gallup).I will be proposing a government-run universal healthcare which provides coverage to all and lowers our healthcare expenditure. This will be cutting out the middle-man and putting American citizens first.