Medicare for All? The Viability of a Nationalized Health System in America: Part I
The American Healthcare Conundrum
This article is part of a series in which we will delve deeper into the controversy surrounding the concept of “Medicare for All.” In particular, we will examine the proposals issued by 2020 presidential candidates Bernie Sanders and Elizabeth Warren and assess the extent to which a universal healthcare system in the United States would parallel the existing programs in other foreign nations, addressing its feasibility, efficiency, and popularity in the context of the current socioeconomic state.
In the years since President Obama unveiled the Affordable Care Act (informally dubbed “Obamacare”) to the nation, there has been no respite in the amount of rhetoric issued over the faulty state of the American healthcare system. The contention usually arises between Republican lawmakers bent on the “repeal and replace” option and Democratic proponents who insist that aside from the necessary fixes, Obamacare should stay; in fact, there are many who believe it was too limited in scope, and modern progressives have been pushing for major ramifications in the structure of American healthcare policy.
Throughout his 2016 presidential campaign, Bernie Sanders repeatedly emphasized his pledge to root out corruption in the healthcare system caused by private insurance companies and implement a nationalized plan under which all Americans would receive coverage directly from the government. Sanders has since renewed the call for “Medicare for All” for the 2020 elections, joined now by Elizabeth Warren, who has been equally vocal about rebuilding the faulty system; both senators have actually contributed to a current bill that aims to establish “a national health insurance program to provide comprehensive protection against the costs of health care and health-related services.” However, both senators have been denounced by members within their own party, and in some cases, derided by their fellow candidates onstage: at one point during the July 30th Democratic Debate, Colorado Governor John Hickenlooper slammed Sanders for his policy’s attempts to “force Americans to make these radical changes [to their healthcare],” and the Vermont senator’s exasperated response quickly went viral.
Democratic presidential hopefuls and US Senators Sanders (left) and Warren are proponents of government-sponsored Medicare for All (image: The New Yorker).
Given how much fire both candidates have taken from their peers for a program that would appear to concur with the general Democratic agenda, it is initially surprising to observe the party as hesitant as it is to lend its support to two of the leaders in the national polls on this singular matter. However, the issue of healthcare is precisely just that: it is a singular topic that concerns every resident in the United States, citizen and non-citizen alike, and could potentially constitute a significant component of the federal budget. And perhaps this is what has unnerved so many members on both ends of the political spectrum, as the receipts attached to some of these healthcare programs unfurl to the floor and out the door. When Massachusetts senator Warren, who seemed reluctant to share information about the price tag on her expansive Medicare plan, revealed that it would require “just under $52 trillion over ten years” to cover the costs, former Vice President and 2020 candidate Joe Biden was quick to criticize her ambitious budget proposal as a form of “mathematical gymnastics.” As for Sander’s single-payer plan, a recent study from Urban Institute crunches out the number to be $32 trillion worth of tax revenue over the span of a decade to fund the program. For some perspective on how large these numbers are, consider that if this bill were to be apportioned evenly amongst the American population, each person would have to pay close to $100,000 at the very least. While Warren and Sanders have taken this issue into account by shifting the burden of the cost to the upper, elite classes, many economists have expressed concerns about whether doing so will truly be as effective as they claim it to be.
To assess each candidate’s ideas comprehensively in the span of one article would be a formidable task indeed, given the complexity of the healthcare dilemma—especially in the United States. It is necessary to make the latter distinction here, as a host of other countries have already shifted to a nationalized system. Some, like Canada, have encountered success with universal healthcare. Others like the United Kingdom have struggled, where a dearth of radiologists and other specialists has slowed the healthcare process to such an extent that in 2017 alone, 115,000 cancer patients only received a diagnosis after their tumor had reached the 3rd or 4th stage. It is difficult to find an appropriate metric of comparison between these programs and a realistic “Medicare for All” plan in the U.S. due to the significant differences in the structure of their economic systems, but they nevertheless offer an example for evaluation of which aspects could work and which ones wouldn’t in the capitalist world of America.