Medicare for all

Healthcare is one of the most pressing and polarizing topics among American voters in this election. Democratic candidates are pushing for, in different forms, Medicare For All (MFA), an idea that many conservatives are vehemently against. Voters have been bombarded with claims about how horrible the current system is (for very good reasons) and also with warnings that MFA will be hugely expensive, lengthen the waiting time and limit choices.

To help you be more informed of the issue, I’ll recommend this piece by John Oliver and his team. It does have a view as in the presenter advocates for some form of MFA, but even if you have doubts about MFA, you should also give it a listen. In addition, there is a recent study by The Lancet, an independent medical journal, on the impact of a single pay, universal healthcare system in the US. Here is a sneak peak

Although health care expenditure per capita is higher in the USA than in any other country, more than 37 million Americans do not have health insurance, and 41 million more have inadequate access to care.

Efforts are ongoing to repeal the Affordable Care Act which would exacerbate health-care inequities. By contrast, a universal system, such as that proposed in the Medicare for All Act, has the potential to transform the availability and efficiency of American health-care services.

Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017).

The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations

Source: The Lancet

You can read the study by registering for free on The Lancet’s website, but you can also download a copy from the link below since I already did so for you (I’m nice that way). All the copyrights belong to The Lancet. I highly recommend it. It’s an informative read.

For example, a vial of insulin costs approximately $300 in the USA compared with $30 in Canada.

The average cost of giving birth in Spain is $2333 compared with $14910 in the USA, yet the prevalence of neonatal mortality in the USA is double that in Spain.

Source: The Lancet

Personally, I think that having one single payer will give back a tremendous amount of bargaining power back to the payer. If that payer is a private company, then there is an incentive alignment as the company will want to maximize profits by inflating the bills and taking more money from citizens, which is the opposite of what the people want. Instead, if the payer is the government whose interest is to keep the cost down given that the tax revenue doesn’t increase and whose lawmakers’ interest is to keep being elected to office, then there is an incentive alignment with that of citizens. Healthcare service suppliers will have no choice, but to work more in the interest of citizens.

Admittedly, there will be flaws with MFA. But I agree with John Oliver. A carefully designed MFA that can help improve the current system, albeit still with flaws, will be appreciated.

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