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Citizen Power is an advocate for the establishment of a universal health care system based upon the single-payer model. We support universal care because we believe that access to medical care is a human right that should be available to everyone and must not be withheld based upon an individuals’ ability to pay. We favor the single-payer model where the government, instead of private insurers, pays for all health care costs because it is the most efficient method of providing universal coverage. Under single-payer, more resources are used to provide medical care instead of being consumed by administrative functions. Citizens will pay less, on average, for health care through higher taxes than they currently pay for premiums under a private health insurance system. In addition, the types of services provided are more comprehensive, covering such things as long-term care, vision, and dental.
The health care system in the United States has performed poorly when compared to other wealthy nations. We spend considerably more than any other country on earth on our health care system; for example, our spending is more than double what the United Kingdom spends on a per capita basis. However, the impact of this extravagant spending has not been reflected in our outcomes as seen in this chart [link to chart]. Our life expectancy is ranked 51st in the world, behind countries such as Jordan, and the World Health Organization ranked our health care system 37th in the world in 2000. The 36 countries ranked above the United States can be characterized by having a greater governmental role in their health care system with many of them favoring universal care. In 2012, a Commonwealth Fund report comparing seven developed countries ranked the United States dead last for health care performance and sixth for quality of care.
In an attempt to improve the current health system, the Affordable Care Act (ACA) was passed in 2010. Instead of following the example of the vast majority of developed nations in the world and establishing a universal healthcare system, the ACA established an extremely complex financing system based on private insurers offering insurance through government established marketplaces with subsidies available for some individuals. Although the ACA improved on some of the problematic aspects of the prior health care paradigm, such as the difficulty in obtaining insurance with a pre-existing condition, it did not ensure that health care is available to everyone nor did it significantly reduce administrative costs.
The first issue with the ACA is that it does not do enough to reduce the number of uninsured. One projection estimated that the number of uninsured after the implementation of the ACA will be around 31 million. These are 31 million people who cannot rely upon quality health care services, who lack preventative screenings, who may wait until treatable problems become worse, and who ultimately could end up in emergency rooms with a more expensive to treat condition that has a worse outcome. These 31 million are subject to the stress of not being able to rely on the health system in times of need and potentially subject to bankruptcy in times of emergency.
The second issue with the ACA is the cost. The United States health system is far and away the most expensive in the world. One of the main reasons for this are the administrative costs related to the private health insurance industry. A study by the Harvard Medical School and the Canadian Institute for Health found that the administrative costs a decade ago accounted for 31% of the amount spent on healthcare in the United States, more than three times the cost in Canada on a per capita basis. These administrative costs include both the administrative costs incurred by the insurer and those imposed upon the healthcare provider through required form submittals. The overhead for private insurance is between 15-25%, as opposed to the 2-3% it takes to administer Medicare, which is run by the government. However, a complicated private insurance system also imposes higher costs on the health care provider through the lack of standardized documentation. Since the ACA does not remove private insurance from the equation, there are significant potential savings that are not being achieved.
Accordingly, Citizen Power supports passage of HR 676, legislation currently pending in the US House of Representatives, titled “The United States National Health Insurance Act” or “Expanded and Improved Medicare for All.” To read a summary of the bill, click here. To see the entire bill, click here.
There are a number of myths created by those who want to maintain the current, for profit, insurance-run, health care system. Click here for some answers prepared by Physicians for a National Health Program to frequently asked questions about single payer health care.
If you’d like to get involved on a local level, click here.