As defined by Mary Gerisch, human rights are “rights to which we are entitled, simply by virtue of our humanity” (2018). These rights are independent of our race, religion, sexuality, political ideology, and income. While this fundamental idea provides American citizens with the ability to do and say many things, something that we have continually been denied is our right to healthcare. The United States is the only developed country in the world that has not implemented a universal healthcare system. As defined by the World Health Organization (WHO), universal healthcare “means that all people have access to the health services they need, when and where they need them, without financial hardship” (2021). For the purpose of this discussion, it is important to note that “universal healthcare,” “single-payer system,” and “Medicare-for-All” are all terms that can be used interchangeably and mean the same exact thing. As described in a 2015 UN report, the United States intentionally refers to their efforts as health “measures” instead of health “rights,” resulting in stagnant progress concerning healthcare reform (Gerisch, 2018). Our country is built on the idea that profit is more important than people, which only allows for the continual denial of healthcare to its citizens. While the United States may not currently have a single-payer system, many people question whether it is plausible. If we were to establish a single-payer healthcare system, it would be important to consider its cost-effectiveness, its ability to adequately provide for a diverse group of citizens, and the integrity of the system compared to our current one.

While some people believe that universal healthcare is a possible solution to our current healthcare crisis, many argue that its establishment would be more costly than our current system and result in economic turmoil. It has been estimated that the upfront costs collected via tax proposals would cost the country 32 to 44 trillion USD over the span of 10 years (Kerr, Moore, Stoner, & Zieff, 2020). The Committee for Responsible Federal Budget presumes that this universal coverage plan “...would result in an additional $19 trillion of federal debt, causing the debt to rise from 74 percent of GDP in 2015…to 154 percent of GDP by 2026” (“Should All Americans Have the Right (Be Entitled) to Health Care,” 2019). While these statistics may pose alarming concern, they are actually quite elusive and should not be taken at face value. In reality, our current form of healthcare spends an ample amount of money on unnecessary items and tests that drive up our GDP. A universal healthcare plan has upfront costs that will eventually recompense themselves which, in turn, saves money and allows for a more economically prosperous country in the long run. As explained by Weisbart, “Uncontrolled costs consuming an ever-increasing percentage of the GDP create the appearance of inadequate resources, but the experience of other nations belies this. Under a single-payer system, regional planning of resource allocation would be aligned with public health needs rather than duplicating services and driving up the medically questionable utilization” (2012).  The irresponsible use of government funds when it comes to health and medicine in this country is a primary cause of having a GDP higher than nearly all other developed nations while still providing lackluster services in comparison to them. A single payer system may seem austere at a visceral level, but its provisions outweigh the complexities that come with our current system since streamlining costs under one provider would reduce the inefficiency of using both public and private insurance. The government spends aimlessly due to the fact that there are no repercussions for them under our current healthcare system. With this reform, the government will be held accountable since the entirety of America’s population will be reliant on them. While there would be necessary upfront costs in order to fund alterations to the system and programs that advocate for a healthier lifestyle, insure the uninsured, and expand upon the services present, it is important to note that over time these initial steps not only save money, but provide a return back on the country’s investment. “Preventative measures lessen costs associated with an uninsured and/or unhealthy population. For example, investing USD 10 per person annually in community-based programs aimed at combating physical inactivity, poor nutrition, and smoking in the U.S. could save more than USD 16 billion annually within five years, equating to a return of USD 5.60 for every dollar spent” (Kerr, Moore, Stoner, & Zieff, 2020). When it becomes the government’s responsibility to pay for every citizen’s healthcare, they will become more incentivized to promote preventative care. This results in economic prosperity as our population begins to become healthier (through the reduction of those diagnosed with preventative diseases), allowing them to stay in the workforce for longer and become less of an economic burden. Ultimately, it is evident that universal care not only saves money, but lives. Through its establishment, the quality of healthcare, along with the economy, would flourish.

It is also important to consider how a system as homogenous as universal healthcare, will impact a country with such great diversity. In our nation, there is great disparity among our citizens when it comes to race, gender, religion, sexuality, income, and even political views. Prejudice against those in the minority has a profound effect on their life and the way laws apply to them. Focusing specifically on economic and racial disparity, it is evident that our current system does not cater to the bourgeois, lower-class, or people of color. The Institute of Medicine claims that approximately a third of medical spending is wasteful which harms low-income citizens as they pay for unnecessary health expenditures. (Blumenthal & Squires, 2014). This has a greater impact on lower class individuals since they are paying for costly services they fail to utilize. In a figure following the Research Supplemental Poverty Measure in 2010, it was determined that “healthcare costs may be directly increasing the number of Americans living in poverty,” which is “...consistent with the observation that health care-related expenses contribute to more than half of personal bankruptcies in the United States,” with a majority being those who worked middle class jobs (Blumenthal & Squires). Our current system continues to impoverish its citizens through exorbitant healthcare costs with a lack of return. This form of healthcare primarily caters the wealthy as they are able to afford such lavish insurance policies. But, under a more sustainable system, such as Medicare-for-All, “...if the health care system were more efficient and less costly, lower-income workers might gain considerably more—as a proportion of total compensation—than higher-income workers” (Blumenthal & Squires, 2014). The establishment of a single-payer system would prioritize equity over profit and provide more benefits to lower-and-middle class citizens, minimizing the margin of economic disparity. This system would also alleviate the financial burden of low-income individuals and enable them to allocate those costs towards other important factors such as a car, a home, or children. 

The Office of Minority Health—a subsection within the Department of Health and Human Services—states that African Americans are typically at a greater risk for things such as heart disease, asthma, stroke, pneumonia, cancer, asthma, influenza, and HIV/AIDS. Shockingly, while Black people are more likely to die from these diseases, they still have the lowest insurance coverage and the highest uninsured population compared to other minority groups. With average healthcare premiums costing one-fifth of an African-American’s household income, we require a plan that alleviates these pressures and caters to America’s minorities (Taylor, 2019). In response to these alarming statistics, President Barack Obama passed the Affordable Care Act (ACA) in order to improve citizens’ experience with private insurance and expand Medicaid to a greater population of low-and-middle class individuals. Through the implementation of acts such as ACA, the ethnic and racial disparity among our country has seen substantial improvement. Although the ACA is not fully universal, it is a step in the right direction. The problem arises when the government does not require states to adopt the ACA which only hurts people of color as “the continued high cost of many coverage options means that access to affordable health care is still a challenge for many Americans—particularly African Americans” (Taylor, 2019). The lack of affordable care, like ACA and Medicaid, can be attributed to the state government’s reluctance, or rather stubbornness, to implement such policies. Under these programs, over 68 million people are insured, with over 20 percent being African American. Public health insurance programs, such as Medicaid, are vital in ensuring affordable healthcare for African Americans since they tend to be less advantaged in comparison to other demographics. “Under the ACA, Medicaid eligibility was expanded for adults with incomes up to 138 percent of the federal poverty level (FPL). This expansion was originally written into the ACA as a requirement for all states, but due to a 2012 Supreme Court ruling in National Federation of Independent Business v. Sebelius, it is now just an option for states” (Taylor, 2019). As a result, over 20 percent of states, mainly concentrated in the South, have not adopted the Medicaid expansion decision. Failure to implement this policy has resulted in the South housing the country’s sickest people, and it is where the inequity of health between White and Black people is most eminent. Through the implementation of a government run and funded healthcare system, we would not have to worry about state jurisdiction. This would prevent the refusal to adopt the system and ultimately expel the racial and economic injustice that accompanies our current system. 

Moral aspects of a universal healthcare system need to be compared to that of our current one in order to determine whether or not the transition will be beneficial to the equity and integrity of healthcare. The county’s reluctance to adopt a single-payer system may be attributed to the origins of which it was built upon. William Graham Sumner was an American political scientist and philosopher who had a significant influence over United States citizens during the 19th century. He believed in the Malthusian economic theory which stated that the world’s population was growing exponentially while its resources were growing arithmetically. This resulted in him promoting the idea of “survival of the fittest” in which those who are most suited to survive will go on to reproduce. (Jones & Kantarjian, 2015). Sumner, along with thousands of American citizens and government officials, believed that government aid interfered with the “natural selection” of a capital economy. This ideology developed into Social Darwinism---the belief that the laws of natural selection apply to humans---which only fueled the belief that healthcare was a privilege and not a right. But gradually, Democrats, in both the House and the Senate, have begun introducing bills to implement a single-payer system. A successful transition to universal healthcare would threaten the vitality of private insurance companies and Big Pharma. To combat this, they have employed the help of politicians to prevent universal legislation from being passed. As described by Facher, “In the last two years, at least 2,467 state legislators — over one-third of all state lawmakers nationwide — used pharmaceutical industry cash to fund their campaigns…The industry wrote over 10,000 individual checks totaling more than $9 million” (2021). The guile displayed by pharmaceutical companies is not only diabolical in nature, but dangerous to the people of this country as laws that would benefit them cannot be passed due to corruption and lobbying. When politicians accept money provided to them by Big Pharma, they are accepting the fact that they are disadvantaging the lives of thousands for their own political gain. In a political cartoon drawn by Amanda Deane, two doctors analyze a chart as a patient lays in bed a few feet away. The chart shows a great increase, so one doctor questions whether it is the blood pressure of their ill patient. The second doctor replies and reveals that it is actually a depiction of their profit (2013). This cartoon signifies the reality of the current healthcare system as economists, politicians, and even our physicians are in it for the profit rather than to serve the people. Our current leaders do not want to transition to universal care because our current system produces healthy profits for them and private insurers.  Although every attempt to amend the healthcare system has been unsuccessful due to opposition from the healthcare industry, it is important that we, as a collective, advocate for Medicare-for-All to ensure the safety and equity of our nation. There is a large misconception that a single-payer system would increase government interference when it is actually the contrary. Insurance companies provide no value in our healthcare system since they are just the go-between who primarily function to make a considerable profit by denying care. This is partially the reason as to why our current system has a surmount level of bureaucracy. "Single-payer" does not equate to a communistic government takeover, it is just a more practical way to finance healthcare. Under a single-payer system, there would be increased coverage and decreased costs since the government is more capable of negotiating prices with providers than an individual insurance company. Our current system is the reason as to why our country expends nearly double the amount per capita in healthcare costs yet has no universal coverage. The primary reason we have yet to establish a universal system is because of the large influence big money in politics has on the United States. We require a government that champions the common good and not wealthy corporations. Under a single-payer system, corruption and deceit among lawmakers will be diminished as they will no longer have Big Pharma and privatized insurance to look to for aid or funding. The morality of our country can be restored as we rework the selfish ideology it was built upon. Politicians and government officials all fall under the scope of “public servants.” With a universal system in place they can truly put their title to work and aim to be altruistic by devoting their service to the welfare of others.

Universal healthcare is a tangible possibility for our country. While it may be considerably difficult to approve and implement, its benefits, in comparison to our current system, truly outweigh the minimal drawbacks. For a smooth transition it would be important to acknowledge the costs that come with its establishment, the equity it provides for such a heterogeneous nation, and its potential to eliminate the political and medical corruption that poisons our nation. Universal healthcare would be such an asset to this country, so it is vital we do not let the opportunity be squandered by advocating for our rights and making it known that we, the people, want access to affordable, quality healthcare. It is when we use our voices that we can invoke change in the legislation and ultimately achieve our goal of Medicare-for-All. 

References

Blumenthal, D. & Squires, D. (2014, September 9). Do Health Care Costs Fuel Economic Inequality in the United States?. The Commonwealth Fund. commonwealthfund.org/blog/2014/do-health-care-costs-fuel-economic-inequality-united-states 

Deane, A. (2015, June 2). Health Care Hikes, YIKES! [Image]. Wibberly. rampages.us/amandadeane/2015/06/02/22/

Facher, L. (2021, June 9). Pharma funded more than 2,400 state lawmaker campaigns in 2020, new STAT analysis finds. STAT. statnews.com/feature/prescription-politics/state-full-data-set/

Gerisch, M. (2018, November 19). Health Care As a Human Right. The ABA Group. americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/health-care-as-a-human-right/#:~:text=There%20are%20rights%20to%20which,enjoy%20a%20life%20of%20dignity.

Jones, G.H., Kantarjian, H. (2015, October 1). Healthcare in the United States---Basic Human Right of Entitlement?. Annals of Oncology. annalsofoncology.org/article/S0923-534(19)35806-5/fulltext#relatedArticles

Kerr, Z. Y., Moore, J. B., Stoner, L., & Zieff, G. (2020). Universal Healthcare in the United States of America: A Healthy Debate.Medicina (Kaunas, Lithuania). 

            doi.org/10.3390/medicina56110580

Should All Americans Have the Right (Be Entitled) to Health Care? (2019, February 14). ProCon.org. healthcare.procon.org/

Taylor, J. (2019, December 19). Racism, Inequality, and Healthcare for African Americans. The Century Foundation. tcf.org/content/report/racism-inequality-health-care-african-americans/?session=1&session=1

Weisbart, E., MD, CPE. (2012). A Single Payer System Would Reduce U.S. Healthcare Costs. AMA Journal of Ethics. journalofethics.ama-assn.org/article/single-payer-system-would-reduce-us-health-care-costs/2012-11