By all accounts, the American healthcare system is broken. Per-capita healthcare spending in the U.S., at almost $10,000 annually, is around three times that of most other major developed countries and a staggering 17% of the nation’s GDP – far more than any other nation save the tiny Pacific archipelago of Tuvalu – is spent on healthcare. Indeed the system is so dysfunctional that even with this largely for-profit model, per capita public healthcare spending in this country is about the same as in other developed countries that provide their citizens with free universal healthcare.
The truly damning piece of the picture is that even with these absolutely outrageous costs, America ranks dead last in health outcomes among the 17 most developed nations, according to the World Health Organization. The obvious cause of these runaway healthcare costs, which have devastating impacts on Americans at a time of declining real incomes, is the fact that the American healthcare system, unlike its counterparts throughout the rest of the developed world, has been run almost exclusively on a for-profit basis, incentivizing money-making speculation at the expense decent, affordable care.
Even as Republican obstructionists seek to keep Americans indebted to price-gouging pharmaceutical and insurance companies by voting to repeal the Affordable Care Act for the 62nd time in a criminally misguided defense of their sacred “market principles”, both of the leading candidates for the 2016 Democratic presidential nomination – Sen. Bernie Sanders (I-VT) and former Secretary of State Hillary Clinton – are hoping to build on Obama’s progress with new measures to curb healthcare costs. Sen. Sanders, who is now the leading candidate in both Iowa and New Hampshire, has been particularly aggressive in his drive for better healthcare, making it a centerpiece of his social democratic campaign.
In perhaps his most poignant expression yet of support for a total overhaul of the healthcare system, Sanders said yesterday in an interview on MSNBC’s Morning Joe that for-profit healthcare must go once and for all in America. “First question we have to ask,” he said, “is should healthcare be a right of all people or should it not? I think it should. We’ve decided public education is a right. You don’t have to be rich to go to high school. We should make that determination [about healthcare]. Every other major country on Earth has done it” He went on to praise the Affordable Care Act for eliminating the “obscenity” of pre-existing conditions and expanding Medicaid, but called the Act a “small victory” for the uninsured.
Sanders envisions the creation of a universal single-payer healthcare program along the lines of those in Canada and Europe, which would provide all Americans with the same level and quality of coverage currently provided to seniors through Medicare. While the costs of such a program would undoubtedly be great – as much as $15 trillion over the coming decade according to a Wall Street Journal report – they are nothing compared to the costs of inaction that will preserve a status quo in which, as Sen. Sanders put it, healthcare companies “are out to make as much money as possible” rather than provide quality, affordable care.
Thus, because of both inefficiencies and overcharging in the current for-profit system an estimated 95% of Americans would save money under a universal single-payer system, just as Medicare and Medicaid today are more cost-effective than private insurance. To finance his plan, Sanders has proposed the creation of an American Health Security Trust Fund that would be financed by a mixture of tax revenues, subsidies, and credits and would distribute care to Americans. As Sanders put it yesterday on MSNBC, “We need to… come up with a system which is not designed to make the drug companies and insurance companies rich, but rather to provide quality care to all our people.”