Medical bills are the number one cause of bankruptcy in the United States; 30 million (9.7%) people of all ages are uninsured, and 43% of adults are inadequately insured. In the modern age of globalism, the rising costs and inadequacies of the current healthcare model have surfaced on the political table in the hopes of seeking reform under a utilitarian framework. A widely regarded proposal is the Medicare for All Act which plans to nationalize the health insurance industry while maintaining the current infrastructure of healthcare providers, hospitals, and physicians. The act runs on the fundamental principle of comprehensive healthcare coverage free at the point of service, encompassing the dissolution of cost-sharing mechanisms such as copayments and insurance fees. Unlike other reforms, Medicare for All would reduce the widespread and unnecessary suffering of the uninsured by removing the financial barriers to care. A review of the available literature shows that Medicare for All can bridge the complex intersections between social and moral obligations with economic justice by relieving the financial burden on low-income Americans. The aforesaid relationship can be portrayed by exposing the flaws imposed by the current system and addressing how Medicare for All can influence lower drug prices, promote growth in the job-seeking and entrepreneurship industries, and lower administrative costs.
In the status quo, pharmaceutical enterprises employ the tactic of evergreening by expending substantial resources towards prolonging the validity of patents, effectively stifling competition and perpetuating a monopoly resulting in exorbitant drug pricing. Thus, the Census Bureau reports that “11.2 million individuals were pushed below the poverty line owing to the out-of-pocket medical expenses,” which are associated with “insurance premiums, prescription drug costs, and doctor’s office co-pays”. The empirical evidence would imply that amidst the course of evergreening, insurers experience a lack of bargaining power to engage in negotiations for prices, as they are confronted with a demand that is largely inelastic in nature. However, the advent of Medicare for All has the potential to counteract evergreening through a triad of policies that accompany its implementation and are further fortified by the bargaining leverage of unified authority. Rohan Chalasani theorizes in Health Affairs that Medicare for All can negotiate more favourable drug prices via the Medicare Drug Price Negotiation Act, enable ‘consumers’ to procure cost-efficient prescription drugs from other industrialized nations with the Affordable and Safe Prescription Drug Importation Act, and halve prices by anchoring them to the median drug price in Germany, the United Kingdom, Japan, Canada, and France through the Prescription Drug Price Relief Act. In accordance, Alison Galvani, a professor at Yale University writing for The Lancet, justifies the aforementioned policies by suggesting that the US Department of Veterans Affairs (VA) would now have the aptitude to negotiate prescription costs that are commensurate with their established therapeutic value, potentially yielding pharmaceutical prices that are 40% lower. The correlation between Medicare for All and lower drug prices can be explained because national healthcare financing would align the remuneration the government pays a pharmaceutical firm to the dollar amount patients benefit from the company’s products. Therefore, in the long run, this would foster a dynamic where pharmaceutical corporations are motivated to create medications that render the maximum therapeutic advantage to patients rather than simply those that command premium prices.
The escalating significance of health insurance has led to “1 in 6 U.S. workers [to] stay in unwanted job[s] for health benefits,” with the fear being further pronounced among marginalized populations . Succinctly, the perpetuation of remaining in unsatisfying employment has resulted in a vicious cycle, wherein employees facing discontent exhibit a decline in productivity by 10 percent. As a result, this arrangement has been referred to as the “divided welfare state,” with a dichotomy of access to health and retirement benefits contingent upon an individual’s occupational status.
A paper done by Laurence Seidman entitled “Medicare for All: An Economist’s Case” proclaims that “under Medicare for All, business managers, entrepreneurs, and job seekers would no longer be distracted by health insurance” because managers and entrepreneurs would focus solely upon respective businesses, while job searchers would choose to change employment without regard for health insurance. If this was the case, the take-home wages of Americans are said to be approximately 400 billion dollars higher, given the expanded fiscal capacity to allocate toward wage compensation. Moreover, by promoting the redirection of healthcare expenditures towards worker compensation, the overall quality of employment positions would be raised. This is because all jobs now come with a guarantee of health insurance. A boost to job quality would be especially “higher among women workers, who are less likely to have employer-sponsored healthcare”. Respectively, new dynamism ushers into the economy by relieving “job lock”—authorizing labourers to gravitate towards employment opportunities that align with their inclinations rather than merely settling for positions that offer accessible healthcare benefits.
The intricate demands for “medical billing, documentation, and performance reporting requirements for value-based payment initiatives have made the U.S. healthcare system one of the most administratively burdensome in the world”. This hindrance culminates in unprecedented levels of burnout among doctors and other medical practitioners, diverts time away from providing direct patient care, and institutes billions of dollars in unnecessary administrative costs. Bruce Lee furthers in Forbes that physicians spend 37.0% of their time doing paperwork. The statistic serves as validation of the notion that insurance paperwork is a substantial factor contributing to physician turnover, as many healthcare practitioners prioritize patient interactions over allotting time towards fulfilling bureaucratic requirements.
It can be posited that despite a potential enhancement in the efficiency of physicians under a Medicare for All system, this does not adequately reconcile the inevitable prolongation of waiting times. This phenomenon can be associated with the exacerbation of demand for medical services in conjunction with the constrained availability of resources, leading to a protracted waiting period for patients seeking medical attention. However, Thomas Waldrop expresses in the Center for American Progress that these wait time studies overlook a crucial aspect of the current healthcare landscape; the fact that over 27 million individuals are uninsured and are subject to an infinite wait time would render them uniquely vulnerable in the status quo. Thus, the reduction of the administrative bureaucracy of private health insurance has the potential to result in a long-lasting increase in economic productivity and efficiency. Even given the lower billing administration work, a universal healthcare system is guaranteed to considerably boost overall employment in the healthcare sector via increased job quality, boosted wages, lessened economic shock, and the production of a net increase in public spending.
Medicare for All leaves no one behind. Refining America’s healthcare system offers solvency to the moral responsibility of providing health care as a human right, independent of job or wealth. The medical community should grasp this opportunity to promote well-being, boost prosperity, and develop an impartial healthcare system for all Americans. Instead of attempting to limit the expenses associated with expanding coverage, politicians should attempt to alleviate the hardship on those who are defined as “consumers”. Without a shift toward Medicare for All, the notion that healthcare is just another commodity that people may choose whether or not to purchase would continue to linger in the societal norms surrounding healthcare.