The Trillion dollar question - making the case for Single Payer in America
In February 2004 I started to experience chest pains on my left side. They persisted for several hours and I finally decided it would be wise to see a doctor. Prior to that day I had been a relatively healthy 23 year old.
Upon arriving at the Hospital I was seen quickly, meeting with a doctor in under 40 minutes. After several cardiac tests and a chest X-ray, it was determined the cause of my pain was in fact a muscle spasm caused by anxiety.
At the time I was in college and unemployed. My net cost for that ER visit? $0
How is this possible?
I lived in Canada…and we have single payer.
Now that I live in the U.S. and have experienced the other side of the health care coin and heard all the arguments for and against universal care I’d like to do my best to set the record straight, since I’m tired of hearing and responding to misconceptions about the cost and effectiveness of my country’s “terrible socialist health care system”
It’s often said that Universal health care would cause costs to increase even higher than they already are. Let’s put that one to rest, shall we?
It’s been well documented the United States pays significantly more per capita for health care than most other industrialized nations.
The U.S. Census Bureau reported that a record 50.7 million residents (which includes 9.9 million non-citizens) or 16.7% of the population were uninsured in 2009. More money per person is spent on health care in the USA than in any other nation in the world and a greater percentage of total income in the nation is spent on health care in the USA than in any United Nations member state except for East Timor.
Here’s a graph illustrating the disparity:
As you can see, the United States spends nearly TWICE as much per capita than Canada on health care. That’s the same Canada that has single payer by the way.
Now look at this graph comparing health care costs to GDP:
Notice the United States all the way up there in the corner?
So, if universal health care is so costly, why are all these countries that have it spending less than we are on health care?
What would U.S. health care costs look like if we had single payer?
Let’s run a comparison with Canada and see what we get.
For the year 2007, total U.S. health care costs were approximately 15% of GDP or roughly 2.25 Trillion dollars (based on a GDP of 15 Trillion).
In Canada during the same period, health care costs were approximately 10% of GDP or roughly 150 Billion dollars (based on a GDP of 1.5 trillion).
But here’s where it gets interesting. REALLY interesting.
Let’s assume the U.S. implemented universal health care and total health care costs were brought down to the Canadian level of 10% of GDP.
For the year 2007 that would equal approximately $1.5 trillion.
Look up a few lines, that’s nearly $1 trillion LESS than was actually spent.
With that kind of savings potential, does it not seem a bit stupid to not at least explore the possibility of single payer?
Now don’t get me wrong here. I know from experience single payer is not perfect. There are issues with doctor shortages and longer waiting periods and limited availability of certain tests and procedures, but in my opinion it would still be a huge step forward from what we have now.
I should point out there that even in the Canadian system, if you have money you can seek all kinds of procedures and treatments from private health care companies, it’s not ALL government run (another common misconception).
Some people who oppose single payer like to the point to what happened in the UK when the government passed a mandate requiring patients to be seen within 4 hours upon arrival at an emergency room: Hospitals would hold patients outside in ambulances prior to admitting them to better guarantee they would hit the four window.
Conservative health spokesman Mike Penning said: “Not admitting people to hospital but stacking patients in car parks beggars belief in the 21st century.”
However the Department of Health said the statistics did not reflect time spent by patients in the ambulance before being admitted to accident and emergency.
“They measure the time taken to turn around an ambulance for its next emergency, including cleaning and restocking the ambulance,” said a spokesman.
“These figures must be seen in the context of the 4.3million patient journeys undertaken by emergency vehicles in 2006/07.”
Those 4.3 million patients represent roughly 10 percent of total ambulatory patients in the UK for that same period. In other words, 90 percent of the people got seen without issue.
It also must be stated that this is just one incident in one country. Every nation that has single payer does it a little differently with varying rates of success. And really, for all the countries that have single payer, how often do you hear of shaningans like this? (answer: not very)
Also it’s plain foolish to pretend that this kind of stuff never happens in the United States. There was quite an uproar a few years ago after reports that Hospitals in the Los Angeles area were releasing patients on to skid row, in some cases far earlier than they should have been.
But the main benefit to single payer is cost reduction, both to providers AND to patients.
The number one cause of bankruptcy in the United States is medical bills and, to add insult to (sometimes literal) injury, many of those bankruptcy filings are from people who HAVE health insurance.
Medical bankruptcy IS an issue in Canada as well, but interestingly when you go to Bankruptcy Canada to find information on the leading causes of bankruptcy, you come across this:
The last on our list of leading causes of bankruptcy in Canada, are medical problems; they often can and do lead to a lot of financial problems. Fortunately, in Canada most of our medical expenses, such as hospital care, are covered by the government, unlike in the United States where medical bills for uninsured Americans are a leading cause of bankruptcy in America.
Well how about that? (For the curious, unemployment and divorce rank AHEAD of medical when it comes to the top causes of bankruptcy in Canada).
Of course Single payer is not “free”. Everyone pays for it in the form higher taxes. Having said that, I doubt you’d find many Canadians (or people in other countries with single payer) who didn’t like paying more to avoid the kind of health care issues we see in this country every day.
Even accepting it’s flaws, I appreciated the Canadian system. I appreciated being able to get medical care without worry of going broke in the process.
It can happen in America.
I’m not saying it won’t be complicated. I’m not saying their won’t be growing pains, I’m not saying it will be perfect.
What I am saying is…it can happen
And it would probably change a lot of things for the better if it did.