Why do people support the change?
The three pillars of health care, known as the “iron triangle,” are cost, quality, and access. In today’s health care system, experts believe that improving one or two sides of the triangle comes at a detriment to the third. Medicare for All proponents believe that while a new system may not completely eradicate this problem, it can come close to addressing each side of the triangle.
Cost: Though many people are now covered by insurance, the costs can be staggering. Higher deductibles leave many with higher out-of-pocket expenses on top of rising premiums, and many cannot afford to go to the doctor. And that’s for those who do have insurance. According to conservative estimates, approximately 35,000 Americans a year lose their lives unnecessarily due to a lack of insurance. A survey from the Kaiser Family Foundation and the New York Times found that one in two Americans has reported having trouble paying a medical bill. And more than 60 percent of all bankruptcies in the U.S. can be attributed to medical debt. The elimination of cost-sharing through the proposed Medicare for All plans would remove this obstacle to receiving medical care.
“It’s all about shifting the spending,” Lui explains. “Medicare for All is fixing the finances to fund the system.” As for the possibility of an increase in taxation, Lui says, “People are not feeling how much [of their money] is going into the health care system with payroll taxes and employee contributions. With a federal entity, it will be more explicit. Out-of-pocket costs will go down and instead of people paying deductibles and copays, it’s through taxes. But no one will face financial barriers when they are seeking care immediately.”
And, at least according to some estimates, it’s possible that a Medicare for All system would cost less than the current system, in part by reducing and simplifying administrative costs. In terms of drug costs, Americans are much more likely to skip doses or not get prescriptions filled at all due to expense, when compared to nations with nationalized health care, according to data from the Commonwealth Fund. Though certain drugs may be available, they can be more expensive because of the U.S.’s lack of drug price controls.
Quality: According to a 2016 public health poll, initiated by Harvard University, the Robert Wood Johnson Foundation, and NPR, 13% of American adults say that the quality of their last doctor’s visit was fair or poor. Some doctors spend minimal time interacting with patients. And due to restrictions set for doctors by private insurers, some patients only see their physician for 15-minute appointments. In a country where administrative costs may account for as much as 30% of health care spending, according to previous estimates, proponents say that a Medicare for All plan would create a streamlined system in which doctors will be incentivized to focus on quality of care and spend less time dealing with unnecessary administrative tasks and red tape.
Access: As stated above, the biggest barrier to health care access for many Americans is cost. With the proposed single-payer systems, everyone would be covered. Lui explains that insurance coverage would no longer be tied to employment status, which could facilitate more financial freedom for those who feel locked into a job for the insurance. With an estimated 30 million people currently uninsured in the United States, Medicare for All proponents say that it would ensure health care as a right rather than a privilege only available to some.
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