A single-payer system makes economic sense

By:  Sen. Bernie Sanders (I-Vt.)

Americans spend about twice as much per capita on healthcare as almost any other developed nation, but our outcomes are not as good as others that spend much less. We can do better. We must do better.

Today, some 50 million Americans lack health insurance. Many others delay going to the doctor because of high deductibles and unaffordable copayments. While the number of uninsured Americans will go down with the implementation of the Affordable Care Act, widely known as ObamaCare, tens of millions of Americans will remain uninsured.

The goal of an effective healthcare system is to do everything possible to enable people to live long and healthy lives. Sadly, the American system fails to do that and falls behind many other countries. While we devote 18 percent of our gross domestic product to healthcare, we rank 33rd in life expectancy and 34th in infant mortality, and trail in many other health outcomes. A Harvard University study indicated that, incredibly, some 45,000 Americans die needlessly each year because they do not get to a doctor in time. 

I start my approach to healthcare from a very basic premise: healthcare is a right, not a privilege. Unfortunately, uniquely among major nations, that statement is not true for the United States, where access to healthcare depends on how much money you have and what your employer is willing to provide.

It is simply unconscionable that the most advanced nation in the world has so many people who lack health insurance. It makes no sense that millions more are one diagnosis or car accident away from financial disaster. And, despite the trillions of dollars we spend on healthcare, the disparity in the quality of care between the rich and everyone else grows wider.

Our system doesn’t make economic sense, and it certainly doesn’t make moral sense. In a civilized, democratic society, every man, woman and child must be able to get the medical care they need regardless of income.

It is incomprehensible that drug companies still get away with charging Americans twice as much — or more — than citizens of Canada or Europe for the exact same drugs manufactured by the exact same companies. It is an outrage that insurers still want to hike premiums by as much as 60 percent a year on individual policyholders.

It boggles the mind that approximately 30 percent of every healthcare dollar spent in the United States goes to administrative costs rather than to delivering care. Taiwan, for example, spends only a little over 6 percent of its GDP on healthcare, while achieving better health outcomes on some key indicators than we do. The reason, of course, is that they spend a fraction of what we do on administrative costs.

If our goal is to provide high-quality healthcare in a cost-effective way, what should we be doing?

Clearly, we must move toward a single-payer system.

The health insurance lobby and other opponents of single-payer care make it sound scary. It’s not. In fact, a large-scale single-payer system already exists in the United States. It’s called Medicare. People enrolled in the system give it high marks. More importantly, it has succeeded in providing near-universal coverage to Americans over the age of 65.

Establishing a single-payer system will mean peace of mind for all Americans. When health insurance is no longer tied to employment, people will not fear losing both their job and their family’s access to healthcare. Millions of Americans won’t have to stay in jobs they don’t like because their family needs healthcare. Entrepreneurs and small businesses will be free to develop their business plans without worrying about the cost and complexity of providing healthcare for themselves and their employees.

For these reasons and more, Rep. Jim McDermott (D-Wash.) and I have introduced the American Health Security Act, which would guarantee healthcare as a human right and provide every U.S. citizen and permanent resident with healthcare coverage and services through a state-administered, single-payer program.

I am very proud that my home state of Vermont is now taking big steps to lead the nation in healthcare by moving forward on a plan to establish a single-payer healthcare system that puts the interests of patients over corporate profits. The American Health Security Act would make sure every state does the same.

The goal of real healthcare reform must be high-quality, universal coverage in a cost-effective way. We must ensure, to as great a degree as possible, that the money we put into health coverage goes to the delivery of healthcare, not to paper-pushing, astronomical profits and lining CEOs’ pockets.  

Sanders is the junior senator from Vermont, serving since 2007. He sits on the Environment and Public Works; the Energy and Natural Resources, the Health, Education, Labor and Pensions; and the Budget; and the Veterans’ Affairs committees, as well as the Joint Economic Committee.