Portside

In 2015, Nobel Prize-winning American physicist Leon Lederman had to sell off his Nobel Prize to pay his medical bills, following a diagnosis of dementia. His medal ended up selling for $765,000.

In the debate about single-payer healthcare, there is a lot of anxiety around the question of “how do we pay for it?” The emphasis is always on a big, scary number: $650 billion annually, $30 trillion over 10 years, etc. This is a relatively common tactic of private interest groups that oppose new legislation—fear-mongering about costs, and implying such-and-such policy will bankrupt the country.

Actually, it’s been demonstrated a number of times that single-payer healthcare would save money. Taxes would go up, but private healthcare premiums would be eliminated, so the average American would pay substantially less, it would just be in the form of a tax, instead of a premium.

Instead of viewing healthcare as simply a matter of pricing, we should recognize that we are needlessly losing lives every day by keeping things the way they are.

This is supported by findings from our own government. In 2021, the Congressional Budget Office did a study on the potential economic impacts of Medicare For All, and found that we could have universal coverage with no copays or deductibles, and overall healthcare spending would decrease. This is not a new discovery. It’s been understood for decades. As far back as 1991, the Government Accountability Office reported that if we adopted a Canadian-style system, “the savings in administrative costs alone would be more than enough to finance insurance coverage for the millions of Americans who are currently uninsured. There would be enough left over to permit a reduction, or possibly even the elimination, of copayments and deductibles.”

We don’t have to look far to see this in action. We can simply look to the rest of the world. In every other developed country on Earth, there is some form of single-payer, and those countries pay substantially less for healthcare. Health spending is the one area where America unquestionably leads the world. We have, by far, the most expensive system on Earth, with about twice the per-capita costs of other industrial nations.

But even the premise of this question about cost employs a one-sided framework. To get a full picture, we need to ask a second question: What does it cost not to have single-payer?

According to a 2020 study by Yale epidemiologists for The Lancet, around 68,000 people a year die in America because they don’t have access to healthcare. Simply put, we let large numbers of people die from illnesses that could be treated. No other rich country tolerates that kind of inequality. It’s basically unheard-of in places like the U.K. and Canada. In 2022, the Proceedings of the National Academy of Sciences (PNAS) released a study estimating that the U.S. could have seen around 338,000 fewer deaths from Covid-19 if we’d had single-payer.

A second consideration that’s not included is medical bankruptcies. A 2009 study by The American Journal of Medicine found that 62% of bankruptcies in the U.S. are medical bankruptcies (roughly 500,000 annually). In 1981, that number was 8%. Healthcare costs have risen to the point that many Americans simply can’t afford health insurance, and many who can are underinsured. So people can have their savings wiped out because of a medical emergency, or a healthcare crisis in their family, without warning.

You almost never hear these factors (deaths from treatable diseases, medical bankruptcies) brought up in media discussions about healthcare reform. They’re effectively censored out of public debate. In reporting about Medicare For All, chances are you’ll only hear the price tag. As a consequence, we think of healthcare exclusively in terms of financial costs. This framework, which is used by most major outlets, encourages us to think of the status quo as, essentially, cost-free, and hides these external considerations in places that are easy to ignore. Instead of viewing healthcare as simply a matter of pricing, we should recognize that we are needlessly losing lives every day by keeping things the way they are. This gives us a more accurate picture.

There’s a way out of this. Healthcare could be established as a basic human right, the way it is in every other developed country, by replacing our for-profit system with a single-payer system, which would both dramatically reduce costs and save tens of thousands of lives per year. Our current way of doing things is inhumane and unsustainable, and it is essential that we transition to a system which prioritizes patient care over profit. The cost of not doing this is other people’s pain and lives.