The Case for Universal Healthcare in the United States

Published by BNN

1. Standing Alone Among First‑World Nations

It's true: the United States remains the only high-income OECD country without universal health coverage. This anomaly places a significant burden on individuals, families, and businesses, with approximately 37 million uninsured and another 41 million underinsured. Despite spending nearly 18% of GDP - or over $12,000 per person - the U.S. trails behind its peers in key health outcomes: life expectancy is ~77.2 years (versus 81 - 84 in countries with universal care), and infant/maternal mortality remains concerningly high.

2. Top 5 Universal Systems - A Comparative Lens

Let's examine five leading universal systems, focusing on cost, financing, outcomes, and administrative efficiency.

• Per-capita spending: ~$9,000 (~11.8% GDP)
• Model: Mandatory private insurance with strong risk-sharing mechanisms
• Outcomes: Life expectancy ~84 years; low infant mortality

• Spending: ~$7,200 (~10.9% GDP)
• System: Private insurers regulated with community-rated pricing
• Performance: High satisfaction and primary care access

• Spending: ~$7,383 (11.7% GDP)
• Financing: Sickness funds (social insurance); employer + employee
• Key facts: Comparable health outcomes at less cost than the U.S.

• Spending: ~$5,631 (~10.7% GDP)
• System: Public single-payer for core services; provincial management
• Outcomes: Life expectancy ~82 years, outperforming the U.S.

• Spending: ~$5,381 (~10.2% GDP)
• Structure: Tax-funded universal care via NHS
• Outcomes: Strong on access, equity, and efficiency per Commonwealth Fund 'commonwealthfund.gov'

These nations spend significantly less per capita, maintain better or comparable health outcomes, and support universal coverage.

Many critics still argue that citizens from countires like Canada often come to the United States for their health care needs, arguing that wait times for needed care is too long. Even if that were true, the outcomes still speak for themselves. This argument begins to weaken when you consider that citizens from other countries can actually afford this option, unlike many citizens in the United States who can barely afford the basic coverage forced upon them through employer sponsored insurance plans, let alone a choice.

This arguement becomes even less convincing when you consider the rise in "health-tourism".

For less than the average deductable of a single-coverage health insurance plan in the United States ($1,790), Colorado-based health-tourism influencer, Bryn Elise, traveled to Turkey and received an $810 full-body comprehensive health scan - including over 30 scans and tests (EKG, X-rays, ultrasounds, bloodwork, etc.) at Memorial Hospital Bahçelievler, which can all be done in less than week, at this highly rated state-of-the-art hospital near some of the worlds most beautiful beaches. Not a bad way to spend a week while you get your next comprehensive physical.

The rise in health care deductibles in the United States equates to an average 6.13% year-over-year increase from 2006-2025, far outpacing the 2.49% average inflation rate for the same period.

First-person influencer accounts and clinic pricing data show individuals can obtain comprehensive, multi-scan full-body exams in other countries for far less than U.S. insurance premiums alone, and certainly less than paying out-of-pocket for the same services in the U.S., which begs the question, why would anyone come over the border for health care services and pay comparatively astronomical rates for those services? As it turns out, they really don't.

3. The U.S. Paradox: Higher Spending, Worse Health

Despite colossal investment, the U.S. healthcare system delivers subpar results:

• Life expectancy (~77.2 years) ranks last among rich countries
• Infant mortality ~5.4 per 1,000, nearly twice that of Finland or Japan
• Excessive administrative costs: ~$1,055 per person vs. ~$193 OECD average - saving ~ $286 billion annually is possible
• Price inflation: American drug costs are roughly double OECD norms (~$1,126 vs. $536 per capita)
• Wasted care: Up to 25 - 30% of spending is unnecessary or inefficient - equating to $800 billion a year
• Administrative complexity: U.S. systems require far more billing staff - e.g., Duke Hospital has 1,300 clerks for 900 beds

4. Can Universal Care Save Money in the U.S.?

1. Administrative Streamlining
   • Commonwealth Fund: ~$285 billion annual savings from admin cost reduction
   • CBO projections: ~$400 billion/year in savings by reducing insurer overhead to < 2%, and trimming provider admin rates
   • RN study: Billing-and-insurance-related expenses could drop by 33 - 53% under Medicare-for-All
2. Drug Cost Negotiation
   • U.S. pays roughly 2x the global average for prescription drugs; national negotiation could halve drug spending - saving 4.5% of total health spend ($150 - $200 billion)
3. Lowering Provider Rates
   • Medicare rates are ~22 - 50% lower than private insurer rates; extending these by default could save $200 - $400 billion annually
4. Reduced Waste and Fraud
   • Estimates attribute 25 - 30% of U.S. spending to inefficiencies - streamlining could save hundreds of billions annually
5. Total Savings Estimates
   • Lancet/PMC: 13% annual savings ($450 billion), plus ~68,500 lives saved/year
   • Sanders Institute: ~19% system cost reduction, saving ~$600 billion/year
   • RAND/Pollin-Blahous systematic review: 86% of 22 studies project net savings initially; 91% over time
   • CBO: Even high-utilization scenarios can lower spending by ~$400 billion/year

5. Transition Options & Political Dynamics

• Pro: Dramatic cost control via global budgets, standardized fees, bulk drug negotiation, and universal access
• Con: Requires substantial tax increases (up to ~$1 trillion/year); potential resistance from providers over lower reimbursement

• Expand Medicare eligibility or offer a public-insurance alternative alongside private plans
• Pro: Less disruptive, politically feasible
• Con: Retains fragmentation; limited bargaining power compared to a single-payer system

6. Case Insights: Norway & Denmark

• Per-capita spend: ~$7,727/year (~10% GDP)
• Universal access with nominal user fees and robust exemptions
• Strong nursing capacity and high life expectancy

• Spend 10.4% GDP ($5,200 per person)
• Tax-funded with regional management; user fees minimal, private insurance supplementary
• Outcomes and efficiency comparable to top OECD nations

These Nordic systems show that universal care with modest costs and strong outcomes is achievable.

7. Broader Impacts & Considerations

• Human cost: 68,000+ annual deaths in the U.S. are tied to lack of insurance - a preventable tragedy
• Economic drag: Poor health undermines labor productivity; Goldman Sachs attributes a ~10% GDP loss to health deficits
• Industry effects: Healthcare forms a large GDP chunk - cutting inefficiencies could slow GDP but enhance welfare and long-term growth
• Job transitions: Shifting from administrative roles to preventive and care-based jobs is feasible with proper policy
• Political hurdles: Powerful industry lobbying and public fear over provider paycuts are significant roadblocks - but not insurmountable, as other nations have shown.

Conclusion: A Healthier, Smarter Future

The data is incontrovertible:

• Coverage: Universal systems ensure no one is uninsured.
• Cost: Real savings of $300 - $700+ billion annually are achievable via reduced administration, streamlined pricing, and elimination of waste.
• Health: Better life expectancy and lower mortality in peer nations.
• Equity: Universal systems reduce financial hardship and health disparities.

The U.S. must pursue universal healthcare - not only as a moral imperative but as a smart economic strategy. Thoughtful implementation (single-payer or public option), transparent financing, provider transition support, and rigorous oversight will be key to success. It's time to replace inequity and inefficiency with a system that saves both money and American lives.

Next Steps: Make It Stick

• Choose a model (single-payer vs. hybrid), with clear financing via taxes or premiums
• Set benchmark targets: administrative costs below 10%, drug prices within OECD norms, universal coverage
• Implement provider support: transition aid, fair reimbursements, focus on primary/preventive care
• Build political consensus: grassroots advocacy, bipartisan commissions, phased rollout
• Track metrics: cost, health outcomes, equity, GDP impact - adjust policy responsively

With the United States currently on a financially and morally untenable healthcare trajectory, universal healthcare isn't just preferable - it's essential. Let's overhaul a broken system and build one that's equitable, economically sound, and truly American.

References

• The United States is the ONLY industrialized country without universal healthcare. www.politifact.com
• Indicator overview: Country dashboards and major trends. www.oecd.org
• High U.S. Health Care Spending: Where Is It All Going?. www.commonwealthfund.org
• Improving the prognosis of health care in the USA. pubmed.ncbi.nlm.nih.gov
• United States Healthcare System Ranks Last Among Fellow Wealthy Countries, New Report Says: 'Dramatically Lower'. people.com
• America's sickness economy. www.ft.com
• Congressional Budget Office Scores Medicare-For-All: Universal Coverage For Less Spending. www.healthaffairs.org
• Reducing administrative costs in US health care: Assessing single payer and its alternatives. pmc.ncbi.nlm.nih.gov
• Medicare For All – I Like It! How Do We Pay For It?. sandersinstitute.org
• 'Medicare for All' Could Cost $32.6 Trillion, George Mason Study Says. time.com
• National Health Spending Estimates Under Medicare for All. www.rand.org
• The Savings from Lower Administrative Costs in a Medicare-for-All System. aneconomicsense.org
• Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. pmc.ncbi.nlm.nih.gov
• Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. pubmed.ncbi.nlm.nih.gov
• How the US could afford 'Medicare for all'. www.pbs.org
• 22 studies agree: 'Medicare for All' saves money. thehill.com
• Healthcare in Denmark. en.wikipedia.org
• Healthcare in Norway. en.wikipedia.org
• Health care finance in the United States. en.wikipedia.org
• More support for Medicare for All. www.reddit.com
• Why does the US have a lower life expectancy than every developed country even though we spend the most in the world on healthcare?. www.reddit.com