I’m just getting over a cold. It’s lingered for a bit. I keep thinking it is done, but then *hack* or *cough*. It’s gross. I’ve even debated calling the doctor and getting something stronger than what’s at Walgreens. I decided my immune system would make it, but I never worried if I could make the payment. See, I met my deductible so my healthcare is already “paid”. At least for the next month or so. And then I have to come up with a few thousand dollars in spending. For many Americans the deductibles are so high, they never reach them. They have insurance, but it doesn’t really kick in, and when it does, you’ve already put out more money than you likely bargained for if you’re low income. I’m not sure I call that insurance nor would I say it’s accessible.
I’m going to guess most people reading this feel healthcare is a government issue. We may disagree on the extent, but most Americans support some form of government involvement. And, as we move towards a fully digitized world, we will have to manage longer living populations with lower infant mortality rates. The US will have to adjust its healthcare policy to accommodate the fiscal realities of an aging population. Universal healthcare is less a matter of “if” and more a matter of “when”. Expanding Medicare to include any health adult who wants it, would be a great way to achieve universal coverage.
Since millions can barely afford the status quo, a progressive funding scheme is necessary to fund this expansion. Broadening taxation and reducing spending would be ideal ways to balance the books. Spending can be reduced by closing some corporate tax deductions and reallocating subsidies for private insurance. Taxes can be raised on unhealthy consumption and medically unnecessary elective procedures (people will need to be free to consume medical procedures without government boundaries, but there can be an increased fee for the unnecessary x-ray, belly tuck, or bag of Cheetos). Further taxes can be raised on the general population replacing current premiums: many people will abandon private insurance. If the tax is fiscally neutral for most Americans, expanding Medicare would be financially feasible. And yes, some of us may end up paying more than others. Some may put in more money than we would ever use. And so, what? If your neighbor’s house is burning, do you really bicker with yourself about having to use your hose and water to put it out? Those of us who would pay more are likely the same people who will profit from a healthier workforce. And even if we aren’t, what kind of country are we if we don’t invest in our collective safety? We have no problem investing in swords, so let’s also invest in medicine. And if it comes down to spending, our military budget can be reduced by billions without harming out status as the highest-funded military.
The government should also find ways to lower the cost of healthcare in general. Doctors in the US make considerable more money than doctors in the Western world on average, yet our health outcomes are lower than most of Western Europe. A Columbia University study found that in 2008 the average doctor in US earned 186,582 while in Canada, a country with higher healthcare satisfaction, the average doctor earns $125,000. In the US, the average income after expenses for an orthopedic surgeon is $442,450. In France is it $154, 400. Though there may be reasons why this difference exists, the government should take steps to stabilize the market, and an expansion of Medicare would help use market forces to drive down costs.
Expanded Medicare funded by a mix of taxes, spending reductions, and appropriation reallocation coupled with strong abuse regulations, could make universal coverage a reality for the United States.