☭ Universal Healthcare: The Only Solution to the United States' Privatization of Health ☭

Katie Schieffer, an American woman who goes by the user of Slimkwow on Tik Tok, published a video venting about the financial hardship she's facing due to having to pay for her child's type 1 diabetes treatment. She starts the video by saying that both her and her husband work full time jobs, that they have been paying medical bills for their son since he was born and they still aren't able to afford their 9-year-old son's prescription, which costs her $1.000, since he needs insulin every two hours. Fortunately, Kate's video went viral, and many people donated money to her family, however, not many people have the same luck. This same situation happens with thousands of people in the United States, the country that has both the biggest GDP in the world and the biggest spending in healthcare, which are respectively $23 trillion and $4.3 trillion in 2021. Still, the United States has many people going through the same situation as Katie Schieffer. This only goes to show that the "country of freedom" has a broken health care system that reflects its capitalistic and consumerist culture, the only sane solution is a universal healthcare system.

Health care is a basic human right that should be provided to all citizens without any cost. Currently in the United States, there are two governmental programs that were created to democratize access to healthcare, Medicare and Medicaid. In the Medicare’s official website, the program is called a “federal health insurance”, eligible for its coverage are people 65 and older, young people with disabilities and people with end-stage renal disease (ESRD). Medicare is divided in 3 parts: part A, which is hospital insurance, part B which is medical insurance, and part D which is prescription drug insurance. If a person or their spouse pay for medicare taxes while they were working, they won't have to pay for a monthly premium for part A, you have access to hospital insurance for free, however, everybody has to pay for part B, which in 2023, the standard amount is $164, however, depending on your income, you may be subjected to pay an extra charge called IRMAA, which stands for Income Related Monthly Adjustment Amount. Medicaid, however, provides care to adults, pregnant people, children, individuals with disabilities and low-income individuals or individuals receiving Supplemental Security Income (SSI). The services covered by Medicaid depends on each state, since the federal government only provides half the funding for the program, but some of the mandatory services provided by Medicaid include in-patient and out-patient hospital services, physician services, transportation to healthcare, nurse midwife services and more.

It's undeniable that Medicare and Medicaid help many people in the United States. In 2020, there were 76.4 million people under Medicaid and CHIP (Children's Health Insurance Program). However, only expanding Medicare and Medicaid is not enough to resolve the United States' systemic healthcare issue. Despite the fact that the U.S spends more money on healthcare than any other country the system remains ineffective and unequal. The reason behind this is that the money is not spent efficiently because of structural and systemic flaws. To illustrate this, imagine two people trying to fill a bucket with water, but one of the buckets has a hole on the bottom. The person with the broken bucket can pour as much water as they want, but that bucket will never fill up because of the leak. While programs like Medicare and Medicaid help many people, they don't address the deeper issue, they simply drain more and more money and don't use it efficiently.

The U.S healthcare system is a private business, their main goal is to profit, and like any business, insurance companies seek profits, not the health of their clients. The reason why healthcare is so expensive is that these costs are not only market driven, but they're meant for companies to pay, not individuals. To understand how absurdly expensive health care costs are in the United States are we can reference the International comparisons of Health Care Prices from the 2017 IFHP survey by John Hargraves and Aaron Bloschichak to compare the price of an angioplasty surgery (a procedure that unblocks a blood vessel by using a stent) in the United States and other developed countries : In the Netherlands this surgery would cost around $6,400, in New Zealand that would cost $16,500, and the United States it would cost $32,200. Now, taking into consideration that according to the National Average Wage Index by the United States Social Security Administration in 2021 the average annual wage in the United States was $60,575.07, an angioplasty would be 53.1% of the annual income of an average American. For that reason, many Americans have a legitimate fear of seeking medical attention at hospitals, according to the NORC (National Opinion Research Center) at the University of Chicago, a survey conducted in 2018 found that 1 in 4 Americans (27%) skipped necessary medical care in the past 12 months because they couldn't afford it, another concerning statistic that they found is that 30% reported that in the last year, they had to choose between paying for necessities like food, housing or heating and paying medical bills. These are concerning statistics that only show how the United States desperately needs a healthcare reform that aims to help the American people, not the market or corporations.

Many countries were able to implement a successful universal healthcare system, the most notable being Germany, the U.K and Brazil. Germany is well known for their high quality healthcare that legal resident of the country can access called SHI (Statutory Health Insurance) which covers inpatient services, outpatient services, preventative services, prescription drugs, physical therapy, rehab, sick leave, dental care, eye care, hospice care, physical therapy, and even mental health. The U.K has a similar system called the NHS (National Health Service), in which all citizens are automatically enrolled in, it also has a large coverage of services including mental health. Unlike the U.K's NHS and Germany's SHI, Brazil's SUS (Sistema Único de Saúde, in English, Health Unic System) treats any patient regardless of citizenship, residence or visa status. In 2021, the U.K spent 19.1% of its GDP on healthcare, while Germany and Brazil spent 12.8% and 13% of their GDP, respectively. In comparison, the U.S spent a staggering 4.3 trillion dollars on healthcare, which accounts for approximately 18.4% of its 2021 GDP. Given its similar size and population to Brazil, the fairest comparison for the U.S would be with this South American country that also provides universal healthcare. In 2021, Brazil had a GDP of 1 trillion dollars, which highlights the stark contrast between the U.S and Brazil's healthcare spending priorities.

One of the main arguments against a universal healthcare system in the United States would be that the quality of healthcare would decline if it was available for everyone for free, however, in the article Mirror, Mirror 2021: Reflecting Poorly Health Care in the U.S. Compared to Other High-Income Countries published by the Commonwealth Fund, the United States ranks last among other 10 developed nations – among them, countries that offer universal healthcare such as Canada, the U.K, the Netherlands, and more – when it comes to healthcare in general. They found that the U.S had the highest infant mortality rate (5.7 deaths per 1,000 live births), the highest rate of preventable deaths (177 per 100,000 population) and poor results for maternal mortality (17.4 per 100,000 people). Based on those statistics, we can conclude that even with a public healthcare system, countries are able to provide good quality health services for their population without charges. 

Another popular argument against universal health care is that it would increase government spendings, and the main victims of this would be middle class taxpayers. However, as mentioned previously, the United States already spends trillions of dollars on Healthcare, and it's still very a fragmented system that doesn't work for anybody who can't afford health insurances or pay medical bills, for example, the middle, working class, which is the class who already suffers the most with the healthcare system, since they can’t either apply for medicaid, nor afford good insurance. 

A recurring argument that's used frequently against the implementation of universal healthcare in the United States is that such a system would limit freedom of choice of Americans. However, in reality, only wealthy Americans have access to real choice in healthcare. This privilege is often reserved for white Americans, leaving a significant portion of the population with only one option: seeking treatment and dealing with medical debt afterward or going without necessary treatment altogether. Not to mention that many working Americans have their health insurance provided through their employer, these people have no say in their healthcare options. They are simply given whatever coverage their employer chooses, which may not cover their specific healthcare needs.

In conclusion, healthcare is treated as a commodity in the United States, with a focus on maximizing profits rather than finding the most effective ways to help people. This approach creates a healthcare system that is exclusionary to low-income families and marginalized communities, who are already facing financial challenges due to historical and systemic reasons. Nationalizing healthcare could significantly reduce racial disparities in access to healthcare and provide a more equitable system for all Americans. It is time to acknowledge the suffering caused by the current unequal healthcare system and embrace the compassionate and just solution of universal healthcare. Implementing it in the United States would provide access to healthcare for all, regardless of their financial or social status. It would also shift the focus of healthcare from profit maximization to ensuring the best possible health outcomes for all Americans. Universal healthcare is a compassionate and just solution to the current healthcare crisis, and it is essential for ensuring the overall health and well-being of the American people.

Works Cited

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Cooper, James. “Healthcare Expenditure, UK Health Accounts Provisional Estimates: 2021.” Healthcare Expenditure, UK Health Accounts Provisional Estimates - Office for National Statistics, Office for National Statistics, 8 May 2022, https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/healthcareexpenditureukhealthaccountsprovisionalestimates/2021. 

Mendoza, J. “Topic: Health in Brazil.” Statista, Statista, 10 Mar. 2023, https://www.statista.com/topics/5030/health-in-brazil/#dossierContents__outerWrapper. 

Schieffer, Katie [@Slimkwow], “#type1diabetes #kids #struggle #ontheedge #imdone”, TikTok, 23 Dec. 2020, https://www.tiktok.com/@slimkwow/video/6909568584704380165?is_from_webapp=1&sender_device=pc&web_id=7149985571234301446.

Schneider, Eric C., et al. “Mirror, Mirror 2021: Reflecting Poorly.” Commonwealth Fund, 4 Aug. 2021, https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly. 

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Statista Research Department. “Germany: Health Expenditure as a Share of GDP 1980-2021.” Statista, Statista, 15 Nov. 2022, https://www.statista.com/statistics/429202/healthcare-expenditure-as-a-share-of-gdp-in-germany/#:~:text=In%202021%2C%20Germany%20spent%2012.8,Germany%20from%201980%20to%202021. 

Tikkanen, Roosa, et al. “Brazil.” Home, The Commonwealth Fund, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/brazil. 

Tikkanen, Roosa, et al. “England.” Home, The Commonwealth Fund, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/england

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UnitedHealthcare Services, Inc. “What Is Medicaid and What Does It Cover?” UnitedHealthcare Community Plan, UnitedHealthcare Community Plan, 5 Apr. 2021, https://www.uhccommunityplan.com/dual-eligible/benefits/medicaid.