For as complex as this topic is, it’s really fairly simple. The cost of healthcare coverage, like any insurance pool, depends on the size of the pool of people who participate. The bigger the pool of people, the easier it is to spread out the burden of averaged-risk of how many people get hospitalized and when, and the financial cost that comes with it.
What bigger pool of people can there possibly be, than “every single citizen”? And, as practically every other 1st-world nation on Earth has demonstrated – many of which are not nearly as wealthy per-capita as us – if it’s done right, it also means a higher overall quality of healthcare too.
It’s no secret that our current Healthcare system has … problems. Namely things like a lack of competition in the medical supplies and pharmaceuticals markets to keep prices at a reasonable level, and non-compete contracts for medications and supplies through Medicare and Medicaid.
To give you an example, I stepped on a rusty roofing nail bare-foot on Thanksgiving morning, about two years ago. Embedded ALL the way in. Ouch. I had to go to Lafayette General to get a tetanus shot. When I got the bill, I noticed that just the cost of the tetanus shot itself was +/- $500. When I got home, I looked up the manufacturer’s charge for a shot of tetanus, because I didn’t believe it could be that expensive to produce, and … it turned out to be about $5.00 for two doses. That’s a 20,000% markup. Twenty. Thousand. Percent.
Likewise, a bag of sterile saline-drip solution for IVs cost about $1.00 on average to produce, but hospitals charge an average of $550 for them. From $1.00 to $550. There’s just no sense in that. That’s a clear sign of a total lack of free-market competition, and supply-side companies charging astronomical rates just because they can. In any other industry, competition would stabilize prices and make them affordable.
Single Payer. Single Payer is the solution. This is not “radical,” this is just a fact. Single Payer is a collectivized form of Healthcare. It’s like a Farmer’s Co-op, or a Credit Union. It comes with several key advantages that mostly eliminate the problems that we’re currently struggling to cope with to wrestle the cost of healthcare back down to a reasonable level.
For one thing, by pooling all of our ‘premiums’ into a single fund, we don’t have to pay for the elevated overhead expense of private insurance profit-margins or shareholder dividend payouts.
Then there is the leverage of supply-side contract negotiation we could take advantage of. This is the #1 reason why we need to go with Single Payer. By negotiating supply-side contracts, pharmaceutical companies and medical supply companies would have to compete on an open market to negotiate the prices of their products, based on both level of quality and affordability. We would have the power to tell companies charging a 5,000% mark-up to “go kick rocks, we’ll give our business to someone with a more reasonable profit margin.”
Using that alone, in a Single Payer system, you could reasonably expect to see tetanus shots fall to around $20.00 per shot, and IV bags fall to $10.00 per unit – where they should be. After all, the producers of those products do need to make a profit for themselves from their mark-up – that’s just fair Capitalism – they deserve to get paid for their labor.
But you deserve not to be gouged for something that may very well save your life. When you need medical treatment, you don’t have the luxury of time to “shop around for the best price” (not that you’d currently find a “best price,” anyway). Life or Death is not exactly like shopping around for a new pair of shoes.
Speaking of paying – let’s talk about the actual cost of Single Payer. Because OF COURSE it’s not ‘Free’ – no one ever assumed it was.
You would pay your premiums through your taxes. That’s not to say that you would pay more. You’d just pay it to a different fund. And a good deal less than your current premiums, since supply-side contract negotation and the lack of having to pay for an insurance company’s profit margin would drastically reduce the overall price of healthcare. You’d simply pay it as a payroll tax, instead of when you pay your monthly premiums. Where’s the negative side to that?
Dozens of other developed countries have been doing it for decades – some of whom don’t have nearly the resources that we do, and yet offer a much higher quality of medical care than what our private insurance system offers us now.
It’s time we stop fooling ourselves into thinking that we cannot make it happen. The only thing stopping us is our squeamish lack of trying.