The Numbers Don’t Lie — Why Single-Payer Universal Health Care Should Be Adopted in the United States
By: Kristen Proctor
Tags: Bernie Sanders, Politics, Medicare For All, Healthcare, Public Policy

The Numbers Don’t Lie — Why Single-Payer Universal Health Care Should Be Adopted in the United States Kristen Proctor Mar 25·24 min read

Health care coverage and costs have become a hot button political issue in the United States recently, and with good reason. In 2019, nearly 23 million people in American were uninsured for health care, and another 64 million were underinsured (Bivens, 2020). Lack of affordability of coverage is one of the most common reasons for being uninsured. Health care costs, in general, are higher in the United States; the United States spends more per capita than other wealthy countries on health care, with nearly 17% of the country’s gross domestic product in 2016 utilized for health care (Doherty et al., 2020).

An often proposed alternative to today’s private, multi-payer health care system in the United States is a single-payer health care system, also referred to as Medicare for All. Key elements of a single-payer system include government financing, universal coverage with a comprehensive benefits package, elimination of private insurers, and negotiation of provider service and drug pricing. Two-thirds of Americans support universal health coverage through a national plan like Medicare for All. As of November 2019, there were two Medicare for All Act of 2019 legislative proposals in the US Congress: Senate Bill 1129 and House of Representatives Bill 1384 (Cai et al., 2020).

Though universal health care programs exist in 117 other countries around the world (World Population Review Countries with Universal Healthcare, 2020), many American politicians argue that such programs are either unnecessary or would be ineffective or economically unfeasible in the United States. This paper will review how adopting a single-payer universal health care system is economically feasible and would benefit the United States, by expanding health care coverage and access to all Americans, improving health outcomes, reducing health care costs, and supporting economic growth.

Single-payer universal health care would expand health care coverage and access to all Americans.

One of the most important benefits of adopting a universal health care policy in the United States would be the expansion of health care coverage and access to all Americans. The definition of universal health care from the World Health Organization’s world health report 2010 includes a health care system that enables all people to obtain the health services they need, and that the services are of sufficient quality to be effective, while also offering protection from financial hardship to those who need them. The goals of achieving effective health care coverage include reducing the gap between those in a country who need health services and usage of those services, and that services are of high enough quality to likely improve the health of those who use them (Kutzin, 2013).

With nearly 23 million Americans uninsured, and another 64 million underinsured in 2019 (Bivens, 2020), nearly one in three people in the United States either don’t have access to or can’t afford health care services they may need to survive and thrive. To combat this challenge, the American College of Physicians recommends the implementation of “a health care system where everyone has coverage for and access to the care they need, at a cost they and the country can afford.” This would include a health care system that eliminates social factors that contribute to inequitable health care, provides coverage for underserved populations, and ensures that no one is discriminated against based on personal identities, such as national origin, ethnicity, rade, gender, secual orientation, or religion (Doherty et al., 2020). By adopting a universal health care policy, the United States could expand health care coverage and access to everyone in the country, regardless of income or ability to pay for coverage. This would cover tens of millions of Americans who don’t have sufficient access to affordable health care today and greatly benefit everyone in the country by affecting health outcomes.

Single-payer universal health care would improve health outcomes for Americans.

Adopting a universal health care policy in the United States would significantly improve the health outcomes of millions of Americans. One of the ways this improvement can be measured is by evaluating life expectancy at birth. In 2018, a study was published by Frontiers in Pharmacology that explored the relationship between Universal Health Coverage (UHC) and life expectancy across 193 UN member countries. The analysis found that universal health coverage was associated with significantly increased life expectancy at birth across all member countries evaluated. According to the study, “There have been significant gains in life expectancy worldwide, with global life expectancy at birth (LEAB) increasing by 6 years (65–71) since 1990…Life expectancy at birth for low-income countries is now 62 years, compared to 79 years in high-income countries, and there is a 34 year gap between the lowest country (Lesotho, 50 years) and the highest (Japan, 84 years).” (Ranabhat et al., 2018). This means the average life expectancy at birth is 17 years higher in high-income countries with universal health coverage than in lower income countries without it.

There are, of course, many factors that contribute to increased life expectancy at birth, especially in developed countries. But according to researchers, “Many explanatory factors such as per capita income, education, government and private health expenditure, access to safe water, physician ratio, nutritional outcomes, geographical status and urbanization have been found to significantly influence life expectancy, especially in developing countries.” (Ranabhat et al., 2018). This means that even when all other factors that impact life expectancy at birth are taken into consideration, the presence of a universal health care system can still be directly attributed to increased life expectancy outcomes. As the researchers conclude, “Our study highlighted that UHC has greater predictive power for long-term health outcomes than other components like education and economic growth rates.” (Ranabhat et al., 2018).

One of the reasons for universal health care’s positive impact on life expectancy at birth is that when unaffordable costs are removed from the equation, people can access the healthcare they need without taking on significant health care debt that can lead to poverty in the United States. Researchers concluded in the Frontiers in Pharmacology study that, “Out-of-pocket payments deepen the poverty headcount and reduce healthy life years and life expectancy,” (Ranabhat et al., 2018). Other studies have also concluded that out-of-pocket health care payments contribute to negative life expectancy at birth outcomes. The Organisation for Economic Co-operation and Development (OECD), an intergovernmental economic organization with 37 member countries and founded to stimulate economic progress and world trade, has also published research on life expectancy at birth related to universal health coverage with similar outcomes to the Frontiers Pharmacology study. According to the OECD, “For a selection of OECD countries and emerging economies, a clear positive association exists between life expectancy at birth and UHC indicators reflecting the three core components of health coverage — the population covered by a core set of services (population coverage); out-of-pocket payments (financial coverage); GP density (service coverage) — as well as total health expenditures (as an overall health coverage proxy).” The study found that there was a positive correlation between health coverage of the population and life expectancy — and a negative correlation between out-of-pocket health care expenses and life expectancy. Researchers conclude that health outcomes can be influenced by a population’s financial burden (OECD Universal Health Coverage and Health Outcomes, 2016).

As cited above, health care expenses are just one factor impacting health outcomes. Another contributing factor is access to quality health care. The OECD also positively associates general practitioner (GP) density (service coverage) with life expectancy (OECD Universal Health Coverage and Health Outcomes, 2016). It’s not just increased access to health care that contributes to health outcomes, however. Universal health care systems can increase the quality of health care services. In a 2020 study published by the National Center for Biotechnology Information, the U.S. National Library of Medicine, and the National Institutes of Health, researchers found that single-payer universal health care systems can improve health care service quality. According to the study, “In addition to saving costs, unified payment models such as single-payer have the potential to foster quality and efficient care through payment signals, as well as to monitor trends in care patterns via rapid access to highly standardized claims data.” (Cai et al., 2020). By controlling health care service payments through a single-payer system, governments can financially incentivize service providers that produce the best health outcomes. This health care marketplace regulation also provides governments with access to the health system data needed to evaluate and reward good performance.

In most countries, OECD research shows that increased government spending on health was positively associated with health outcomes. “Across 153 countries for the period 1995–2008, a 10% increase in government spending on health was associated with an average reduction in under-five mortality by 7.9 deaths per 1000, and adult mortality by 1.6 (women) and 1.3 (men) deaths per 1000,” (OECD Universal Health Coverage and Health Outcomes, 2016). One outlier, however, stands out from this trend — the United States, which spends more money per capita on health care than any other developed nation (Johns Hopkins Bloomberg School of Public Health U.S. Health Care Spending, 2019). The difference that makes the United States an outlier of this trend is that the country does not have a universal health care system in place that is funded by the government, like it’s peer countries do.

Although increased health care spending doesn’t positively impact health outcomes in the United States, research does show that the expansion of government sponsored health care programs that do exist in the United States (for limited populations) are linked to better health outcomes for children and adults (OECD Universal Health Coverage and Health Outcomes, 2016). This means that government health care systems that do exist for some Americans are already effective in improving health outcomes. Presumably, this trend would continue if these programs were expanded to provide universal coverage for all Americans, such as with Medicare for All proposals.

Some opponents of universal health care systems suggest that letting the government decide which health care services a person should receive may result in Americans receiving substandard care due to cost-saving measures that would have negative health outcomes. But while cost efficiency is key to a sustainable universal health care system, that doesn’t mean essential care would be withheld from the public. The positive impact of universal health care on life expectancy is clear, which indicates that a universal health care system improves overall health outcomes through increased access to high quality health care. OECD researchers suggest that the best way to build a sustainable universal health coverage system is to critically assess which health services are included. Not by excluding essential services, but prioritizing cost-effective options over services that are not as cost-effective. Health care services with questionable clinical benefits should be excluded, but all essential, cost-effective health care should be covered (OECD Universal Health Coverage and Health Outcomes, 2016).

It is estimated that the 23 million people in the United States without health insurance have a 40% risk of increased mortality (Galvani et al., 2017). With a universal health care system, the United States would improve the health outcomes and increase the life expectancies of millions of Americans, by expanding access to essential health care, improving the quality of health care, and reducing the financial burden of out-of-pocket health care expenses.

Single-payer universal health care would reduce overall U.S. health care costs.

Another way that a single-payer, universal health care system would benefit the United States is that it would reduce health care expenses overall in the country. According to the Centers for Medicare and Medicaid Services, “U.S. health care spending grew 4.6 percent in 2019, reaching $3.8 trillion or $11,582 per person. As a share of the nation’s Gross Domestic Product, health spending accounted for 17.7 percent,” (Centers for Medicare & Medicaid Services Historical, 2020). Health care spending in the United States was also 25 percent higher than the second-highest health care spender, Switzerland, in 2016 (Johns Hopkins Bloomberg School of Public Health U.S. Health Care Spending, 2019). And those costs are only continuing to rise. “Insurance premiums, for example, rose 20% in 2019. Overall spending on prescription drugs rose more than 9% between the fourth quarter of 2018 and the fourth quarter of 2019 — the largest year-over-year change since 2015,” (Bivens, 2020).

Some argue that health care costs are so much higher in the United States because of its large population size, which is significantly greater than most countries with universal health care systems in Europe. But studies show this isn’t the case. According to one study, the higher costs in the U.S. are primarily related to higher prices and administrative inefficiency, not higher service utilization (Cai et al., 2020). Another report by the Economic Policy Institute (EPI), a nonprofit, nonpartisan think tank launched to include the needs of low and middle-income workers in economic policy discussions, suggests the same thing. “Health spending in the U.S. is higher than in advanced peer countries and has risen faster over time — and yet continues to buy worse health outcomes. The higher and faster-growing spending of the United States is driven by faster growth of prices, not by growth in the volume of health care goods and services consumed.” (Bivens, 2020). This study also found that when the government plays a strong role in negotiating the costs of drugs and health care services, cost growth can be controlled. This means that universal health care programs should not be more expensive per capita in the United States than universal health care programs in other countries, if costs in the United States were not so inflated.

The government’s ability to set and negotiate health care costs is one of several ways a single-payer, universal health care system would reduce health care costs in the United States. The American College of Physicians (ACP) has published a policy position report outlining the ways the United States health care system needs to be improved. In the report, they highlight several cost savings opportunities with universal health coverage. “The ACP proposes that costs be controlled by lowering excessive prices, increasing adoption of global budgets and all-payer rate setting, prioritizing spending and resources, increasing investment in primary care, reducing administrative costs, promoting high-value care, and incorporating comparative effectiveness and cost into clinical guidelines and coverage decisions,” (Doherty et al., 2020). Based on all of these cost savings opportunities, the ACP recommends that the United States adopt a universal health care system. They also go on to explain that while single-payer systems and a public choice option alongside private health insurance both have advantages and disadvantages, the evidence suggests that plans which are publicly financed and managed have more potential to reduce administrative costs and burdens on patients and health care providers, than systems that rely on private insurers.

According to the World Health Organization (WHO), three broad health financing strategies can influence universal health coverage. These strategies include more money for health care (raising more funds), strength in numbers (larger buying pools), and more health for the money (improving efficiency and equity in the use of funds) (Kutzin, 2013). When combined, these strategies make sustainable universal health care programs possible around the world today.

One of the biggest opportunities for cost savings of a single-payer, universal health care system in the United States would come from the elimination of for-profit, private insurance companies acting as billing and payment intermediaries between patients and service providers. In 2019, the New York Times published an analysis of Medicare for All proposals by economists and policy experts (Katz & Sanger-Katz, 2019). In this analysis, they discuss how complex the United States health care system is, with many different payers and ways to negotiate pricing and bill for services. The authors conclude that a single-payer system could reduce costs by simplifying the complexities of the United States health care system. The article goes on to explain, “Insurance companies spend on negotiations, claims review, marketing and sometimes shareholder returns. One key possible advantage of a Medicare for all system would be to strip away some of those overhead costs. But estimating possible savings in management and administration is not easy.” (Katz & Sanger-Katz, 2019). Ultimately, all of the economists agreed that administrative costs would be lower under Medicare for All, since Medicare is a lower-cost system of health care coverage today, but they couldn’t agree on how much lower overall.

A 2020 study published by the National Center for Biotechnology Information, U.S. National Library of Medicine, and the National Institutes of Health conducted economic analyses of the cost of 22 single-payer health care plans introduced in the United States over the past 30 years and found a high degree of consensus for the financial feasibility of a single-payer approach in the country (Cai et al., 2020). The researchers identified 22 credible economic models for the cost of single-payer financing in the United States. They found that 86 percent of those models predict net savings in the first year of operations. Savings from simplified payment administration of insurers and providers, drug cost reductions, and other efficiencies ranged from 3 percent to 27 percent. Net savings were also expected to continue to accumulate and grow over time. According to the researchers, “These analyses suggest that single-payer can save money, even in year 1, incorporating a wide range of assumptions about potential savings. More aggressive measures to realize cost reductions are projected to yield greater net savings. This implies that concerns about health system cost growth with single-payer may be misplaced, though costs to government are likely to grow as tax-based financing replaces private insurance premiums and out-of-pocket spending,” (Cai et al., 2020). The median finding from this study was a net savings of 3.5 percent of current system costs. This analysis suggests that even if overall health care costs to the government grow, overall spending on health care in the United States would still be lower overall, when costs for health insurance premiums and out-of-pocket expenses paid by Americans are factored in.

According to the researchers, administrative costs and drug prices were the two areas with the biggest opportunities for savings through a single-payer universal health care system. There is evidence that billing and insurance-related administrative costs are 12 to 15 percent higher in the United States than in Canada’s single-payer health care system. Studies also find major differences in administrative costs between hospitals in the United States and those under single-payer systems in Europe. The United States spends more per capita on prescription drugs than any other country, spending more than twice per capita than the average of other countries (Cai et al., 2020).

The New York Times’ study also concluded that a Medicare for All plan would reduce drug prices in the United States significantly. According to the article, Americans pay higher prices than anywhere else in the world for prescription drugs, due to an overly complex payment system where payers all negotiate separately for drug coverage. If the United States government were to negotiate directly on behalf of all Americans instead, however, it would have the buying and negotiating power of the largest possible pool of patients and reduce drug prices substantially (Katz & Sanger-Katz, 2019). If complex for-profit health care administration overhead costs were removed, and the government was able to negotiate drug prices on behalf of patients, health care costs would be dramatically reduced. These savings could be passed on to the American people.

Another way the United States could leverage a single-payer, universal health care system to reduce health care costs is to improve health care service efficiencies. Maximizing spending efficiency is essential for any government-funded universal health care system to be sustainable. These efficiencies can be achieved through innovative service delivery models that focus on prevention, put patients first, and use data to inform care. According to the Organisation for Economic Co-operation and Development (OECD), some of the ways to maximize health spending efficiency include: investing early in health promotion and disease prevention (prevention often costs less than treatment), shifting services from hospitals to primary care and community health clinics (hospitals are more expensive to operate and deliver care from), revisiting how health care professionals are leveraged (non-physicians such as nurse practitioners can often deliver the same care as doctors for a lower cost), and making better use of big data and information systems (care can be delivered more efficiently and effectively when accurate and timely health data is shared across providers) (OECD Universal Health Coverage and Health Outcomes, 2016).

In the case of investing in preventative medicine and primary care, despite spending more per capita on health than any other country in the world, the United States falls short. According to the American College of Physicians, “Underinvestment in primary care in the United States also contributes to suboptimal outcomes. Evidence shows that greater use of primary care is associated with decreased health expenditures, higher patient satisfaction, fewer hospitalizations and emergency department visits, and lower mortality.” (Doherty et al., 2020). Though OECD peer countries spend an average of 14 percent of total health care spending on primary care, the United States only spends between 5 to 10 percent. Diseases are often less costly to prevent than to treat, so providing more coverage to preventative and primary care would reduce health care costs in the United States, by reducing the need for costly hospital treatments.

Some opponents of a single-payer, universal health care system in the United States argue that providing health care coverage to everyone will increase health care service utilization so much that health care costs will increase. And while most studies agree that health care utilization would indeed increase, many policy proposals still yield a projected net savings when utilization increases are weighed against all of the cost savings opportunities.

If the United States were to adopt a single-payer universal health care system, there would be a major change in who pays for health care services, and where that money would come from. According to the New York Times Medicare for All policy analysis, “In some estimates, the country would not pay more for health care, but there would still be a drastic shift in who is doing the paying. Individuals and their employers now pay nearly half of the total cost of medical care, but that percentage would fall close to zero, and the percentage paid by the federal government would rise to compensate. Even under Mr. Blahous’s lower estimate, which assumes a reduction in overall health care spending, federal spending on health care would still increase by 10 percent of G.D.P., or more than triple what the government spends on the military,” (Katz & Sanger-Katz, 2019). So while overall health care costs in the United States are likely to decrease under a single-payer universal health care system, the government would have to scale up its budget to administer health care payments on behalf of Americans.

The most obvious way to raise the additional revenue needed to cover the increased government funding needs to operate a single-payer universal health care system like Medicare for All is through taxation. According to the New York Times Medicare for All policy review, “Raising revenue would require broad tax increases that are likely to be partly borne by the middle class, potentially impeding passage. Advocates, including Mr. Sanders, tend to favor funding the program with payroll taxes. For some people, any increase in federal taxes might be more than offset by reductions in their spending on premiums, co-payments, deductibles and state taxes.” (Katz & Sanger-Katz, 2019). Though tax increases would be necessary to fund such a system, many Americans would ultimately pay less than they currently do in out-of-pocket health care expenses annually.

Many advocates for a Medicare for All system in the United States favor a progressive tax plan to fund it, which would put a higher tax burden on wealthy Americans who would pay a higher income tax rate than most working-class Americans. Bernie Sanders, the Independent Senator from Vermont and former U.S. presidential candidate, is perhaps the most well-known advocate for a Medicare for All policy in the United States — a policy which he introduced to the United States Congress and included in his presidential campaign platforms.

According to Senator Sanders’ website, he has proposed a comprehensive, progressive tax and financial policy plan to pay for Medicare for All which includes implementing: “a four percent income-based premium paid by employees, exempting the first $29,000 in income for a family of four; imposing a 7.5 percent income-based premium paid by employers, exempting the first $1 million in payroll to protect small businesses; eliminating health tax expenditures, which would no longer be needed under Medicare for All; raising the top marginal income tax rate to 52 percent on income over $10 million; replacing the cap on the state and local tax deduction with an overall dollar cap of $50,000 for married couples on all itemized deductions; taxing capital gains at the same rates as income from wages and cracking down on gaming through derivatives, like-kind exchanges, and the zero tax rate on capital gains passed on through bequests; enacting the For the 99.8% Act, which returns the estate tax exemption to the 2009 level of $3.5 million, closes egregious loopholes, and increases rates progressively including by adding a top tax rate of 77% on estate values in excess of $1 billion; enacting corporate tax reform including restoring the top federal corporate income tax rate to 35 percent; and using $350 billion of the amount raised from the tax on extreme wealth to help finance Medicare for All,” (Bernie Sanders How Does Bernie Pay for His Major Plans?, n.d.). Most of Senator Sanders’ policy proposals would financially impact the wealthy while providing relief for working-class Americans.

Studies and analyses on single-payer universal health care systems project that such a system would reduce today’s higher than average per capita health care costs for the United States. These savings would mostly come from removing unnecessary administrative overhead, pooling resources and buying power to drive down drug prices, and maximizing health care service efficiencies. While a single-payer system would require an increase in government spending to fund, the majority of Americans would see reduced overall health care costs when out-of-pocket health care costs and health insurance premiums are taken out of the picture. A progressive tax policy that places most of the funding burden on the wealthy could fund such a system.

Single-payer universal health care would fuel economic growth in the U.S.

While some argue that the increased cost to the government of operating a single-payer universal health care system would have negative impacts on the economy, such a system would support economic growth in the United States. In a study published by Frontiers in Pharmacology that analyzed the impact of universal health coverage on life expectancy at birth, researchers found that in addition to its positive impact on life expectancy, universal health coverage also had a positive impact on economic growth. “After UHC achievement, economic growth tended to be faster than usual. For example, after the achievement of UHC in South Korea, the economic growth rate almost doubled. This suggests that economic growth may be a proxy advantage of UHC,” (Ranabhat et al., 2018). There are several ways in which a single-payer universal health care system could boost the United States economy, including increased job mobility, increased wages and salaries, increased availability of “good jobs”, reductions in damage from periods of unemployment, increased entrepreneurship and small business creation, new job creation, and a net overall increase in jobs for American workers.

According to a 2020 report by the Economic Policy Institute, fundamental health reform like Medicare for All would help the labor market in the United States (Bivens, 2020). The World Health Organization also cites increases in job mobility in countries with universal health coverage. In countries with national health care systems, as is the case in most of western Europe, people are free to leave their jobs for new ones without losing their health care coverage. But in countries where health care coverage is linked to a particular job, people become locked into jobs they don’t want because they risk losing their health care if they leave (Kutzin, 2013). With a single-payer universal health care system, American workers won’t get stuck into “job lock” where they’re unhappy with their work but can’t leave their jobs for fear of losing their health insurance.

Another way a single-payer universal health care system would benefit the United States economy is through increased salaries and wages. The Economic Policy institute asserts that removing the burden of health insurance funding from employers allows them to redirect that money they’re spending on health care to their workers’ wages. “Medicare for All could increase wages and salaries for U.S. workers by reducing employers’ costs for health insurance — freeing up fiscal space to invest in wages instead. The share of total annual compensation paid to American employees in the form of health insurance premiums rather than wages and salaries rose from 1.1% in 1960 to 4.2% in 1979 to 8.4% in 2018.5 If this post-1960 increase had been only half as large — and employers had spent the health cost savings on wages and salaries — the take-home wages of American workers would have been almost $400 billion higher in 2018,” (Bivens, 2020). A $400 billion increase in wages for American workers would increase disposable income and certainly boost the United States economy.

A single-payer universal health care system would also increase job quality and the availability of “good jobs” in the United States. “Good jobs” typically mean jobs that come with health insurance benefits, in addition to good wages. A system like Medicare for All could substantially improve the quality of jobs and job satisfaction for Americans (Bivens, 2020). If every job came bundled with a guarantee of health care, job satisfaction across all jobs would increase.

Another big economic benefit of a single-payer universal health care system in the United States would be a lessening of the damaging financial impacts of job loss by ensuring all Americans would have health care coverage regardless of their employment status. “Medicare for All could make job losses and transitions less stressful by delinking employment and access to health insurance, emulating the universal access to health care offered by our rich country peers.” (Bivens, 2020). When health coverage is uncoupled from employment, periods of joblessness become less damaging and stressful to American workers and their families.

A single-payer universal health care system would also promote entrepreneurship and small business formation in the United States. The United States has a notably smaller share of self-employment and small business employment relative to our peer countries. In many wealthier countries, people are more likely to start their own businesses because they don’t have to worry about how to pay for health care if they quit their jobs — and lose their health insurance — to become entrepreneurs. Small businesses in the United States are also negatively impacted when it comes to recruiting employees because health insurance costs are much higher for small businesses than for larger ones (Bivens, 2020). When entrepreneurs don’t have to worry about paying for private health insurance and small business owners don’t have to worry about covering the cost of their employees’ health care coverage, new businesses are more likely to be created.

Finally, single-payer universal health care would produce a net increase in jobs in the United States. According to the New York Times, “Other changes to Medicare for all would also tend to increase health care spending. Some proposals would eliminate nearly all co-payments and deductibles. Evidence shows that people tend to go to the doctor more when there’s no such cost sharing. The proposed plans would also add medical benefits not typically covered by health insurance, such as dental care, hearing aids and optometry services, which would increase their use,” (Katz & Sanger-Katz, 2019). Increased utilization of health care services would increase the demand for jobs across the entire spectrum of health care professions.

Some argue that the job losses in health insurance and billing administration would hurt the economy. But while these impacts should not be ignored and efforts should be made to help displaced workers find new jobs, the increase in health care service delivery related jobs should outweigh any decline in administrative jobs. “While the overall effect of fundamental health reform on the labor market would be unambiguously positive, this does not mean policymakers should ignore the distress caused by job transitions forced by this reform. Specifically, policy support should be provided to help displaced health insurance and billing administration workers move into new positions.” (Bivens, 2020). A Medicare for All policy could create more than 2 million jobs for Americans. “Pollin et al. (2018) estimate that expanded access to health care could increase demand for health services by up to $300 billion annually. Given the current level of health spending and employment, this would translate into increased demand for 2.3 million full-time-equivalent workers in providing healthcare,” (Bivens, 2020).

From increasing the availability of good jobs, wages, and entrepreneurship, to reducing the impacts of job loss and creating millions of new jobs, a single-payer universal health care system would clearly have a major impact on the United States economy. That impact appears to be an overwhelmingly positive one for most American workers.

Key takeaways:

In conclusion, adopting a single-payer universal health care system is both economically feasible, and would benefit the United States, by expanding health care coverage and access to all Americans, improving health outcomes, reducing health care costs, and supporting economic growth in the country. Many reputable organizations support the adoption of universal health care systems, including the World Health Organization, the Organisation for Economic Co-operation and Development (OECD), and the American College of Physicians.

Beyond all of these compelling data-driven and economic arguments, adopting a single-payer universal health care system in the U.S., such as Medicare for All, is also the right thing to do morally. The question should not be whether or not to adopt such a policy in the U.S., but rather how. It won’t be easy. Overhauling a very complex health care system and radically changing the way it operates will require extensive research, experimentation, and solid, sustainable policy development. It will also require strong political support to be successful.

More than 100 countries already have universal health care systems and their citizens enjoy the benefits today. With millions of Americans uninsured and underinsured, and feeling the pressures and stresses of soaring health care costs, poor health outcomes, job insecurity, poverty, and even early death, implementing a single-payer universal health care system in the U.S. is long overdue.

The time for policymakers to take action on universal health care for the American people is now.

References:

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