This is a pivotal moment in American history. Does it, as a nation, join the rest of the industrialised world and guarantee comprehensive health care to every person as a human right? Or does it maintain a system that is enormously expensive, wasteful and bureaucratic, and is designed to maximise profits for big insurance companies, the pharmaceutical industry, Wall Street and medical equipment suppliers?
America remains the only major country on earth that allows chief executives and stockholders in the health-care industry to get incredibly rich, while tens of millions of people suffer because they can’t get the health care they need. This is not what the United States should be about.
All over the country, I have heard from Americans who have shared heartbreaking stories about this dysfunctional system. Doctors have told me about patients who died because they put off their medical visits until it was too late. These were people who had no insurance or could not afford out-of-pocket costs imposed by their insurance plans.
I have heard from older people who have been forced to split their pills in half because they couldn’t pay the outrageously high price of prescription drugs. Oncologists have told me about cancer patients who have been unable to acquire life-saving treatments because they could not afford them. This should not be happening in the world’s wealthiest country.
Americans should not hesitate about going to the doctor because they do not have enough money. They should not worry that a hospital stay will bankrupt them or leave them deeply in debt. They should be able to go to the doctor they want, not just one in a particular network. They should not have to spend huge amounts of time filling out complicated forms and arguing with insurance companies as to whether or not they have the coverage they expected.
Even though 28 million Americans remain uninsured and even more are underinsured, America spends far more per capita on health care than any other industrialised nation. In 2015, the US spent almost $10,000 (Dh36,780) per person for health care; the Canadians, Germans, French and British spent less than half of that, while guaranteeing health care to everyone. Further, these countries have higher life expectancy rates and lower infant mortality rates than America.
The reason that America’s health-care system is so outrageously expensive is that it is not designed to provide quality care to all in a cost-effective way, but to provide huge profits to the medical-industrial complex. Layers of bureaucracy associated with the administration of hundreds of individual and complicated insurance plans is stunningly wasteful, costing us hundreds of billions of dollars a year. As the only major country not to negotiate drug prices with the pharmaceutical industry, America spends tens of billions more than it should.
The solution to this crisis is not hard to understand. A half-century ago, the US had established Medicare. Guaranteeing comprehensive health benefits to Americans above the age of 65 has proved to be enormously successful, cost-effective and popular. Now is the time to expand and improve Medicare to cover all Americans.
This is not a radical idea. I live 50 miles (80km) south of the Canadian border. For decades, every man, woman and child in Canada has been guaranteed health care through a single-payer, publicly-funded health care programme. This system has not only improved the lives of Canadian people, but has also saved families and businesses an immense amount of money.
Yesterday, I introduced the Medicare for All Act in the Senate with 15 co-sponsors and support from dozens of grass-roots organisations. Under this legislation, every family in America would receive comprehensive coverage, and middle-class families would save thousands of dollars a year by eliminating their private insurance costs as we move to a publicly funded program.
The transition to the Medicare for All programme would take place over four years. In the first year, benefits to older people would be expanded to include dental care, vision coverage and hearing aids, and the eligibility age for Medicare would be lowered to 55. All children under the age of 18 would also be covered. In the second year, the eligibility age would be lowered to 45 and in the third year to 35. By the fourth year, every man, woman and child in America would be covered by Medicare for All.
Needless to say, there will be huge opposition to this legislation from the powerful special interests that profit from the current wasteful system. The insurance companies, the drug companies and Wall Street will undoubtedly devote a lot of money to lobbying, campaign contributions and television ads to defeat this proposal. But they are on the wrong side of history.
Guaranteeing health care as a right is important for American people — not just from a moral and financial perspective; it also happens to be what the majority of the American people want. According to an April poll by the Economist/YouGov, 60 per cent of American people want to “expand Medicare to provide health insurance to every American”, including 75 per cent of Democrats, 58 per cent of independents and 46 per cent of Republicans.
Now is the time for Congress to stand with the American people and take on the special interests that dominate health care in the US. Now is the time to extend Medicare to everyone.
— New York Times News Service
Bernie Sanders is an independent senator from Vermont.
