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Universal Health Care

Sometimes I think we fail to realize how absolutely insane our health care system truly is. This comic by Sarah Mirk imagines what it would be like if all public services in the US worked like our healthcare system.

I am perfectly happy to not insist on “Medicare for All” immediately, as long as we start to offer a “public option” where people have a choice between our current system and and a Medicare-like system. But our goal should be to move toward single-payer health insurance, the only question is how we get there.

The main objection I hear against going to a Medicare-like system with universal coverage is that it would raise our taxes. But as this article in the NY Times points out, we are looking at this the wrong way. We should think of the premiums that we (and our employers) pay for health insurance as taxes. After all, it is all just money out of our pocket.

Most Americans who have health insurance get it through their employer. I have started several companies and served as a CEO, and I can assure you that if a company didn’t have to spend the time or money providing health insurance — something that is a huge distraction and money sink from the company’s core business — then that company could easily afford to pay their employees a significantly higher salary. In fact, typically enough to more than offset the extra taxes that people would have to pay to support universal single-payer health insurance.

And there are other benefits that most people don’t even realize. For example, I have lived in three countries that have single payer systems, and in those countries insurance for your car is a small fraction of what it is in the US. Why? Because the biggest cost of car insurance is liability insurance to cover health care costs for you, your passengers, and other parties when you are involved in an accident. But if everyone’s health costs are covered by a single payer system, then there is no need for that insurance.

In addition to saving companies time and money, and saving us the premiums that are automatically deducted from our paychecks, a universal single payer system would save all the time that individual employees spend dealing with their health insurance companies and filling out paperwork. Every time I have lived in a country with public health insurance, the paperwork I had to deal with to get health care was far far less than it is in the US.



  1. Raymond Gergen wrote:

    The conservative thought process does not involve anyone who can not be a profitable asset, hence, “pre-existing conditions.”
    Just my opinion.

    Saturday, August 31, 2019 at 8:15 am | Permalink
  2. rk wrote:

    I’ve always wondered why companies and Republicans aren’t for this. I’m not sure that it would increase the salaries for workers, but it would decrease some of their costs at least. I suspect most of the money would end up in CEO’s and people on the board of director’s pockets. But it would still be a win.

    It doesn’t have to mean the end of insurance companies. They could offer all sorts of supplemental insurance.

    Saturday, August 31, 2019 at 9:51 am | Permalink
  3. Iron Knee wrote:

    RK, in fact, in many countries with universal public health insurance, there are also health insurance companies. The public insurance covers catastrophic and preventative health care, and the insurance companies add on extra coverage (for example, elective surgery, better hospitalization care, etc.).

    So everyone has enough coverage to stay healthy and take care of accidents, but you can buy coverage for other health care. This is the plan that I would support!

    Saturday, August 31, 2019 at 11:13 am | Permalink
  4. notycoon wrote:

    I’m still a fan of the Swiss system. There are several health insurance companies in Switzerland. The government sets the standards for what is to be covered and what the premiums are to be. The insurance companies compete on the level and quality of services provided to the public. There is universal coverage, but not single payer. I wish the Dems would drop the term “single payer” and focus on universal health insurance. And, for heaven’s sake, drop the Medicare for all talk.

    Saturday, August 31, 2019 at 10:56 pm | Permalink
  5. Dan wrote:

    It’s a matter of if you believe health care is a privilege or right. If a person walks into an emergency room, where cost is the most, they MUST be treated regardless of ability to pay, which wastes valuable resources,treatment those with insurance pay for through insurance premiums.
    Have a one payer system paid for in part with a sales tax included in the sticker price,that way it doubles as a tariff that won’t start a trade war.

    Saturday, August 31, 2019 at 11:16 pm | Permalink
  6. James wrote:

    I’ve always been baffled by why US businesses tolerate the massive competitive disadvantage foist upon them by health insurers and the medical industry. Distressingly, the trend over the past 25+ years has been to push risk and costs off onto employees (anyone remember pensions?) without any corresponding increase in wages to offset the risks and costs. This lopsided equation is enabled by the disappearance of labor organizations, so the prevailing force only comes from one side.

    Sadly, observing the above unfold is why I have slowly abandoned my once firm faith in incrementalism and centrism. Sensible policies makes small incremental gains that are subsequently swept far out to see by a tsunami of extremism when a new, ever more extreme right wing takes hold. Continued faith in incrementalism is now little more than wishful thinking.

    Sunday, September 1, 2019 at 7:25 am | Permalink
  7. ebdoug wrote:

    Not a sales tax or “tariff” but a progressive tax rate. During six years of my life after I left my parents, I had a company paying my insurance. Other than that I was always self pay. Ten years ago, I reached 65 so was on Medicare. Other than my long term insurance, I pay a lot less now. Companies paying health insurance came after world war II to attract employees. Health insurance should leave the companies and become self pay BY INCOME. ACA has a built in payment by income now that when you hit a six figure income, you pay more for Medicare. If you are poor enough, you aren’t required to file a tax return, then you will qualify for Medicare/Medicaid. All based on income. This increases the taxes on the rich which is what this country needs to increase its quality of life. The Warren Buffets of this country would happily pay more to increase the quality of life for others. The Donald trumps have not learned that you can’t take it with you and want not to pay any taxes.

    Monday, September 2, 2019 at 12:02 pm | Permalink
  8. Hassan wrote:

    Ok I am voting for Andrew Yang

    Monday, September 2, 2019 at 3:37 pm | Permalink
  9. Monica Neil wrote:

    Richard Nixon created the system that we have now. Before that doctors rarely considered their field to be for profit. If the doctor came to your house and gave you the medicine you needed, he might have walked away with a dozen eggs or a wheel of cheese. Only after the HMO came about in the 70s did people go into medicine so that they could get rich.

    Tuesday, September 10, 2019 at 10:47 am | Permalink