The current U.S. healthcare system is broken.
The problem is bigger than affordability. Our system is a for-profit mishmash of disparate insurers and payment plans cobbled together in reaction to economic and political issues. The result is an increasingly unaffordable, ineffective, confusing mess, which frustrates patients, doctors and hospitals alike.
Opinion
The solution is “Medicare for All.”
It would bring high quality, affordable care to everyone. You wouldn’t lose your health insurance if you lose your job, move, get divorced, age out, or make too much money. A catastrophic illness or injury wouldn’t plunge you into medical debt. It lets you choose your doctors and hospitals, improves your access to healthcare services regardless of where you live, reduces health disparities, and improves the health of individuals and our communities.
Studies show that having health insurance is strongly correlated with more disease prevention, better chronic disease management, less infant and maternal mortality, and greater longevity.
Medicare for All builds on and expands traditional Medicare, which is well liked, to provide comprehensive benefits — medical, prescription drugs, mental health, dental, vision, hearing and long-term care to every person in the U.S. With everyone covered in the same plan, care is affordable. There are no insurance premiums, out-of-pocket costs, copays, deductibles, coinsurance, surprise bills, nor network restrictions.
The benefits to doctors and hospitals are significant. With Medicare for All, a single-payer system, billing is standardized and streamlined, saving an estimated $40 billion annually. Providers are paid the same for the same service, instead of payment varying by geography and insurer. When everyone has health insurance, providers aren’t burdened with bad debt, charity care and overcrowded emergency departments.
Opponents claim Medicare for All is too expensive and would raise taxes. The fact is we cannot afford not to implement Medicare for All. America has the most expensive healthcare system in the world, an estimated $5.3 trillion was spent in 2024.
Broken down, the average cost to insure a family of four was about $29,000 — $3,564 out of pocket, $6,296 in premiums and $19,276 in employer contributions, according to the Peterson-KFF Health System Tracker, which monitors the U.S. health system’s performance.
In other words, those premiums are a kind of tax. Right now, we are all paying for each other’s health insurance. For instance, employer contributions are indirectly subsidized by us, paid for through higher prices when we buy the company’s goods or services, and are directly subsidized by the worker, through reduced compensation to offset what employers spend on employees’ health insurance.
The U.S. spends almost twice as much as comparable countries who have healthcare for all — $13,432 per person versus an average $7,393, using 2023 Organization for Economic Cooperation and Development data. Yet, our health outcomes are poorer by all major metrics. Here’s the kicker — 60% of U.S. healthcare costs come from tax dollars. Sixty percent of $13,432 equals $8,059 — still more than our counterparts pay for better healthcare. We pay much more because the U.S. is not a unified system but a conglomeration of competing, for-profit parts. Costs cannot be controlled in a for-profit system, only shifted.
Motivated by quarterly growth, the U.S. healthcare system functions much like the children’s game of musical chairs. Insurers, big Pharma, hospitals and doctors compete with each other, expecting their profits to grow quarterly. Comparable countries keep their costs low because they are not motivated by quarterly growth, investor dividends and stock buybacks.
Their healthcare systems are funded through some form of income-based progressive taxes, or a combination of progressive taxes and limited household contributions. Everyone is automatically covered and costs are controlled through a systemwide budget, known as a global budget, which unites all parts of the system and spreads the money equitably so hospitals don’t go broke, nor eliminate services. All communities, including rural communities, have access to necessary care.
You don’t have to be a fan of U.S. Sen. Bernie Sanders to see that his proposed Medicare for All legislation is a good step in the right direction — a move toward a single-payer system that provides comprehensive coverage to all Americans, regardless of income or health status. To control costs, Medicare for All must be explicitly a non-profit system, integrated by a global budget. It also must be adequately funded. Medicare for All, however, will not be welcomed by those who are profiting from the current system. They have the money to lobby Congress, and disinform the public, to maintain the status quo. If we want affordable healthcare, then Medicare for All is worth fighting for.
Piecemeal reform, whether at the state or national level, can only bring us more of the same: rising costs and diminishing returns.
It was pharmaceutical advertising and lobbying that allowed widespread distribution of opioids to the unsuspecting public and caused millions to become addicted. The for-profit pharma, health insurance and health care conglomerates should all be blacklisted from participating in any discussions about Medicare for all. It was they who ruined the “Medicare-for-all” potential of the Affordable Health Care Act by lobbying Congress to finalize it with very expensive and virtually useless coverage that made money for the insurance companies, who took the government subsidies and ran. Before I went on Medicare I had a $5,000 deductible Affordable Health Care Plan with $11,000 annual out of pocket expenses. In effect, I had $16,000 to pay up front before the insurance paid a dime. It cost $2,200 a month, most of which was paid directly to the insurance company by the U.S. Government, with me paying them the difference. What a deal! The government paid the insurance company $26,400 a year for my insurance and I paid the difference plus $16,000 for my medical care. Needless to say, I almost never went to the doctor unless it was an emergency. Since I’ve been on Medicare, I have had annual checkups and two surgeries that were deemed necessary by those checkups. All paid for by Medicare and my Medicare supplemental plan. Donald Trump and his Medicare lackey Dr. Oz, want everybody on Medicare to go to a Medicare Advantage Plan, which would put us all back into that private insurance box that I was in before. In truth they want to privatize Medicare for the benefit of insurance companies even more. No Thanks, Dr. Oz! Medicare for all will work and no insurance companies or lobbyists should have anything to do with it. Period!
Good morning all! I saw a few comments opposing, and wanted to add more to the dissenting side.
First of all, we can agree that our healthcare system needs massive reform, or, as some might say, complete overhaul. However, I do not believe the solution is more government involvement, and that is where we differ.
To begin with, a standardized Medicare for all is a huge fiscal responsibility, one that I don’t think the United States can handle given its current deficits. There would have to be additional taxes on everyone in order to support the program (and of course, this is just to keep the deficits at status quo, which long term is unacceptable). Then, in order to keep private hospitals and care providers from bankrupting the system, the Government would either have to legislate price caps on everyone single service provided, or simply institute a government run hospital and health care provision. Neither of these options are good, as the first is an overreach of government authority (with many negative, unintended economic and medical consequences following, I assure you) and the latter would require more funding, more taxes, ultimately resulting in a poorly run and insufficient system. I have never thought the government was an entity that runs efficiently or effectively, and wanted to give them more responsibility. As a whole, they can’t even stay within a budget! When we see a teenager spend money recklessly, we call that immature and irresponsible. When the government does it, we ignore it and want to give them more fiscal responsibility? I hope to convince that this is unacceptable.
Now, what I did find interesting were several comments by Ms. Sowada relating to her ideas for reform. While I haven’t analyzed it completely, I would propose, why trust the government with such an endeavor as you have laid out? As far as I can tell, a version of what you have proposed would work excellently in the private sector. Think about how many successful non-profit organizations there are. Why couldn’t that be applied to health care? In fact, it already has been to a degree. Look up private health sharing programs. One of the most effective and affordable alternatives to insurance that I have ever seen. I am sure that my point is evident though, that I would support entrepreneurship and innovation in a private manner, as opposed to giving the government another reason to tax us, and another program to run poorly.
Ultimately, we have see in our lifetimes the effect of government involvement. To the extreme, I would highlight the authoritarianism illustrated in China, Russia, and North Korea. In our own beloved country even, one does not have to look far to see that giving the government more responsibility and power breeds corruption. I value my liberty too much to give more power to the government for a little perceived safety and comfort. Lastly, to anyone reading this comment, I ask of you; what government action have you seen take place that you would desire to see them take more action directly resulting in more taxes at best, and an overt disregard for your personal liberty at worst? Some might even equate the two. I know that government seems like an easy cure-all, but let me assure you, there has been no more insidious of a snake oil in all of history. The negative consequences of well-intended government action far too often leave the citizens to foot the bill. I implore you, reconsider looking to the government for answers. If government is removed from the healthcare industry, I am sure you would be surprised at the innovation and success that would move in to fill the gap.
When everyone has health insurance, you get to wait months and years for service, you are also relieved of alot more of your money through taxation.
Anything that requires the labor of someone else is not a “right”.
We’re already ‘relieved’ of a lot of our money. Many developed countries have CHEAPER health care costs with BETTER outcomes. Look it up.
Barbara, I appreciate your thoughtful support for Medicare for All and agree with much of your diagnosis. The challenge is timing. Given the current political environment, Medicare for All is unlikely to provide near-term relief, while Wyoming families are facing immediate premium shocks.
There is, however, an existing tool that does not sunset: the Section 1332 state innovation waiver. It addresses one of the main drivers of high premiums — catastrophic cost concentration, where roughly 10% of patients account for about 70% of spending. In a small state, that’s like a ranch losing an entire herd in a single disaster: no individual operation or insurer can absorb that loss alone. Wyoming ranchers understand this well. After brutal winter storms in 2022–2023 killed large numbers of cattle, ranchers across nearly the entire state relied on federal disaster programs, such as USDA livestock indemnity assistance, to stay solvent. Those programs didn’t replace ranching — they prevented collapse.
Source: Cowboy State Daily, Aug. 9, 2023; USDA Farm Service Agency, Livestock Indemnity Program.
States using Section 1332 waivers apply the same principle to health insurance, absorbing the most extreme medical costs so premiums for everyone else don’t explode. Wyoming explored this option in 2019 through House Bill 85 but did not pursue it. The option still exists. A backstop wouldn’t conflict with long-term reform goals — it could serve as a practical bridge to help people now.
Not opposed to this idea, but some things in the article are deceptive, if not outright falsehoods. I am grateful for my Medicare, but it was and is not free. I paid for it during my working life, as did my employer. I still pay $200 for my premium for part B and $140 per month for my prescription plan (part D). Even with those payments, I still often have a deductible and some of my medications are not covered. Definitely willing to look at Medicare for all, but I would be a lot happier to see congress ban pharmaceutical advertising and ban for profit hospitals as a start. These things were not allowed in the past and only one other developed country in the world allows pharmaceutical advertising.
I wonder what would happen if the echo chamber caucus in Wyoming’s Legislature grabbed onto this totally rational idea. Imagine how many voters across the state would pat the caucus bros on the back. “Great job!” we’d all say, “Great Job!!!”
The problem – the Freedom Caucus isn’t rational. It lives in an echo chamber that far too often excludes the interests of the people who voted them into office.
My only health insurance is Medicare and a Medicare Plan D. The AARP Plan D costs me about $5.00 a month and my Medicare costs me $202.90 a month which is taken directly out of my Social Security check. Medicare is not free, and it is a great insurance plan and pays 80% of my medical bills. I encourage those who have Medicare, not to buy a health plan because they already have a good one, and the money they save should cover their medical expenses. My wife and I have both had air transport to the hospital in Idaho Falls, and Medicare has covered most of the very high costs.
Impressive read. Sowada’s book “Healing the Fragmented U.S. Healthcare System” should be in every library, & every healthcare facility should have a copy of this book in their on-site library.
Medicare for all means simply “Medicare for no one” .
Our Federal deficit is crippling the USA and Federal health programs are already one of the main problems. More Federal handouts are never the answer for anything.
Nobody thinks medicare for all would be free. It’s still the best solution, and has been proven in many developed countries.
Gordon, there isnt a single thing the Govt. runs anymore that is efficient and fiscally responsible. This Nation is Bankrupt.
The ACA put a good but imperfect American Healthcare system on a dead end road. Medicare for all would put a Grand Canyon where the road stops.
Agree 100%! My friend from Belgium stated that in the United States that healthcare is a business. He, my friends in Scotland, New Zealand and Australia are very pleased with their universal/medicare for all healthcare. Those who are getting richer and richer will not give up their wealth generator easily even though it has caused unbelievable suffering to so many in this country.
This is correct and obvious to people all over the world who shake their heads in wonderment that the USA struggles with the most ineffective and expensive healthcare anywhere. Not everything should be for profit. Our laws have deteriorated to a point where only big spenders, not average citizens, are represented in Washington because of lobbyists and legalized bribery.
Thank you, I totally agree. A medicare for all system is proven in the rest of the developed world. The PEOPLE can make this happen.
Barbara: I agree with you 100 percent. Unfortunately, our billionaire overlords will claim it makes too much sense and smacks of egalitarianism.
Yes, our healthcare system is badly fractured. In fact, I don’t see how the current system can be saved.
However, it’s going to be very difficult to get the big wigs like the insurance companies and big pharma out of our healthcare. Our legislators have their hands in the pockets of big business. This does influence their decisions. We all know that.
Another issue I see with medicare for all is the potential collapse of our economy. Sadly, the stock market is very intertwined with our healthcare and economy. Medicare for all isn’t going to be an easy fix for our nation.
Taking care of Americans must be a real burden for this republican administration , affordable healthcare is not an option.
Very well explained Barbara, and so obvious how badly we need a major overhaul of our present heath care system. Medicare is a financial life saver for seniors and I bet there isn’t one among us that isn’t thankful that our old age isn’t filled with a constant threat of financial ruin from lack of insurance coverage or a catastrophic heath event. I’ve witnessed what a lack of affordable heath care does to low income people that have no other choice than to go without insurance; and the costs capitulate throughout the entire health care system. The richest country in the world must be able to devise a system of health care that makes it available to every person. We can afford it as a country and as individuals; the logical and humanitarian choice is Medicare for all. Thank you for providing your thought provoking opinion. Hopefully it is read by our congressional representatives and taken to heart.
I don’t disagree with your statement, “The richest country in the world must be able to devise a system of health care that makes it available to every person,”
But the key here is the country doesn’t want to. Medical insurance, pharma are all big business that remain profitable year after year, all at the expense of the public. Politicians have no incentive to iron out this problem, because (1) it doesn’t affect them, (2) the industry spends more money lobbying than any other sector , and (3) they heavily invest in political contributions. Politicians are not going to kill the golden goose.
Is this right, of course not, but until the American public educate themselves and start holding politicians accountable for their actions, or lack of, this will continue to be problematic.
Bravo. Well argued. Thank you. Now let’s do it!! No more families ruined through unnecessary grief of loss of a beloved or from debt due to unnecessary healthcare costs when a loved one becomes ill.