It’s Time for a Medicare for All Bill


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The healthcare system is an undue hardship

I work at a pharmacy, and one of the hardest things about my job is informing people that their health insurance won’t cover necessary prescriptions. It breaks my heart when I have to look someone in the eye and say “I’m sorry but your insurance says they won’t pay for your prescription.” I have found ways to help these people get their prescriptions by accessing additional help, but what good is their insurance? It won’t cover medications that they need.

Why are Insurance companies pushing the workload to charitable contributions to bridge the gap?

Most Americans are one paycheck away from financial ruin, and medical bills are the leading cause of bankruptcy. The rising costs of healthcare practically guarantee that this problem will continue to grow.

Financial hardship affects your decision-making, and it’s no different with healthcare. Medical debt makes people less likely to fill a prescription, see a specialist, or visit a doctor for a medical problem. People burdened with medical debt are also more likely to skip a needed test, treatment, or follow-up visit. It’s no surprise that people want to avoid increasing their debt. Unfortunately, in our current system, that means waiting longer to get well (if you get well at all).

American healthcare is worse than healthcare in other first-world countries

Even if you have insurance and can afford to pay for healthcare, the care we receive in America is not on the same level as other first-world countries. The United States ranks #17 in quality of life and #43 in life expectancy. Most of our allies have moved to a single-payer health system and consistently outrank us in quality of care.

I believe that the United States is the greatest country in the world, and there is no reason we should be ranked lower than #1. While no healthcare system in the world is perfect, we have lessons we can learn from our allies to drastically improve our quality of care. Expanding Medicare to cover all Americans is a good first step in fixing what’s broken with our healthcare system.

We are already paying for it

A common refrain from opponents of universal healthcare is “who will pay for it?” I know exactly who will pay for it. The American people will pay for it. How do I know that we can pay for it? Because we already are. We pay for it every time we pay a health insurance premium, when we cover the out-of-pocket cost for needed prescriptions, and when we miss work because we’re too sick to go in but not sick enough to want to spend money on a doctor. We already pay for universal healthcare—and then some—yet we don’t have universal healthcare.

Healthcare should not cost as much as it does in America. There are a number of factors that feed into the astronomical price of healthcare in this country, and I believe we can address them all.

High administrative costs

The United States leads in hospital administrative costs, which makes up nearly 30% of the total cost of healthcare. This is in large part due to our system having innumerable health insurance providers, which leads to a duplication of effort in healthcare administration. This problem is becoming significantly worse over time, with the growth of healthcare administrator roles significantly outpacing that of physicians.

Employer-provided health insurance

While America has a more complex health insurance system than most other first-world countries, individual Americans feel like they have few options for healthcare.

Most Americans’ health insurance plans are inextricably tied to their employment status. You change jobs, you change insurers. You lose your job, and, well… Your options are to pay through the nose for COBRA or find your own plan which will almost certainly be worse and cost more than that provided by your previous employer.

Drug companies focus on making money, not helping people

Pharmaceutical companies do what they can to stifle competition so they can set their own sky-high drug prices. Every time a patent is about to expire on a lucrative drug, researchers simply go back to the drawing board, tweak the formula just a bit, and get a brand new patent to continue with their monopoly. Even the method of injecting drugs can be patented, resulting in massive price increases like what we’ve seen with EpiPens.

However, they don’t stop there. In addition to price-fixing, pharmaceutical companies employees spend billions of dollars every year sending salespeople to push their drugs on doctors. Simply meeting with a sales rep makes doctors more likely to prescribe their drugs over competitors or generics.
Drug companies even pay doctors to push opioids, which has largely contributed to our country’s opioid crisis. Congress even gave the crisis a helping hand, gutting the DEA’s ability to freeze suspicious drug shipments believed to pose an “imminent danger” to our communities.

Doctors practice defensive medicine to avoid lawsuits

Many doctors practice “defensive medicine”—the use of unnecessary tests—to avoid malpractice lawsuits. Even when doctors are certain of a diagnosis, they may run multiple tests to ensure they are right. It’s not a matter of need: it’s a fear of litigation. These unnecessary tests come with costs which are passed on to the patient or their insurer. Regardless of who is footing the bill, the cost comes back on us, be it in the form of medical bills or the rising cost of insurance.

Record profits for health insurers

Finally, health insurance providers are raking in money. It makes no sense for insurers to collect record profits when we’re simultaneously experiencing record healthcare costs. Unsurprisingly, insurers earn most of their profit off of employer-provided plans, where spending is at an all-time high.

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We can pay less for better healthcare

When you look at all of the factors that go into our cost of care, it’s easy to see how healthcare has become so complex. There are far too many middle men who want their cut of every healthcare interaction. There are bureaucratic, cruel, and profit-motivated practices in place that keep our people dependent on opioids. Other cruelties of the system saddle the chronically ill with drugs that keep them just well enough to live, maximizing profits instead of helping people fully recover. And there are so many silos and layers in the healthcare industry that no one participant feels responsible for their part in maintaining the status quo.

Imagine if we began eliminating many of these layers that exist solely to maximize profits for healthcare executives who are already rich.

Expand Medicare availability

First and foremost, we can take what already works and offer it to everyone. Medicare has its flaws, but it is effective at keeping the cost of overall care lower than private insurance. By making Medicare available to all Americans, we will set the stage for a more cost-effective healthcare system.

Expand the coverage offered under Medicare

Medicare in its current form is not sufficient, but it’s a good place for us to start. I intend to expand Medicare to cover more services and all types of healthcare needs. Outpatient services, preventative care, vision, hearing, and oral healthcare, mental healthcare, medical supplies, tests, and medication all need to be covered.

Leverage our buying power to reduce the cost of drugs

Expanding Medicare coverage may sound expensive, but only when you look at costs through the lens of our current healthcare system.

Other countries pay far less than we do for the same medications. That fact alone is insane. By creating a single insurance pool, we can leverage our buying power to negotiate similar or better prices than our allies get for the same medicine. We will remove the Medicare restriction on negotiating drug prices and grant the FDA the authority to control drug prices.

Incentivize preventative care

Preventative care such as regular check-ups, exercise, and eating well can eliminate an array of chronic health issues. Expanding preventative care will give us a higher quality of life. It will also drive down the cost of healthcare by detecting and alleviating health problems before they become serious. We will institute programs that motivate people to take care of themselves and expand the availability of counseling for substance abuse, weight loss, depression, and anxiety.

Replace sales reps and direct-to-consumer advertising with public-funded continuing education for doctors

Pharmaceutical sales representatives and medical equipment salespeople are often the primary sources of continued education for physicians. We should replace these biased and profit-motivated sales efforts with public-funded, researched-based continuing education programs that equip our healthcare professionals with world-leading skills and knowledge.

Similarly, drug companies should not try to circumvent healthcare professionals by influencing consumers through direct-to-consumer advertising. These biased drug commercials make massive promises to people who are at their most vulnerable. This type of pharmaceutical advertising is illegal in most countries and was illegal in the United States prior to 1997. I will propose a return of FDA regulations that prohibit direct-to-consumer drug advertising.

Eliminate medicinal patents that stifle innovation

Certain types of patents give innovators room to breathe and should be maintained. However, drug companies should not be permitted to abuse our patent system to prevent the development of generic drugs that will save Americans billions of dollars.

Let’s fight for the healthcare we deserve

Our hard-earned money should not line the pockets of health insurers and pharmaceutical companies. Let’s fight for collective bargaining power through universal healthcare to drive down the cost of necessary prescriptions, replace pharmaceutical company sales reps with unbiased research and continuing education for healthcare professionals, and make it affordable to stay healthy.

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