Obamacare Is Working But Single-Payer Would Work Better

The Commonwealth Fund has released its 2014 report on health care. This report compared health care in several different areas for 11 rich developed nations. Sadly, out of those 11 nations, the health care in the United States was rated last, meaning it had the poorest attempt to deliver health care to all citizens of any of those developed nations.

The survey was done before Obamacare had fully been implemented, so some areas will have improved -- like accessibility and equity. Millions more people now have health insurance in the United States thanks to Obamacare, and even more will probably get that insurance in the future. But a flaw in Obamacare allows the states to continue to control the access to health insurance for poor people, and since about half of the states (controlled by Republicans) refuse to expand Medicaid, millions of poor people in the United States continue to go without health insurance and therefore lack access to adequate health care. In Texas alone, this figure is more than 1.5 million people.

And since these states continue to refuse to define health care as a right (instead viewing it as a product for sale to those with the money to buy it), there is little hope that all states will expand Medicaid in the near future. But even if they did, there would still be some Americans (a few million) left without health insurance. That's because Obamacare was designed to help people get health insurance, but did not make it a requirement for all people to be covered with adequate insurance.

There is another problem with health care in the United States. It is just too expensive -- and this is a problem that Obamacare won't, and probably can't fix. Note in the chart above that the United States spend much more than the other developed nations on health care (on a per capita basis) -- and it does that in spite of the fact that millions of Americans are not offered or given access to the health care system.

Now one might be tempted to say that the cost is so high in the United States because those who do receive health care in the United States get better care than in those other countries. That is just American exceptionalism, and is not true. According to the Commonwealth Fund report, the United States doesn't finish first in any aspect of health care among these developed nations. Health care is so expensive in the United States because it is treated as a profit-making business (on all levels) rather than a right of citizens -- and government doesn't do anything to control the costs (as it does in those other countries).

There is a simple way to reduce the cost of health care significantly in the United States. We could adopt a single-payer health care system (where all citizens would be covered with government health insurance, sort of like a Medicare for all system). Even if we left doctors and hospitals as profit-making businesses, which is the most likely scenario for single-payer in the United States, health care costs could be significantly reduced.

The costs would be reduced for several reasons. First, the profit-making private insurance companies would be taken out of the equation. Second, government insurance has a lot lower overhead cost than private insurance. Third, government could negotiate with doctors and hospitals to control the costs. And fourth, overhead costs for doctors and hospitals would be reduced since they would have to deal with hundreds of different insurance companies (all with their own policies and regulations).

Obamacare has improved the health care situation in the United States, but it falls far short of fixing the broken system. A single-payer system would cover ALL citizens with health insurance, give them access to adequate health care, and lower the cost for that health care. All citizens have a right to decent health care -- and a single-payer system is the best way to accomplish that.