More Americans believe that health insurance should be more than a privilege for a select few; a growing segment of the U.S. population is supporting the idea that health coverage should be a right for everyone. A new poll by the Associated Press-NORC Center for Public Affairs Research indicates that there is burgeoning support for government-sponsored health care for all Americans. Among those polled, 62 percent agreed all Americans should be covered, while 37 percent disagreed.
This sentiment has been fueled in part by the recent changes in the U.S. health care system enacted by the Affordable Care Act, as well as the efforts by Congress to repeal and replace the ACA. More than 20 million Americans obtained health coverage through ACA-subsidized health plans or the Medicaid expansion, and as the failed repeal initiatives demonstrate, much of the public does not support rolling back that coverage.
Support for universal coverage has spiked dramatically in the past year. In another AP-NORC poll taken just last year, only 52 percent of respondents supported government involvement in ensuring all Americans have access to medical services, while 47 percent opposed such involvement.
Currently, federal, state and local government agencies pay almost $3 trillion to cover various American populations including the poor, elderly, disabled and children. This constitutes almost half of the nation’s entire expenditure on health care. Much of the remainder is paid by employers who are often subsidized by government tax breaks, leaving a relatively small portion of the American public who obtain health insurance through private insurers.
It is only human nature to truly value something when it is threatened or removed. For the majority of Americans who obtain health coverage through an employer or government agency, it is merely a fact of life. However, when Congress threatened to eliminate that life-saving health insurance that many people got when the Affordable Care Act was passed, more people recognized the true value of such coverage, and that public concern translated into enough political opposition to stop any push to repeal the law.
In addition to the renewed focus on health care that recent political initiatives have engendered, there are also lingering memories of campaign promises by last year’s presidential candidates. Although all of the major candidates had a personal take on how American health care could be improved, Democrat Bernie Sanders had a radical platform that nevertheless resonated with many Americans. He proposed a single-payer system in which all Americans got their health insurance through the federal government, similar to how Medicare provides coverage to all retirees.
America has flirted with a single-payer system in the past, most notably President Harry Truman proposed a universal health coverage system in 1945. However, there is now a grassroots movement that recognizes many Americans are losing their lives because health care companies are putting their profits ahead of patients’ welfare. A huge number of Americans continue to struggle paying off medical bills—almost one in three.
Many point to the outrageous fees that many hospitals demand, while others argue that much of the cost of health care is related to the mountains of paperwork that are related to medical services. It is estimated that almost 15 percent of health care expenditure goes towards billing and administrative duties, or $375 billion each year. More Americans are realizing that they are paying for unnecessary services when they visit their doctor, and this is fueling a growing movement for universal coverage.
Finally, there is a growing unhappiness that American health care costs so much, but is so poor in quality. Despite spending the most per capita on health care among developed nations, the United States consistently ranks last in access, efficiency and patient outcomes, according to the Commonwealth Fund. Among the world’s wealthiest nations, only the United States lacks universal health coverage.
Despite mounting public support for a single-payer health care system, it appears highly unlikely that the U.S. will adopt such a system in the near future. There are many reasons for this, but, perhaps, the most important among these is a current health insurance system that covers 91 percent of Americans. More than 170 million Americans are covered through their employer health plans. Fifty-six million retirees obtain coverage through Medicare, and Medicaid covers an additional 70 million disabled and impoverished Americans.
That leaves only 9 percent of the U.S. population—or 28 million—without health insurance. Although this is still a very large group of Americans, it may not pose a big enough problem for government leaders to consider upending the entire health care industry. Most lawmakers are much more comfortable with merely modifying existing programs to help shrink this population in more modest measure.
There is a significant political cost to such a revolutionary restructuring of the U.S. health care system. Despite a growing majority of the public supporting universal health care, only 3 in 10 Republicans support the idea (while 8 in 10 Democrats support it), and it would almost assuredly require bipartisan support in the U.S. House of Representatives and Senate for such a proposal to pass. Few GOP politicians, including President Donald Trump, are likely to vote for a measure that so much of their party so strongly opposes.
Finally, there is a huge investment cost that few Americans are willing to support. Although studies show that almost 90 percent of Americans would financially benefit from a single-payer system, there would have to be a large tax increase to initially pay for the system. These taxes would help jump-start the universal health care program and would be repaid in full to most Americans in the form of access to medical services, but most politicians would be unwilling to endure the huge political backlash that would erupt when the public sees how much their taxes would rise. Similarly, although most American companies would become more competitive because the government would shoulder the employee health care burden, few would want to pay such a large increase in taxes.
