The article “Report: Patients’ out-of pocket costs increased up to 14%” is a stark reminder: With many American workers living paycheck to paycheck, even expensively insured families can face financial ruin from routine illness and injury. That dilemma is echoed on a national scale: with healthcare consuming nearly 18% of gross domestic product and rising, the question is not whether we can afford to change the system radically but whether we can afford not to.
Soaring healthcare costs are driving America’s wage stagnation problem. Employer-sponsored health coverage is compensation, and the cost has risen so fast that there’s little room for wage increases. When we ask how we can pay for universal health coverage we should remember that the amount employers and employees now spend on health coverage could become taxable income under a single-payer system.
Making the system affordable will require cost reductions, and the “public option” proposals will not achieve them. A single billing and payment system could address runaway administrative costs, and a single payer would have the leverage to control prescription drug costs. Economies of scale still exist. Hospital administrators worry about Medicare-level payments, but they would also lose the burden of uncompensated care.
The status quo is no longer an option. This is a crisis, and it needs an immediate and decisive response. Single-payer systems are working all over the world; they can work here too. We just need the courage to act.