Actually Making America Great

Universal Healthcare

September 18, 2020 Oliver Niehaus Episode 3
Actually Making America Great
Universal Healthcare
Show Notes Transcript Chapter Markers

This is the third of 5 episodes in our series on Actually Making America Great. We aren't Democrat or Republican, but we try to find some common ground as we analyze 5 policies that we believe would have the most impact on the lives of the average American. These are typically issues you won't see talked about on the news or by your Congresspeople, but they should. Our goal with this series is to make the case for these policies so that America can actually be Great. That only happens with your support. If you agree with this, please like, subscribe, and share this just about everywhere.

And if you really really liked it, call your Congressional representatives and make them get behind these five issues:

1. End the Drug War

2. End the Foreign Wars

3. Universal Healthcare

4. Hand the Economy Back to the People

5. Get Money Out of Politics

Thank you and hope you enjoy!


Thank you to Naser Al-Fawakhiri for his outstanding work in helping to research and craft the material you heard in this series.
Thank you to Oscar Gregg for crafting the wonderful music you hear for this intro and all the music for the intro and outro of this series. His new single Acrobats is out on all major platforms which you should all give a listen!
This podcast is associated with The New Millennia news organization. 

Welcome to the third episode of our series called Actually Making America Great! Thank you so much for tuning in and I hope you enjoy listening to this as much as we enjoyed putting this series together. Before we begin, a few mentions need to be made. Thank you to Naser Al-Fawakhiri, who contributed greatly to the research and crafting of the content for these episodes you hear. Also my greatest appreciation needs to be given to my good friend Oscar Gregg, who crafted this intro music you’re hearing as well as the music at the end. His own single, Acrobats, which is absolutely phenomenal, is out everywhere which you should check out and will be linked in the podcast notes below. With that out of the way, our third topic, Universal Healthcare, Like the War on Terrorism, really shows once again how powerful corporate interests are, and how people will do anything, even allow 26,000 Americans to die every year, for money. So without further adieu, let's get into it


Imagine going to the hospital and being told you had a rare form of cancer that no treatment was effective against, but the hospital said they would pay your expenses until a treatment became available and, since obviously you can't work when plagued by cancer, they'll take care of your family too. No bills, no health insurance claim. Just a check to your family and free room and board for you.

Sound insane? That's actually how the first-ever modern hospitals were run. Medieval Muslim hospitals turned no profit, sent home no bills. Instead, they were funded by taxes (on screen: ON THE RICH) and had no difficulty staying afloat. When someone came in with leprosy, a nasty disease with no known treatment at the time, they housed the patient and paid their families living expenses. Treatments and cures were handed out at no cost. Beds were offered for free, regardless of who you were or how much money you had.

Back then, the hospital was meant to take care of you, regardless of your income or how bad your disease was. The first principle of healthcare, when it was invented, was to look out for the ill and tend to their *every* need.

It was under this system that medicine thrived. While Europe was in the Dark Ages, Muslims, after inventing the modern hospital, also brought about a great deal of medical advancements. Out of these hospitals came the great Avicenna, known as the "father of modern medicine", and other Muslim doctors revolutionized surgery techniques, anesthesia, and advanced our understanding of anatomy and physiology. These discoveries were brought to Europe and the field of medicine would not be what it is today if it weren't for those Muslim hospitals.

Today, hospitals are run like businesses, with an emphasis on efficiency, the belief being that medicine can provide the best possible care if market principles and economics dictate the care provided at a hospital. The healthcare industry rakes in 2.5 trillion dollars in revenue annually, money that comes from hospital bills to purchase life-saving medicines, or simply stay in a room with an IV drip. To help with the cost, people pay into health-insurance policies run by for-profit health insurance companies, whose sole aim is to help cover the costs of your medical bills if you need it, while charging you monthly to help cover the cost of your claims and everyone else’s claims, and also pay the salaries of their executives and employees, and to lobby Congress...

Woah Woah, I'm getting ahead of myself. For-profit health insurance may have its problems but I haven't even told you the point of all this healthcare talk yet. The question is: does the American healthcare system work as best as it can, or does another system (flash on the screen: Universal Healthcare) exist that works better? And if you're a Republican who hates Obamacare stay tuned, because I'll attack that too. So, how does our healthcare system do?

THE AMERICAN HEALTH CARE SYSTEM IS AN ABYSMAL FAILURE

Our system is incredibly expensive, horribly wasteful, and, frankly, deadly, which isn't really anything you want out of a system that is meant to take care of the sick.

So what happened? I thought running medicine like a business would bring efficiency and top-notch quality.


It turns out, providing high-quality healthcare just isn't profitable. Hospitals can't make much money if they don't send home bills and instead shell out money to feed every helpless leper's family.

 

The Ways and Means Committee in Congress ran a study in 2019 asking how well the US stacked against other countries in terms of providing life-saving drugs at a low enough cost that people who need them could afford them. They compared US drug prices to those in 11 countries. I'll read them out here: The UK, Japan, Canada (Ontario), Australia, Portugal, France, the Netherlands, Germany, Denmark, Sweden, and Switzerland

They found, on average, the US was paying 4x as much for equivalent drugs as people paid in those countries, and that number was sometimes as high as 50x as much. Imagine walking into McDonald’s and ordering a cheeseburger and being asked to pay $50 in the US, when it’s on the dollar menu everywhere else. Yeah, that's what we do, but with drugs, that people need, to, uh, stay alive. And what’s worse is this came after the supposed "rebates" your insurance can give you on drug prices. 

Bottom line, compared to all 11 of the countries in the study, our healthcare system is ripping you off. No wonder 8% of US adults skip their medications cuz they're too expensive. Nearly a quarter of Americans could not afford their medications at least once in the last year. 26,000 Americans die every year because they can't afford healthcare. Odds are, you know someone who has died for that reason. 1 in 8 Americans do. If you happen to survive, congrats and welcome to bankruptcy. At least half a million Americans declare bankruptcy due to medical bills, accounting for two-thirds of all bankruptcies in the US. Sorry, you got sick, now you're bankrupt. Doesn't quite have the same ring as, "sorry you got leprosy. We'll take care of your family for you". Hospitals are nothing like how they began.

Our system is way too expensive, completely inefficient, and extremely deadly. This isn't really up for debate. 26,000 Americans die because they cannot afford healthcare. That number in the 11 countries from the Congressional study is zero. Zero people die in those countries because they can't afford healthcare. 26,000 Americans die every year due to that exact reason.

Interestingly, the 11 countries Congress chose to compare us to all have one thing in common: they all have a universal health care system, something I'll talk about later. We have a for-profit private healthcare system. I wonder, could that be the reason?


IT DEFINITELY IS THE REASON, DUH

Okay, so why is our system 4x as expensive and kills 26,000 more people? This isn't a loaded question-- it's exactly the one researchers who take a good look at our system ask themselves all the time. Luckily, they have the answer.

Our healthcare system is so expensive because we don't regulate it. Drug companies can spend as much as they want on advertising to make sure people only get their drugs and not cheaper generic alternatives. And there's nothing stopping them, and the generics, from charging whatever they feel like, regardless of the actual cost of the drug.


Want an example? The EpiPen is a drug used to buy people time when they have a dangerous allergic reaction to get to the hospital. Without them, thousands of people would die because the allergic reaction would get to them before the ambulance. Without any change in the cost to make the EpiPen, the company decided to quadruple their price. Why? Because they could. All because each pen costs $100 doesn't prevent people from needing the drug to survive an allergic reaction. So even if a few people don't buy it because they can't afford it, a bunch of people will shell out $100 per pen, and the company makes more profit. It's as simple as that. Every drug company works this way-- they can charge whatever they want because people will always need their drugs to... well.. stay alive. So if raising the price increases revenue, even if a few more people die, they will do so.

And this isn't hypothetical. That's how Americans pay 4x as much for equivalent drugs compared to other countries. Americans consume fewer prescription drugs but pay the most, per person, for them. Meanwhile, most of the revenue in the health insurance industry goes to pharmaceutical companies with massive profits.

And while the prices are high, health insurance companies offer their customers (the people who need the drugs) discounts, which only incentivizes the drug companies to jack up the prices and then offer the insurance companies a "discount", while still charging more for the drug than it actually costs. Meanwhile, insurance companies reward the drug companies for their generous "discount" and offer those drugs to their customers. Everyone wins... except for you, who has to pay.

There's also nothing preventing health insurance companies from shifting the burden of paying for your drugs on to you. Insurance companies offer reduced premiums if you shoulder a higher percentage of your drug costs. Remember why you had insurance? To pay for your medical bills? Well, they can get out of doing that and then make it up to you by asking you to pay them less. You know, because they aren't doing the only thing you're paying them to do.


BUT WASN'T OBAMACARE SUPPOSED TO FIX THIS?

Look, it wouldn't be fair if I talked about our current healthcare system if I didn't address Obamacare, which was a failure of a policy. The idea was simple: the problem with our healthcare system isn't that it's for-profit or run based on market principles. It's that it isn't run by market principles ENOUGH. There simply isn't enough competition in the industry for it to be good, and so a few companies have a monopoly. How do you fix that? Have the health insurance companies compete with each other on an exchange.

Smart idea if you're conservative. In fact, it was invented by a conservative think tank, the Heritage Foundation. And then Mitt Romney implemented it in his state. It's a Republican plan.

First, mandate everyone has health insurance. The problem of uninsured people is solved! (On screen: NOPE). 

Second, allow *some* people to get health care-- by expanding Medicaid (optionally), offering *some* people subsidies, and creating a marketplace where people can shop cheap insurance. Exchanges were created at the state level so people would be able to find the cheapest coverage, and if your income was low, but not low enough to qualify for Medicaid, the government would help you out with a little extra cash. And the rest was left to the power of competition, which would obviously, naturally bring down the costs of premiums. Oh wait, my editor is trying to tell me something, oh wait, premiums actually doubled? Well, this is awkward

And Many states didn't expand Medicaid, which left a lot of people in the awkward gap between qualifying for Medicaid and being able to afford health insurance. And to the extent that mandating everyone gets healthcare, worked by getting 20 million more people insured, at least initially, this was great, if you're a private health insurance company that profits off of an increased consumer base. If you're the person who signed up for health insurance, you just got screwed. Because in the four years after Obamacare got passed, premiums did indeed double. Unsurprisingly, between 2016 and 2018, 2.5 million Americans could no longer afford insurance and lost it, undoing 40% of the gains Obamacare had made.

Also, giving health insurance companies a monopoly with no regulation or outside competition (ahem, a public option, where the government competes with the private insurance companies), gives them no incentive to improve the quality. So while premiums double, quality of coverage went down, leaving 45% of Americans inadequately insured. That means, if they got sick, they would not get adequate help from the health insurance companies to which they now pay twice as much. Oh, and 12% of the country remains uninsured. That leaves 43% of the country as getting adequate coverage, the vast majority of whom get coverage through Medicare and Medicaid, aka government health insurance (90% by my calculation). So who do private health insurance companies help? Largely, almost no one.


IT GETS WORSE

All of this is absolutely terrible, but somehow it actually gets worse. You see, all the numbers I just cited? They're from before the Coronavirus pandemic. The picture is so so much worse now.

First, nearly half of Americans get their health insurance through their employer. Due to the pandemic, the real unemployment rate is nearly 20%, and since most people get their coverage through their jobs, a lot of people lost health insurance. In fact, an estimated 27 million Americans lost their health insurance, doubling the number of previously uninsured.

During a pandemic, when people actually need health insurance, the number of uninsured doubled. Meanwhile, the health insurance companies took your money, in the form of twice as expensive premiums, and when you asked them to do their jobs and help pay your medical expenses, they dropped your coverage and left with all your money. Seems a bit broken.

Who's to blame? Obamacare, obviously. Obamacare entrenched a system where people are dependent on their employer for health insurance and if they lose their job, oh I don’t know, say because of a massive pandemic, they have no way of seeking affordable coverage.

You're hit twice: you lose your job, and you lose your health insurance.

The system isn't meant to help you when you need it. When you actually need your health insurance, they’ll find clever ways to shift the burden back on to you so they can retain their profits. That's how companies work. And thanks to Obamacare, you're forced to buy from them. If you're poor or can't afford it, sorry health insurance isn't for you, and we won't help you. In the US, we do pick and choose who gets healthcare and who doesn’t: it's decided by the size of your wallet. Meanwhile, the health insurance and drug companies get rich. They win. You lose. 


THE BETTER WAY

So, is there a better system? Remember those 11 countries from the Congressional study I spoke of earlier? They all had universal healthcare. In the last episode I tried to name all the countries we had bombed in the last 75 years in one breath and to my disappointment, I didn’t quite make it. It’s time to try again, naming all the countries that provide universal healthcare, so here goes!

So do all of the following countries:

Algeria, Botswana, Burkina Faso, Egypt, Mauritius, Morocco, Rwanda, Seychelles, South Africa, Tunisia, Argentina, the Bahamas, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Mexico, Peru, Trinidad and Tobago, Bhutan, Georgia, Israel, Japan, Macau, Maldives, China, Singapore, Sri Lanka, Taiwan, Thailand, Albania, Austria, Belgium, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Russia, Serbia, Spain, Sweden, Switzerland, the UK, and New Zealand. 

Alright I’ll confess, I took at least a couple breaths, but 

That's 56 countries. Not all of them are rich European countries. Is Rwanda, or Sri Lanka, or Syria just a better country than the US since they can all ensure everyone has access to healthcare? Are they all better than the US because in those countries zero people die because they can't afford healthcare? In the US it’s 26,000. In these countries it’s none.

It's not as if these countries don't have problems with their health insurance. Elective procedures meaning non vital ones might have waiting lines as limited care goes to people who *need* it first. Sometimes these countries need to better fund their hospitals. 

Healthcare looks different in all of these countries. Some of them offer everyone coverage, but at an affordable cost. Others offer medical care free of charge. In many, the majority of hospitals are government-run, instead of for-profit. In many, private health insurance still exists and is available for those who can afford it and want luxury healthcare. In others, the government covers 100% of people. Those are Bhutan, Canada, Denmark, Albania, Macau, Taiwan, Trinidad and Tobago,  Luxembourg, Norway, Sri Lanka, and Sweden.  In those countries, the quality of healthcare is amazing. Taiwan, a far poorer country than the United States, ranks number one in the world for the best health care system. Their government provides 100% of it. Co-pays are roughly $5. There are no waiting lists. Everyone gets care.

But the bottom line is they implement a system that ensures everyone can afford healthcare, and no one dies because they can't. And no one goes bankrupt. And they spend less on drug prices, and their system is cheaper. Yes you heard that right, not only is it immensely more efficient and saves lives, it's cheaper.

WHY IS UNIVERSAL HEALTHCARE CHEAPER?

Frankly, I shouldn't have to be defending universal healthcare as a cheaper alternative to what we have. We're the richest country in the world. Even if it costs a little extra, we could easily find a way to finance this without raising taxes. Come on, just listen to the previous segment on the military. Suddenly we're too poor to pay for something Taiwan easily pays for? Seriously? Can’t do anything to save 26,000 lives, can we? But war? Naturally.


But actually, luckily, it is cheaper. You pay more under our current system than under a universal healthcare system. Conservative analyses suggest universal healthcare would save Americans $2 trillion over a decade. Other analyses bring that number closer to $5 trillion, or $500 billion per year. That's enough to house every homeless American 30 times over, every year.

Yes, it would raise taxes. That's because the government would be providing the services you pay private health insurance to cover, and which they don't cover. But for a majority of people, they wouldn't be paying for private insurance anymore. Thus a slight raise in taxes, coupled with a military budget cut and other budgetary measures, would make universal healthcare tremendously cheap compared to what we have now. The people who tell you it would cost you more are like saying that switching to an automobile economy would cost us more and then including the cost of the horse and buggy industry in order to say that.

This is a system that is cheaper, more efficient, and less deadly and is one every other industrialized nation (and many poorer nations too) have. Meanwhile, the US is living in the age of the horse and buggy and paying more, in money and in lives, for it.

Why would you pay less? Under a universal health care system, private health insurance companies have to compete with a government-run program that's available to everyone. In order to get customers, private companies have to offer cheaper coverage or better coverage at a reasonable price. Suddenly, premiums can't just rise without a tangible improvement in coverage, and premiums would be forced to return to rates suitable for the value of the coverage you receive. Also, most countries with universal healthcare negotiate their drug prices directly with pharmaceutical companies. This means price control: drug costs can't explode for no reason and drugs would likely go to the prices they are in other countries (or otherwise the government would just import drugs from other countries where they are cheaper, a practice not currently allowed). Thus drugs would be 4 times cheaper and actually tied to their value. For Medicare alone, we would save billions annually if Medicare were allowed to negotiate drug prices. It would be way cheaper if we implemented this across the board.

Universal healthcare also cuts out a middle man. Instead of paying for the salaries of private insurance companies executives, their ad campaigns, the money they spend lobbying Congress, and the bureaucratic nonsense of working through hospitals and the government to provide healthcare, there's no need to pay for any of that with a government-run program.

Unsurprisingly, universal healthcare is far more efficient than for-profit health care, which makes it cheaper.

It's also tremendously popular. Medicare and Medicaid, the two programs that provide the majority of comprehensive healthcare coverage in America, are government-run. They are single-payer, but for a limited portion of the population (those in poverty and the elderly). They are also two of the country's most popular programs. Universal healthcare means expanding both of them to cover everyone. That's why some people call it "Medicare for All". A recent poll suggested that even 51% of Republicans are in favor of some form of universal healthcare. That brought overall support for the policy to 70%. 70% of Americans want universal health care. We need it now more than ever.

So why don't we have it? Because private health insurance companies and pharmaceutical companies lobby Congress to ensure we don't get it. That's where all your money goes: you pay them, they make a profit, and then they lobby Congress to make sure you never get affordable healthcare. And it works. And 26,000 Americans die because of it.

You won't lose your coverage. The definition of this policy is *everyone* gets comprehensive coverage. You won't lose your doctor. You can see any doctor you want under this system, because everything falls under the umbrella of your "insurance network", because your network is the United States of America.

Back when hospitals started, healthcare paid you and your family. Now we bankrupt half a million Americans annually, and if they can't pay for it, they die. Meanwhile, in 57 other countries, no one dies because they can't afford healthcare. They get affordable high-quality health care, and cheaper drugs for a lower cost. Everyone gets it, no questions asked. It's time for the US to catch up. Universal healthcare would actually make America great.









This is the third of 5 episodes in our series called Actually Making America Great. We aren't Democrat or Republican, but we try to find some common ground as we analyze 5 policies that we believe would have the most impact on the lives of the average American. These are typically issues you won't see talked about on the news or by your Congresspeople, but they should. Our goal with this series is to make the case for these policies so that America can actually be Great. That only happens with your support. If you agree with this, please like, subscribe and share this video just about everywhere. And if you really really liked it, call your Congressional representatives and make them get behind these five issues:

1. End the Drug War

2. End the Foreign Wars

3. Universal Healthcare

4. Hand the Economy Back to the People

5. Get Money Out of Politics

Thank you for listening 


Intro
Why is our current system an abysmal failure?
But wasn't Obamacare supposed to fix this?
The effects of COVID-19 on our healthcare system
So is there a better system?
Universal Healthcare is actually less expensive
Conclusion