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Universal Healthcare in America—A Pie in the Sky?

Universal Healthcare in America—A Pie in the Sky?

December 21, 2017 | Last week, I spent a cold Friday evening crammed into a community bookstore in New York City, where I spoke about my experiences with universal healthcare in the UK. The event was organized in support of the New York Health Act, which, if passed, will provide universal, comprehensive health care to all residents of New York State. In 2017, the bill passed in the New York State Assembly by a vote of 92 to 52, and was only one vote short of passing in the State Senate.  

This legislation has garnered high profile support, with New York City Mayor Bill de Blasio commenting that the implementation of single payer in New York State could “actually have a very positive impact on the whole national debate.” Even New York Governor Andrew Cuomo has called single payer a “good idea.”

Moreover, an academic endorsement from Gerald Friedman, a Professor of Economics at the University of Massachusetts at Amherst—who concluded that a single payer system could save New York State over $44 billion from administrative costs and monopolistic drug pricing—gives single payer advocates reason to believe that universal health care can be more than a pipe dream.

The current state of health care leaves much to be desired. With federal politicians at an impasse over the Affordable Care Act, people are looking to their state governments to provide solutions, with states being forced into action to ensure continued healthcare coverage for their residents.

From marijuana legalization to same sex marriage, recent years have seen states set a precedent for novel policymaking. Consider Massachusetts’ healthcare reform of 2006, which introduced an individual mandate and provided subsidized health insurance for families with income below 150% of the federal poverty level. Notably, this reform was lead by then Governor Mitt Romney, a self proclaimed “severely conservative [Republican] governor”. The success of this legislation had major consequences for the country at large, as it formed the basis of the Affordable Care Act of 2010, lead, of course, by the Democrats.

State leadership on such matters is by no means a new concept of policy making. In 1932, Supreme Court Justice Louis Brandeis coined the term ‘laboratories of democracy’, noting that, “a single courageous State may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.” This gives the federal government the luxury of observing the implementation of such state initiatives, and consequently, the freedom to cherry pick the most successful elements, thereby designing less risky federal laws.

At a time when retaining the Affordable Care Act is a daily struggle, universal healthcare in the U.S. does seem like a pie in the sky. But if just one state can act as a laboratory of democracy by implementing a successful single payer system, it could be the push the federal government needs to recognize universal healthcare as an optimal option.

Critics of universal healthcare routinely cite it as being costly and financially unfeasible. Yet the U.S. spends more on healthcare per person than any other country in the world and still falls behind countries with longstanding universal healthcare programs on key health outcomes including life expectancy, infant mortality, and maternal mortality.

Healthcare spending is a bipartisan concern, with both parties recognizing the unsustainable nature of the current system. Healthcare makes up nearly 18 percent of the country’s GDP, amounting to $3.3 trillion in spending per year. If a statewide single payer system can improve health outcomes and do so at a lower cost, critics of universal healthcare may be forced to reconsider their dismissal of universal healthcare.

New York is edging closer and closer to passing single payer legislation and the possibility of universal healthcare is more attainable than ever before. If New York does successfully pass the bill and a statewide single payer system is established, those universal healthcare advocates packed into a tiny bookstore on a Friday evening may just be campaigning for a lot more than they bargained for.

Zehra Abedi serves as a healthcare researcher in New York and possesses a Master's in Public Health in Health Policy from Yale University.


The views reflected in this piece do not reflect the views of other Arbitror contributors or of Arbitror itself.

Photo "Healthcare Justice March". Originally taken by United Workers with a CC BY-SA 2.0. Use of this photo does not indicate an endorsement from its creator.

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