By Ranen Miao
Artwork by Lea Despotis

When Josh Wilkerson, a young man from Leesburg, Virginia turned 26, he was aged out of his stepfather’s health insurance plan. Left without health insurance coverage, Wilkerson was forced to pay $2,400 in co-pays every month for insulin, over twice as expensive as his monthly rent. Unable to afford his traditional insulin, he was forced to ration his insulin, and was eventually forced to switch to a much cheaper but less effective type of insulin; months later, he suffered multiple strokes due to high blood pressure, and died on June 15th.

Josh Wilkerson’s story is one that illuminates the vile nature of America’s for-profit healthcare sector, where amoral companies have built billion-dollar empires off the suffering and death of our nation’s most vulnerable. Wilkerson is not alone in struggling to afford insulin: 26% of people in the United States with Type I diabetes have reported rationing, a practice described as “extremely dangerous” by the Right Care Alliance. The barriers of cost have become so significant that there’s a name for when people struggle to afford their insulin: the “death or debt dilemma.“

The American people deserve a radical reimagination of public health. If the coronavirus pandemic has shown us anything, it is that healthcare is necessary for a healthy economy and society – and guaranteeing health coverage for every American by expanding the immensely popular Medicare program to cover our entire country can radically improve health outcomes for generations to come. 

Currently, the private healthcare system means that only the wealthy get access to high-quality treatments. Research published by the Harvard T.H. Chan School of Public Health, Harvard Global Health Institute, and London School of Economics found that while the United States spends twice as much as other nations on healthcare, we have worse population health outcomes compared to other Western democracies. Amongst 11 OECD nations, the United States has the lowest life expectancies (which have continued to decline). Every year, an average of 70,000 Americans die from deaths of despair, including drug overdoses, suicide, and alcohol poisoning. Levels of infant and maternal mortality are amongst the worst in the developed world; for non-Hispanic Black women, the maternal mortality rate is 3.5 times higher, a worse rate than war-torn Syria. American patients have some of the lowest levels of satisfaction with our healthcare system than any other country. Before the passage of the Affordable Care Act, the American Journal of Public Health concluded that 45,000 deaths each year were directly tied to a lack of health coverage.

What keeps these costs so high? It’s because private companies indulge in wasteful bureaucratic and advertising spending. 31% of total health expenditures in the United States are spent on administrative costs, including claims submission, claims reconciliation, and payment processing, all inherent only in a privatized healthcare system. This is between 50% to 100% higher than other modern nations. On top of administrative waste, companies including Johnson and Johnson and Pfizer spend over $30 billion a year on marketing their drugs. The focus on profit corrupts the nature of healthcare, displacing the focus from healing the sick to mining every dollar possible from an increasingly economically deprived middle class.

Medicare-for-all addresses these pressing issues. The New York Times reports in 2017 that a single-payer health care system massively reduces administrative costs, streamlining healthcare processing. Furthermore, universal healthcare is by nature universal: it guarantees every person access to affordable healthcare. That means the 28 million Americans who lacked health insurance throughout 2020 would receive desperately needed coverage, saving thousands of lives each year. By simplifying administrative barriers, we can also substantially increase the amount of time physicians spend with patients (currently, physicians spend only 26% of their time with patients, compared to 79% in Canada). With more stable healthcare coverage, we can also offer additional reassurances to those who transition between jobs or choose to leave the labor market.

Medicare-for-all would also offer substantial economic benefits: the Economic Policy Institute found that a universal healthcare system would boost wages and salaries by allowing employers to redirect investments in health care costs to workers wages, guarantee healthcare while workers transition between jobs or struggle with being laid off, and increase investments in long-term care that offset losses in the health insurance and billing administration fields. This is beyond the massive savings a universal system would generate. As a meta-analysis of 22 reports concludes, Medicare-for-All would cut costs and expand coverage. 

The issue of Medicare-for-All is not just a practical or economic issue; it’s also a moral one. Harvard philosopher Michael Sandel explains that we have “drifted from a market economy to a market society,” where we have commodified parts of life previously regarded as sacred, free from market forces. Healthcare should be one of those areas: by commodifying healthcare, we place a price tag on the value of life – and inherently favor the health and wellbeing of those with money over those without.

When insulin was first invented in 1923 by Sir Frederick Banting, he said: “Insulin does not belong to me, it belongs to the world.” Banting would be deeply saddened to see that the miracle drug he brought into this world is now being commodified for profit, being sold for thousands of dollars a vial so diabetics can stay alive. Wilkerson’s story and the COVID-19 pandemic should serve as a wake-up call: we need healthcare for everyone, and we need it now.