By Sabrina Morello
“If equity and social solidarity in access to health care and financing health care were fundamental goals of a health care system, the single-payer system provides an ideal platform for achieving these goals” said Tsung-Mei Chen, MA Health Policy Research Analyst at the Woodrow Wilson School of Public Health at Princeton University. Last week, Chen and other experts, including those from Canada, Denmark and Taiwan, provided testimony outlining the benefits of single-payer health care systems in their respective countries to members of the U.S. Senate Health, Education, Labor and Pensions Committee’s Subcommittee on Primary Health and Aging.
Subcommittee chair U.S. Senator Bernie Sanders (I-Vt.) began the hearing by laying out an array of issues with our current fragmented health care system, with an emphasis on the fact that we are the only major industrialized nation that does not guarantee health care as a fundamental right. Senator Sanders cited 2012 data showing 15 percent of our population (more than 48 million Americans) are left uninsured and even more have high deductibles and co-pays or caps on coverage that end up driving citizens into bankruptcy.
This statistic stands out sharply from countries like Taiwan, which established a single-payer system in 1995, and currently has more than 99.6 percent of its population covered by national health care, according to Dr. Ching-Chuan Yeh, former Minister of Health for Taiwan, Professor at the School of Public Health, College of Medicine at Tzu-chi University. Dr. Yeh’s testimony was a poignant example of a far more equitable system than exists in the U.S.: “[a]ccess to health care is an inalienable right in [Taiwan’s] constitution. Residents living in remote mountainous areas and offshore islands, and the poor, the disabled, the aged get pretty much the same access and health care as anyone else.”
In addition to being inequitable, the care we do provide in America seems to lag behind single-payer nations in regards to health outcomes. Victor Rodwin, PhD, MPH, Professor of Health Policy and Management at the Robert F. Wagner School of Public Service at NYU, notes that among 19 Organization for Economic Cooperation and Development nations, France, a single-payer nation, has the lowest rate of avoidable mortality (an important indicator of quality of care) while the U.S. has the highest rate. Our nation could avoid about 101,000 deaths if we were able to decrease our avoidable mortality levels to those seen in France.
With such poor comparable health results to other nations, one would think our country spends very little on health care. However, we spend approximately 18 percent of our GDP on health care while single-payer countries spend much less. For example, Canada spends only 11 percent, Denmark also spends 11 percent, France spends 12 percent, and Taiwan spends less than 7 percent of its GDP. Instituting a single-payer system in the U.S. would dramatically decrease the exorbitant administrative costs of our system, help to eliminate overuse of health care services that lead to waste, as well as provide a unified system that makes policy reform and spending control far easier and more feasible.
The hearing sparked robust debate between senators on the subcommittee and panelists, including the witness from Canada, Dr. Danielle Martin, Vice President of Medical Affairs & Health System Solutions at Women’s College Hospital. A Los Angeles Times article covering the hearing highlighted Dr. Martin sparring with Senator Burr (R-N.C.) where she pointed out the fact that should be driving the health care debate in this country: more than 45,000 Americans die each year because they do not have health insurance.
It’s time that we change that, and universal, single-payer health care is the only way to get us there.
Watch a video of the hearing here.
Sabrina Morello is a Public Citizen health policy fellow.