The United States is the only country in the developed world without a national healthcare program.
We aim to change that.

healthcare profits

We're told national healthcare would be a failure. That it would cost too much money. That it would be “bureaucratic nightmare.” And much of what we've seen delivered from government as applies to healthcare only helps reinforce that narrative. Our national healthcare programs are rife with waste, fraud and ineffectiveness. The Affordable Care Act was not the solution it was originally sold as. This has led us to believe that national healthcare is a bad idea that will only indebt us at the expense of diminished quality of medical services - a message conveniently parroted by medical lobbyists who themselves profit greatly from our private insurance model.

But the circumstances supporting this belief are based not on the effectiveness of national healthcare as a concept, but rather due to the fact that our system has been compromised by the same causes to government failures across the board: inefficient structure, crony capitalism and endemic corruption. As it is our goal to target and remove these causes, it affords us a fresh opportunity to consider national healthcare under honest circumstances - and see for ourselves both why we don't have it today and why it works as well as it does in other countries.

To begin, we'll start by reviewing some basic facts:

At approximately $1.36 trillion per year, our public health programs are one of the largest expenditures of the federal government, yet they generally only benefit the poor, the elderly and low-income children.

Even though these programs are supposed to be funded through an additional income tax on our paychecks (FICA), they inevitably consume additional public money due to rampant waste and fraud. $1.36 trillion is equivalent to roughly $4,200 per-person, which matches the per-person costs of most national healthcare programs abroad. That means we're already paying for what single-payer healthcare would cost if our system were honestly run.

mmi health index

As it's not, we pay massive out-of-pocket costs for healthcare on top of the exorbitant public healthcare taxes we're already paying. Between wage contributions and out-of-pocket expenses, the average family of four pays $11,030 a year for healthcare if they have employer-sponsored healthcare, and upwards of $17,500 if they don't. That’s easily twice what most other western countries pay.

When combined with employer contributions, the total cost of healthcare for an American family of four with employer-sponsored healthcare is $25,826.

Between all levels of government, private companies and households, the United States annually pays $3.03 trillion on healthcare, or $9,523 per person.

WHO health rankings

On average, most Western countries have superior healthcare to the United States at far less money. The United Kingdom is annually rated near the top for average healthcare by the World Health Organization, and it has a per-capita healthcare cost of $3,405 per person that covers everyone in their country. We're nearly three times that. If we hypothetically adopted the UK’s single-payer model at their per-capita cost of $3,405, we’d save $6,118 in per-person total health spending.

Once we start looking at basic numbers the reality becomes clear: we can have single-payer healthcare because we’re already paying for it. And switching under honest circumstances would save enough money that people could buy platinum health plans on top of what a national health program offered and still come out ahead financially.

So why haven’t we done this today? There are six primary reasons.

Problem 1: Privatized Insurance

Problem 1: Privatized Insurance

healthcare CEO salaries

Health insurance and pharmaceutical companies make big profits by being gatekeepers to our healthcare, and their business model is less necessary with a national health program outside of extra, platinum-care options.

These companies want to continue making tremendous profits and maintain relevancy so they pressure government to resist reform through millions of dollars in lobbying and campaign contributions. The CEOs of these six health insurance companies make a combined $158 million annually. That's just at the CEO level; the hundreds of executives down make millions more. Who pays their salaries? If you guessed your checkbook, you guessed right.

  • cost of medical procedures compared
  • cost of medical procedures compared
  • cost of medical procedures compared

Americans also pay inflated costs for prescription medications and medical procedures compared to the rest of the world, which like privatized healthcare, is something established industries wish to maintain. Click on any of the images above to see more in greater detail.

Problem 2: Medical Profits and Development Costs

Problem 2: Medical Profits and Development Costs

pharma profits
Source: BBC

Alongside private insurance companies, pharmaceutical industries rank among the most profitable industries in the history of money - far and away beyond the fortune 500 average. This, as with private insurance companies, is a gravy train that wealthy interests wish to maintain.

But it gets more complicated than that. Pharmaceutical industries claim that because other countries place caps on healthcare spending and allow faster emergence of generic drugs to their brand-name variants, they lose money that invariably comes out of their research and development budgets. And even though some drugs make lots of money, many do not. Indeed, recent studies have suggested that it can cost upwards of $2.5 billion to bring a drug to market. So even if a drug company makes billions of dollars in profits, a string of failed drugs or a problem with their use can be devastating.

The existence of these factors are not mutually exclusive. In order to remain competitive in a market with such high development costs, a company needs to make massive profits to buffer against future losses. And high profits are in turn sustained by high drug costs. Just as seriously, these circumstances act as a barrier to smaller drug companies seeking to enter the market as they don't have the money to compete in such a high-stakes environment. Worse still, this induces pharmaceutical industries to invest in treatments that make money as opposed to cures that save lives because every dollar they invest in research is only recouped if the drug makes lots of money.

The Alliance Party intends to solve this problem through three approaches:

drug research

Streamline regulatory approval processes for drug development. While we in no way intend to diminish the effectiveness of drug approval, the regulatory process for development drugs is less efficient and more expensive to access than it needs to be. As is the case with much of our society, our political class today requires us to choose between overbearing, ham-handed regulation or no regulation at all. We believe there is a third path in ensuring regulation is efficient and accessible while providing its intended task. To determine the best approaches to that end, we would seek public forums with both drug regulators and pharmaceutical industry representatives to come to a compromise balanced for all sides.

Drug research in public universities: In the context of our overhauled approach to national education, we seek to fund drug research efforts at public universities. This allows medical students to earn real-world experience in developing lifesaving treatments, while conducting much of the research for doing so as an educational effort - meaning it doesn't cost a fortune. Just as importantly, this research would be released into the public domain. As any company could use it to develop treatments of their own, this would further reduce money they themselves would have to spend on research.

Raised Corporate Classification. In the context of the Alliance Party's budget model and approach to corporate regulation, we promote classifying companies by transparently defined standards of social impact - and adjusting their tax rates accordingly. To help keep drug development costs low, we would advocate for certain pharmaceutical industries to rise to Class A or class B corporate status, depending on their willingness to invest in treatments that serve the public interest.

Problem 3: Public Health Programs and End of Life Care

Problem 3: Public Health Programs and End of Life Care

rising medicare costs

Public health programs in the United States (Medicare, Medicaid and Veteran’s Affairs) make up the largest single-subject expenditures of the federal government, totaling more than $1.6 trillion a year. Although these programs cover only the poor, elderly and veterans, on a per-person basis they still cost more per-person than the single-payer programs of other countries that cover everyone in their society. Besides the reasons listed above and below, there are several additional factors that contribute to this problem:

Lack of treatment control: for patients on Medicare and Medicaid, federal law generally requires that any desired treatment must be granted upon request, regardless of whether attending physicians deem it effective or not. Even if an experimental procedure has an estimated success rate of 0.5% yet costs $500,000 to administer - if a Medicare/Medicaid patient desires its application, the request cannot be denied. As you can imagine, the combined costs of this occurrence become rapidly stratospheric, which in turn send public health spending through the roof.

rising medicare costs

End of life care: a certainty of the circle of life is that it eventually comes to an end. But for the families of seniors facing their last moments, they understandably wish to keep their loved ones alive for as long as medically possible. Advances in medicine can extend life for a few extra days, weeks or maybe even months - but often at a combined cost of hundreds of billions of dollars. Several studies have shown that upwards of 30% of public healthcare expenditures go to the 5% of beneficiaries that die each year, with 1/3rd of that cost occurring in their last month of life. Consequently, over time our society pays trillions of dollars to keep patients alive for only a few more weeks in hospital or hospice care.

The much feared “death panel”: in the face of these circumstances, public health officials have sought to enact guidelines to restrict paying certain treatments that are known to be ineffective, or will provide an infinitesimal increase in length of life at exorbitant cost to the public in the exact same way private insurance companies will restrict paying for ineffective treatments.

Yet in response, special interests and under-informed interest groups make false claims of “death panels,” suggesting that soulless bureaucrats are seeking to “kill off Grandma” to save a buck. This falsehood is both wrong on the face of it and intellectually dishonest, yet has nonetheless scared politicians into deeming any sort of Medicare reform as a politically suicidal.

The Alliance Party would address this dynamic by creating transparent standards for public healthcare funding based on what’s known as a QALY: “Quality of Life Adjusted Year.” For anything outside of these standards, we would work with a private healthcare exchange where patients could purchase additional insurance for treatments deemed to be too expensive and/or ineffective to be covered by the National Health Service (NHS).

Here’s an example of how this could work:

For young to working-age people with illnesses that can be treated with procedures, even highly expensive procedures, their treatment under the NHS would be automatically approved. If a treatment was highly expensive but shown to be barely effective, this standard would not cover that treatment, which is where the private healthcare exchange would kick in.

Conversely, if a patient was in their nineties and faced a life-threatening illness that an inexpensive procedure could address, their coverage under the NHS would be automatic. Yet if the procedure was both expensive and ineffective, or would only extend their life for a matter of days at exorbitant cost, this standard would have private insurance take over from there.

In doing so, it’s critical to note that this standard isn’t a “panel of doctors determining who lives or dies.” It’s rather an allocation of public resources to where they will have the most effect. Americans would of course be free to purchase additional coverage beyond what the NHS offered that’s tailored to their own needs; our goal is to ensure that public money is spent efficiency and wisely for the greatest public benefit. By working together with specialized add-on coverage, we can meet this goal while ensuring Americans have their own choices in the care they receive in later years.

Problem 4: Sky-high Medical School Costs

Problem 4: Sky-high Medical School Costs

medical school debt

Combined with the costs of undergraduate degrees, medical degrees and time in residency, new doctors are often burdened with extensive debt. According to Forbes, the average medical student left residency with between $100,000-$125,000 in debt - which carried payments of roughly $1,700 per month. And that was back in 2008 - costs of degrees and living has increased significantly since then.

If we make medical degrees cost more than an Italian sports car then our healthcare premiums will reflect that expense. Because of this, the Alliance Party seeks to forgive medical student loans for doctors who work for the NHS. We also seek to reduce income taxes for doctors earning up to a certain amount ($125,000). By making it less expensive to become a doctor, they in turn charge less for medical services, which in turn translates to lower healthcare costs for society.

Problem 5: Abusive Malpractice Lawsuits

Problem 5: Abusive Malpractice Lawsuits

rising malpractice costs

Medical services are complicated and difficult and there are times when patients suffer complications that were unforeseen. There are other times when doctors, overworked and understaffed, make mistakes that they shouldn't. The end result has been a degree of medical malpractice lawsuits that have forced doctors to pay absurdly high sums for malpractice insurance - sometimes exceeding $100,000 per year. Additionally, doctors often run more tests than might be medically necessary to cover themselves in case of a malpractice claim, which across the nation leads to billions of dollars billed unnecessarily.

As you can imagine, these costs and fees are eventually passed on to Americans in the form of higher healthcare costs.

The Alliance Party plans to remedy this by having the proposed Citizen Advocacy Service act as the lone entity with authority to sue the NHS for malpractice, ensuring that only legitimate claims can proceed. If the claim has merit, and the doctor did act improperly, the Citizen Advocacy Service would seek damages on their behalf. But money-hungry private attorneys would be kept out of the loop and doctor's offices would be spared the stratospheric costs of malpractice insurance.

Additionally, our proposed NHS would establish standards for procedures, as between 40,000-90,000 people die every year from preventable medical errors. That's unacceptable. As more stringent federal regulation dramatically increased the safety of the airline industry, we intend to do the same at all public hospitals run by the NHS.

Problem 6: Our Government is Bought and Paid For

Problem 6: Our Government is Bought and Paid For

Of the interests that buy it, few are as wealthy or as dedicated as medical industries.

pharma lobbying

Due to the profits inherent to healthcare industries and weak finance laws governing our broken political system, there is endless amounts of money that can be used to power a massive lobbying machine that “convinces” our legislators to pass laws friendly to special interests.

The pharmaceutical industry, alone, has two lobbyists for every member of Congress. Once you consider the money from private insurance and other medical lobbies, it's clear that the financial incentive to keep the for-profit insurance model alive is enough to throw both reason and the national interest out the window. We intend to remove this conflict of interest by taking private money out of politics. With it removed and the other remaining problems addressed, we intend to propose a national healthcare program to the American public that's designed to work for - and only for - the American public.

The National Health Service

The National Health Service

The honest truth facing Americans is that we pay far more for healthcare than any other country on Earth - between 2-4 times as much - yet we receive, on average, inferior quality than the rest of the Western world. This is because – and nigh only because – our inflated health bills subsidize a for-profit business model that makes billions of dollars from the services that keep our families healthy.

These businesses exist to make money, and they want to maximize their profits to the greatest extents possible. Thus in a political climate that caters to the highest bidder, they are willing to pay whatever it takes to keep their business models afloat.

That is why whenever our healthcare failures are brought to light, politicians are paid to get in front of a microphone and claim that we “have the best healthcare in the world” and that the “free market” is the best way to provide a system that cares for you when you are ill, which in short, is to establish that your health should be determinant on your ability to pay for it.

We disagree, and believe that the strength of society is based on the health of society. As such, we would invest the resources of society to ensure that it is healthy and strong through a single-payer healthcare framework based on the systems most other Western nations have implemented to great success.

Funded by a reallocation of budget dollars, implementing public spending caps and restructuring the tax code, all of which are described within our budget model, this single-payer framework would allow every American citizen to walk into any public hospital and access care of necessity, including mental health, preventive care and routine checkups for a low fee – no more than the average insurance copay today.

Generic-brand prescription drugs would be sold for low rates and the market protections for brand-name drugs would be shorter in this model – similar to most European countries. As mentioned, increased funding of universities will come with earmarks for drug research that will be released into the public domain.

In certain circumstances, reimbursement of healthcare expenses at private hospitals can also be provided if they are for a verifiably legitimate and necessary medical nature. This is a standard the Government Accountability Agency would enforce, and for reimbursements to private medical services the FBI would be directed to prioritize medical fraud investigations – the kinds of fraud endemic to Medicare and Medicaid today would not be tolerated.

We also live in a capitalist society, and people of means may wish to buy a standard of healthcare that the public sector can’t provide. To this end, the NHS would work with a private healthcare exchange that offers platinum-level medical services to fill this need. Should someone want to purchase a higher degree of care, they’d be welcome to, and the NHS would maintain a list of providers and insurance companies that they recommend.

Additionally, private healthcare providers, should they operate ethically, would also be eligible for a higher corporate classification. This would qualify them for lower corporate income taxes, helping to make their business more profitable while competing with a single-payer public healthcare service.

Up Next: