Economists Suggest That Universal Coverage Is Already Possible for the US: What Obstacles Still Stand in the Way?

July 18, 2023

The current state of health insurance in the U.S. needs to be revised, even for insured Americans who face the risk of massive medical bills for their covered care. The coverage is unstable, and the Affordable Care Act did relatively little to reduce the risk of insurance loss among those insured. Since the issue stems from a lack of universal coverage, incremental reforms, such as extending coverage to those without insurance and introducing minimum standards for all insurance plans, are considered futile. Approximately 60% of uninsured Americans can access free or heavily discounted insurance coverage but remain uninsured.

A proposed solution is universal coverage that is automatic, free, and basic. It should be automatic because not everyone will sign up if given a choice, and it should be fundamentally free to eliminate unnecessary costs for patients. The coverage must also remain basic to honor the social contract and provide essential care to all. Extra care can be purchased as supplemental coverage by those who can afford it. Like other high-income countries, the U.S. could use a method involving guaranteed basic coverage with an option for people to buy upgrades.

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What Experts Are Saying: 

Economists Dr. Einav and Dr. Finkelstein explain that, “Keeping universal coverage basic will keep the cost to the taxpayer down as well. It’s true that as a share of its economy, the United States spends about twice as much on health care as other high-income countries. But in most other wealthy countries, this care is primarily financed by taxes, whereas only about half of U.S. health care spending is financed by taxes…In other words, U.S. taxes are already paying for the cost of universal basic coverage. Americans are just not getting it. They could be…The lack of universal U.S. health insurance may be exceptional. The fix, it turns out, is not.”

[Source: The New York Times, July 18th, 2023]

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