October 24, 2026
The U.S. has an underperforming healthcare system. It spends the highest amount as a percentage of its GDP on healthcare when compared to any other country in the OECD. However, this is not reflected in positive outcomes such as life expectancy and low infant mortality rates. In 2024, U.S. life expectancy reached 79.0 years, which remains about 3.7 years lower than the average of peer OECD countries at 82.7 years.
Millions of people are left without insurance or under-insured, causing them to pay huge amounts of money for healthcare. To combat this problem the policy proposal of “Medicare for All” has emerged. This is a single payer system which can help solve the U.S.’s health crisis. It reduces waste from administration, provides preventative healthcare and eliminates cost sharing.
Cost Savings from Administration
The main reason the U.S. healthcare system is not economically efficient, is because there are thousands of different insurance companies. This causes a lot of confusion because each insurance company has different rules for billing, formulary and prior authorisation.
A landmark study published in the Annals of Internal Medicine showed administrative costs make up over 34% of total health care costs in the U.S. However, single payer countries such as Canada have much lower administrative costs of only ~17% (Woolhandler et al., 2003). When moving to a single payer system such as Medicare for All, there is only one method of paying for healthcare. This is similar to the traditional Medicare system. A 2020 study by the CBO looked at single payer options and found eliminating cost from healthcare by simplifying payment and removing profit driven insurance companies, marketing and excessive executive pay will create huge cost savings.
A 2020 study published in The Lancet found implementing a Medicare for All system will save the U.S. $450 Billion per year on healthcare costs and every citizen will receive guaranteed care (Himmelstein & Woolhandler, 2020).
Health & Economic Cost Savings
Not only are there savings from removing the cost of private insurance, but there are also large health related savings. Millions of people do not seek healthcare due to high deductibles, co-payments and fear of debt. In 2019 nearly half of working age adults were left uninsured or under insured meaning they did not seek necessary treatment (Collins et al., 2019).
This causes small health issues to become chronic, acute and therefore much more expensive. By eliminating cost sharing, Medicare for All encourages people to seek the treatment they need. Chronic illness such as Diabetes, Hypertension and Cardiovascular disease can be managed early on meaning expensive ED visits are avoided.
A healthier workforce means there will be more economic benefit. Chronic illness costs hundreds of billions of dollars in lost productivity. By having a universal healthcare system, you guarantee workers will remain healthy and stable.
Better Coverage
The term better coverage refers to how much coverage you get from a single payer system. Private insurance often leaves out essential services, has limited networks and pre-authorisation.
Medicare for All (as seen in the Medicare for All Act) provides extensive coverage. Most proposals include:
Hospital care
Primary care
Prescription medication
Mental Health and Substance Abuse
Dental, Vision & Hearing
Long Term Care
Including dental, vision and long term care is revolutionary. Traditional Medicare does not include dental or long term nursing home care meaning seniors have to deplete their life savings or enter poor Medicaid programmes. By including these services as part of universal healthcare, Medicare for All tackles health inequalities across the lifespan.
A single payer system also removes health inequality based on socio-economic background. Minority groups, low income families and rural areas suffer from a lack of healthcare. By separating healthcare from work, everyone receives entitlement to healthcare creating a fairer society.
Addressing Opposition
Opponents often argue that Medicare for All will cause an increase in federal government spending. This is an incorrect argument as it fails to consider overall cost for society.
Private insurance will be eliminated completely meaning no cost to the individual from insurance, deductibles or cost sharing. Instead this will be covered by taxes. Taxes will increase at federal level, however overall families and businesses will pay much less. As shown in the Lancet study most families will pay less under a Medicare for All system than they currently pay for insurance and cost sharing (Himmelstein & Woolhandler, 2020). Government will also have huge bargaining power as they will be the only purchaser. This will help reduce the price of pharmaceuticals.
The current healthcare system is unsustainable, unjust and inefficient. Moving to a Medicare for All single payer system will provide evidence based solutions to fix the issues. Removing the excessive administration costs of private insurance can save hundreds of billions of dollars per year. Guaranteeing everyone full coverage including dental, vision and long term care will improve health outcomes, increase economic benefit and ensure health equity. Overall, Medicare for All is an essential investment to improve the long term economic future of the U.S.
References
Congressional Budget Office, C. B. O. (2020). Single-Payer Health Care Systems Key Issues for Consideration. Washington, D.C.: U.S. Government Publishing Office.
Collins, S.R., Gunja, M.Z., Aboulafia, G.N., Sahm, L. (2019). U.S. Health Insurance Coverage in 2020: A-Worse-Case Scenario Preview. The Commonwealth Fund.
Himmelstein, D.U., Woolhandler, S. (2020). Health Care Reform Options: Single-Payer vs. Competitive Markets. The Lancet, 395(10223): 512-514.
Woolhandler, S., Campbell, T., Himmelstein, D.U. (2003). Costs of health care administration in the United States and Canada. New England Journal of Medicine, 349(8): 768-775.