The Unarguable Benefits of Universal Healthcare

As political posturing over the Affordable Care Act (aka “Obamacare”) continues, the fiscal and social benefits of expanded access to healthcare become steadily more obvious.

The journal Health Affairs recently reported an 8 percent increase per year in the number of early-stage colorectal cancer diagnoses since passage of the ACA. Extrapolated across the country, the researchers estimate the ACA led to approximately 8,400 additional early-stage colorectal cancer diagnoses among seniors between 2011 and 2013.

A 2015 study published in JAMA found that the ACA had increased the number of early-stage cervical cancer diagnoses in women aged 21 to 25.

Early diagnosis doesn’t just increase the likelihood of successful medical intervention; it significantly reduces healthcare costs. When cancer is caught earlier, it is cheaper to treat.

America’s healthcare costs have long been far higher–and our outcomes considerably worse-– than in countries with universal systems. The lobbying clout of Big Pharma and Big Insurance continue to make a cost-effective “Medicare for All” politically impossible, but even with its problems, the ACA has vastly increased the number of Americans who are insured while significantly slowing the rise of healthcare spending; last June, Fortune Magazine reported

The United States will save about $2.6 trillion on health care expenses over a five-year period compared to initial projections made right after the passage of the Affordable Care Act.

While health spending spiked briefly in 2014, evidence shows that it has once again slowed down and will help save Americans trillions between 2014 and 2019, according to a new study by the Urban Institute and Robert Wood Johnson Foundation.

Spending declines will happen across both private health insurance as well as Medicare and Medicaid. Centers for Medicare and Medicaid Services actuaries predicted that total Medicare spending between 2014 and 2019 would be $455 billion lower than the ACA baseline forecast. Projected Medicaid spending over the same time period is expected to be $1.05 billion lower than previous ACA estimates, while private insurance spending projections declined by $664 billion.

I simply do not understand the Republicans’ hysterical opposition to the ACA. Both health outcomes and cost controls have improved, and problems with the program can be fixed with relatively minimal tweaking. The program’s popularity has also improved. (According to survey research, approximately half of those who do remain unhappy with Obamacare complain that it doesn’t go far enough–they would prefer a single-payer system.)

It isn’t just the ACA. Paul Ryan and the GOP are threatening to dismantle both Medicaid and Medicare–programs with low overhead and proven effectiveness– and they are intent on defunding Planned Parenthood, which delivers critical medical services to millions of poor women.

It isn’t as though a free market system could work for healthcare. Market transactions require a willing buyer and a willing seller, both of whom are in possession of all information relevant to the transaction. Equal bargaining power doesn’t describe real-world doctor-patient relationships. In that real world, insurance companies have virtually total control over the options available to those fortunate enough to have coverage.

It seems inconceivable that Ryan, et al, simply do not see the multiple fiscal and social benefits of universal–or at least expanded–access to healthcare. So what accounts for their persistent hostility to programs that have proven their effectiveness? Why are they intent upon substituting block grants for Medicaid, turning Medicare into a “voucher” system, destroying Planned Parenthood and eviscerating the ACA?

If the answer to that question is what I think it is– slashing social programs that benefit millions of Americans will allow them to subsidize the insurance and pharmaceutical industries even more generously and deliver more tax cuts to their wealthy patrons–I wonder how they sleep at night.


  1. It’s not just that they are subsidizing the pharmaceutical and health insurance industries. It’s also because they are ideologues. The Republicans BELIEVE that leaving everything to an unregulated market will fix the economy. It’s never been tried and it won’t work. They also are in denial about the fact that the economy has done better under Democratic administrations for years. A lot of Democrats don’t realize this either. But check this out and you’ll see that the Democrats are better for the economy than the Republicans:

  2. Paul Ryan, his republican cohorts, and the health insurance and pharmaceutical industries simply do not want to have to provide insurance and meds to people who cannot afford to pay for those “luxuries”.

    Oh, and we must include the Koch brothers and their fake foundation Americans for Prosperity in this group. They have spent a sinful amount of money fighting the ACA. Their mantra of Death Panels that was used to fight the ACA and create a hatred of it by millions of Americans worked, but the real Death Panels have always been the insurance companies. They do not want to really pay for the health care of people with the most expensive illnesses. For decades they could refuse insurance for pre-existing conditions and could stop paying for expensive conditions when people reached their lifetime limit.

    They are cold, cruel, heartless, evil people who have never been in a vulnerable position and simply do not care about what happens to anyone else but themselves.

  3. Universal Healthcare (with stipulations) on the same lines as Medicare would be the answer. I have always said this. That is odd coming from a citizen that proclaims to be a conservative liberal and voted for Trump.; Democrat on the rest of the candidates. We must bring all of the jobs that were exported from our nation. Every man and woman deserve a good paying job with a living wage. That is where the ( with stipulations) would kick in. If every worker , that is a citizen, had a good job offer; then all would be forced to work, except for the sick, elderly, and citizens in special situations. If they do not work; then no healthcare nor welfare. This would not apply to the sick and elderly. Nor would illegals or foreigners receive any benefits. The universal healthcare would be financed by what is already being paid by our government on Obamacare subsidies, Medicaid, Medicare, Premiums already being paid, money paid on unnecessary welfare and a tax on anything that has a negative effect on health-tobacco and alcohol. The government would be responsible to end all abuse by drug companies and health care providers. They would work for a predetermined amount. Its overall cost would not be that much more and people would have pride again. Bob Gooch

  4. “As political posturing over the Affordable Care Act (aka “Obamacare”) continues, the fiscal and social benefits of expanded access to healthcare become steadily more obvious.”

    Excuse my language but..”political posturing” is simply the ongoing and escalated pissing contest between Republicans and Democrats. The ACA battle lines were drawn long before the bill was passed into law; at which time it became known “Obamacare” as in insult against our FIRST Black president and remains so because Republicans do not know what to do with this health care situation to continue their soaring profits in all areas of health care. It is also one of the “hostage situations” used against the Obama administration in their threats to shut down government. It is but one segment of the total economic picture in this country and it is failing due to greed and avarice.

    My 2017 “Medicare And You” book arrived with no monthly premium provided because they had no idea what it would be. My annual Social Security Benefit Statement listed the increase. The book lists several Medicare changes; my IU Health Care Medicare Supplemental also listed changes – increased co-pays. Not sure whose idea it was to change the “free” preventive yearly mammogram to every two years but…my supplemental charges a co-pay for the specialist to read and provide the test results. Not a lot but…this makes the test not a “free preventive provision”, why have the test if you don’t get the results.

    One of our local “social programs”; the Trustee’s Office, yesterday denied my daughter-in-law all assistance for the second time. She lost her job at Ford on English Avenue when they shut down; then lost her job 4 years ago when Rolls Royce fired 2,000 + employees and rehired workers at minimum wage. My daughter-in-law has worked when she can find it, at anything available, she was told at one job fair last year that at age 50 she is unemployable. The Trustee’s Office denied assistance again yesterday because “she lives in a house she cannot afford”; she bought the small 2-bedroom home, one block from railroad tracks, 14-15 years ago and is in the process of losing it due to being out of work. Of course she is “living in a home she can’t afford”. She is struggling to keep her home; she is not “living large” or “high on the hog”, she is trying to survive. Years of factory work have caused hip dysplasia and she needs surgery for torn rotator cuff. Working off and on denies her Medicaid assistance and she would have qualified for $10 in food stamps – had she accepted them.

    These conditions, suffered by millions in this country, are causing serious health issues which are going untreated and are part and parcel of this never-ending ACA/”Obamacare” fiasco Trump continues to say HE will take care of. They are among those falling through the cracks who have no health care due to ridiculous rules and laws. Trump doesn’t mean to take care of those who need health care; he will take good care of health care providers and Big Pharma to maintain their soaring profit limits. Looking at the big picture; how does he believe he can accomplish his support of Koch brothers, et al., when people have no jobs and no health care and are unable to work to support the 1%?

  5. We know that the R issues around the ACA are irrational so the only way to fight is to focus on the problems created by their supposed ‘solutions.’ None work–or they would have come together in an alternate plan in the last six year. High Risk Pools, tax credits, vouchers, buying insurance across state lines, medicaid given in block grants to the states, etc. Great point about needing a buyer and seller to make competition work. When I first arrived in Bloomington and called Anthem saying I am a cancer survivor and wanted to know my options…the sales rep laughed…why should we insure you? he said.

    The focus needs to be on
    Seniors–the sleeping giant who votes R– who need to understand that medicare will go away and,probably sooner than the 10 years they propose.

    Healthcare is being taken away to give a big tax break to the wealthy. $2.8 Billion to the most wealthy 400 families in the US alone.

    No matter what they promise in terms of funding…unless its in a law as the ACA and Medicare are, they can and will change their mind, leaving their new programs with no $$.

  6. Now Sheila; How was that true thought out of a citizen that thinks SB309 may not be the answer in its present form, but thinks that a common ground solution to end net metering in its present form must be accomplished? I am a true conservative liberal that believes there is hope for the Democrat party; but not with Obama nor the Clintons nor George Soros. Universal Healthcare is a must; but only if it has stipulations. Currently, there are people getting health aid; only to sell their pills illegally. Some doctors are double billing. All recipients need to report them. Nothing can be totally free; and we must constantly monitor all situations. Bob Gooch

  7. Just to be clear, Planned Parenthood receives reimbursement for services rendered from Medicaid and Medicare. When the GOP speaks of “de-funding” what they mean is that they will make Planned Parenthood ineligible for reimbursement. By saying it the way they do, they leave people thinking that PP gets funds as a budget line item.

    So far every Republican plan to fix Medicare or Medicaid has been a plan to reduce the scope of both programs. Paul Ryan wants to make them vouchers programs, with the money going to the states. 45 has said he wants to protect both Social Security and Medicare, but he will go along with Ryan’s plan on Medicare. We will continue to have Medicare, but it won’t BE Medicare.

    Republicans are master marketers. They are selling a bill of goods.

  8. It’s a well known fact in the wellness industry that $1.00 invested in disease prevention, nets a 300% return.

    The last I checked, 85-90% of all diseases are preventable.

    So, why doesn’t our state and federal policy makers advocate for prevention like exercise, eating right, and stop writing scripts for mental illness which aren’t supported by scientific facts?

    Maximizing shareholder value and jobs.

    Well people don’t use pharmaceuticals or hospitals. People who eat fried fat and salt have side effects. People who eat more than they need have negative consequences.

    Indiana was just ranked in the bottom 5 states again for the least well of all 50 states. There is a $$$PRICE$$$ for this. Healthcare costs are much higher, but so are profits for manufacturers of drugs and replacement body parts.

    The same mentality is now trying to “reform” or privatize education into a market driven industry driven by choice. If you project out education reforms under this scenario, only the rich will be able to afford good schools and the poor will be subjected to schools where teachers don’t want to be. We planning on using low priced immigrants to educate our kids.

    When our medical system gets help accountable for producing healthy citizens, versus profiting off sick people, the medical professionals will hold the food industry accountable, and several others as well.

    A market based system should only be used with a select few industries. Health and education industries shouldn’t be allowed to profit off sick Americans. Period.

  9. We are lagging behind the rest of the civilized world in not coming up with a single-payer system. As with any system, it has warts and moles from time to time but such are fixable and that system at its worst does not begin to compare with our chaotic “system” of political payoffs to the pharmaceutical and healthcare companies that drive our costs and poor results into the stratosphere. France, for instance, is widely regarded as having the best healthcare system in the world (and at roughly half the cost we pay for greatly inferior results). We should have had single payer long ago. It not only would have provided better results at a lower price (since we wouldn’t have to pay for the some 25-30 percent in profits HMO executives and shareholders rake off the top of the premium dollar), it would have reduced our deficit (all aside from humane considerations of early death and immense human pain and suffering of our fellow Americans).

    Corporations are in or nearing total control of our economy, education et al.; but the nation’s health is not a commodity subject to securitization by private interests on Wall Street. HMOs are buggy whips; they have seen their day. We cannot afford them or their influence on the greedy politicians they finance. It is long since time we adopted single payer, so let’s do it.

  10. People seem to miss the point that about half of today’s healthcare expense in America is socialized through Medicare and Medicaid even though they cover a relatively small population. The explanation? Us old folks need lots of repair work before we can’t be fixed anymore.

    The remaining half is largely funded by corporations as a benefit that’s demanded by the labor market for high in demand employees.

    Obamacare is based on the assumption that health care is a right as well as a great investment. We don’t let people die in the streets so everyone ultimate gets some level of critical care paid for by others but the low demand employees often are disease spreaders because they can’t afford anything but critical care.

    Obamacare was a small step expected to be expanded.

    It’s fate as it turned out was sealed by the GOP naming it Obamacare because their political fate depends on erasing all memory of their failures during his administration. Remember the Ministry of Truth?

    Their goal is exceptional healthcare for only those who can afford it. The current effort is to get that without having to say it.

  11. This whole conversation makes me so sad. We talk in generalities (except for JoAnn who gave us a specific and human face to the issue) while missing the very real impacts of directions in which the Republicans are headed.
    Stress is a leading cause of disease. Having little or no access to affordable healthcare adds so much stress to already stressful lives. The struggle to find a job (assuming you are under 50), dependable transportation to said job, trying to live on take home from that job, rising utility and services costs, paying debts accrued when you still had options and hope, now being afraid that your ethnicity or religion will mark you for subtle or not so subtle disadvantage in the workplace and community and just the general feeling that you have no solid ground to stand on anymore heap stress on an already anxious population.
    So waiting until illness is at a crisis point before acting is not surprising at all.
    Having been raised in a very poor family, job and transportation insecurity were a daily struggle for the adults. Healthcare was a luxury and when needed was only used when it was a life and death matter. Think about a child with pneumonia or whooping cough, an adult with an injury as simple as a dislocated finger or broken bone (making manual labor nearly impossible), anyone with flu or even measles. Sounds like just a bump in the road for most people who have resources and some kind of backup. For the poor, any of those events could mean homelessness and the loss of any credit.
    Generalities ignore the real cost to individuals in less than ideal circumstances.

  12. WE are the commodity being bought, sold, and traded. Our bodies, our health, our wellbeing, our livelihood. A commodity. Just like a widget on the shelf at the store and with just about as much input to our cost, experience waiting to be bought, and the character of our new owners. The great genius of Barack Obama was including in the ACA every good idea a Republican ever had about improving healthcare costs. So much so they have nothing truly original to bring to the table even if that was ever their motive. I wonder if it will take the eventual brink of implosion of the healthcare industry to get them to do something. You know, like they save the bankers.

  13. Judging from today’s responses to Sheila’s Affordable Health Care blog, there seems to be a universal feeling that Fake President Donald Trump and his minions are in the process of introducing an Unaffordable Health Care Plan. How can anyone tell? It’s difficult to change a plan when you’re not aware of what the original plan is. When the Affordable Health Care act was published, Republicans universally complained about the number of pages in the bill, and indicated they were not going to take time to read it. Is there any chance they changed their minds and actually know what they’re talking about?

  14. Max Baucus (D) from Montana would not even give Universal Health Care advocates, representatives from groups calling for single-payer health care a seat during the discussion oh Health Care. Baucus said, “single payer was not an option on the table.” This was back in 2009.

    Per Wiki- From 2003-08, Baucus received $3,973,485 from the health sector, including $852,813 from pharmaceutical companies, $851,141 from health professionals, $784,185 from the insurance industry and $465,750 from HMOs/health services, according to the Center for Responsive Politics.

    The facts are:
    Total health expenditure per capita (per person) in US dollars. 2015
    Source Organization for Economic Co-operation and Development (OECD)
    Canada $ 4,608, vs USA $ 9,451.

    Average life expectancy at birth in years, and rank out of 183 countries.
    Source Data List by the World Health Organization (2015)
    Canada 82.2 years rank # 12, vs USA 79.3 years rank 31.

    In Canada, everyone is covered automatically at birth – everybody in, nobody out. In Canada, health care coverage stays with you for your entire life. This is in contrast to the USA where your coverage is in many cases is determined by your employer.

    In Canada, the government negotiates drug prices so they are more affordable.

    We have here in the USA a Frankenstein Health Care System. V.A., Medicare, Medicaid, employer health care, and private health care. I doubt if the Canadian or Universal Health Care will even get a fair and impartial hearing. Why – Two reasons I can think of quickly – One is the financial power via Campaign Contributions to our elected officials and Two Ideology.

  15. Here’s the truth: Republicans are in a panic. The American people have caught on to the fact that the repeal of Obamacare, without a plan to make it better, would be an absolute disaster.
    They have caught on to the fact that despite the grotesque levels of income and wealth inequality and growing poverty among seniors, almost all Republicans want to cut Social Security benefits and privatize Medicare. They want more austerity for seniors, children, the sick and the poor.

    This Saturday, February 25th, we make our next stand in the fight to save health care for millions of Americans.

    Indiana State House 200 W Washington St, Indianapolis IN 46204, Feb 25 (Sat) 12:00pm.
    Bernie Sanders
    I plan to be there!!!!!

  16. Louie – I will be there with you in spirit but not in body as I am in southwest Florida. You are right about grotesque levels of income for the superrich, who now wish our (?) representatives to make them richer by having those in poverty contribute yet more to their Midas trove through selling out voucher appropriations to the money-hungry states for health care as though healthcare were just a commodity. Go for it and good luck!

  17. The problem here is greed–have you ever looked at a medical bill? My brother recently had cardiac bypass surgery. The hospital bill alone, for only 6 days, was over $111,000! That doesn’t count the doctors, anesthesiologists, radiologists, and so forth. Who could afford this? Why do they charge so much? Because no one stops them. Medicare places caps on this nonsense. That’s why Ryan wants to do away with it–doctors, hospitals and insurance companies want to gouge even more than they already do. After all, it’s only life/death, suffering/relief of suffering that are at stake, so why not charge as much as you can get away with?

    If everyone had Medicare, then hospitals would stop their frantic building of suburban satellites, purchase of physician practice groups, and Aetna, Well Point, Cigna, et al, would be toast. No more multi-million dollar CEO salaries, luxurious insurance office buildings, handouts, meals, trips for doctors, and so forth. No more $10 a pill for prescription drugs, $5,000 a dose for injectables and chemotherapy, the development of which the public helped subsidize. All of this is good, because all of this contributes to the absolutely ridiculous cost of health care.

    Health care is like police and fire protection–it exists for the public good, to help people be able to live in peace and security. How long before enough people stop being scared to demand this as their right? Maybe the Republicans will repeal Obamacare, people will start dying, and then change will happen.

  18. Texas AG got slapped down by the courts again saying Texas cannot defund Planned Parenthood based on discredited, O’Keefe videos claiming Planned Parenthood was selling baby parts.

    Apparently the courts want actual, factual facts which are foreign to wingnuts and must therefore be shipped back to country of origin.

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