Universal Health Care-Medicare-for-All

This paper discusses the political, socioeconomic and cultural-ethical issues around the Medicare-for-All bill and what it portends for stakeholders in the process. It also presents the current legislative issue, the most affected persons, socio-economic issues, political issues, cultural and ethical issues, and stakeholders.

Running head: UNIVERSAL HEALTH CARE-MEDICARE-FOR-ALL
Universal Health Care-Medicare-for-All
Name
Institution

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Introduction
Universal health care is currently an issue of public debate and a serious concern in the
US. This is owed to the fact that the US despite being one of the wealthiest countries in the
world, has one of the highest inequalities in access to quality healthcare. These disparities exist
in different population groups in the country. It is manifested across different demographic
dimensions such as race, ethnicity, geographical location, disability status, gender and sexual
orientation. The Medicare-for-All bill has been proposed as redress for these issues. This paper
presents the political, socioeconomic and cultural-ethical issues around the Medicare debate and
what it portends for stakeholders in the process.
Current Legislative Issue
Bernie Sanders proposed the Medicare-for-All bill in September 2017. According to
Friedman (2017), Medicare-for-All sought by the bill is a system where all Americans benefit
from privately offered health services that are financed by the public coffers. It seeks to enroll all
Americans on a public insurance system, hence correct the imbalance in the uninsured
Americans which stands at 12%. In this proposed plan, no deductibles are allowed; opting out is
exclude too. According to Gresham (2017) healthcare disparities matter because disparities in
healthcare provision do not just affect the disadvantaged groups alone; they hinder the collective
gains made towards achieving better health care for the entire population and in effect, increases
the burden of healthcare through unnecessary costs. Particularly, the low income earners and the
people of color record the highest numbers of persons with no health insurance or are under-

UNIVERSAL HEALTH CARE-MEDICARE-FOR-ALL 3
insured. These disparities in healthcare have characterized the conversation around universal
healthcare and are the principal reasons for which it is sought.
The Most Affected Persons
The most affected by this proposed healthcare are the high income earning citizens and
the healthcare providers and doctors. The legislation proposes that the publicly financed but
privately delivered healthcare shall be funded by taxing every working citizen and pooling the
resources to a common public insurance plan (Seidman 2013). High income earners will be taxed
higher to pay for the health services of the low income earners, the underinsured and the
uninsured. The common practice world over with single payer health insurance systems (like the
proposed Medicare-for-All) is that healthcare is paid for by the working population.
In the US case, the bill proposes to implement the plan through a combination of
strategies: compulsory health insurance and taxation. The contention of the high income earners
with this approach comes two-fold: firstly, they do not need a compulsory health insurance cover
because they can afford to pay high premiums for expensive comprehensive health covers
(Seidman 2013). The other contention is that they will have to pay more taxes to the public
health insurance plan to pay for the medical care of others. The healthcare providers in the US
are also going feel the effects of the bill if passed. The healthcare sector in the US has largely
been profit driven for a long time (Longman 2017). The Medicare-for-All bill however will give
the government power to control the cost of medical services both through negotiation and
regulation.

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The government’s involvement comes with the elimination of administrative costs from
which the healthcare providers have for a long time been making money. If the bill is passed and
operationalized, the government through its buying power will have considerable influence on
the cost of medicine and medical services; through standardization of procedures of billing and
streamlining of rules for medical insurance coverage (Jaffe 2018). Medicare for all will also
compel health care provider and doctors specifically to charge standard prices for the same
services which are not the situation as is today. Doctors will also be left with no choice but to
deal with the government agency. The danger that lies herein is that the quality of healthcare is
likely at stake. US doctors (who are currently largely motivated by profits) are likely to
compromise on the quality of services they offer because the practice may no longer be as
lucrative as it is now.
Socio-economic Issues
One of the major socio-economic issues pertinent to the Medicare-for-All bills is the
healthcare disparities which in most instances are tied to economic disparities. The term
healthcare disparity is used in reference to health care provision between different segments of
the population or other dimensions (Welch 2016). Fundamentally, healthcare disparities manifest
between population groups in their abilities (or lack thereof) to access medical health services,
medical insurance coverage and quality medical care.
The population of uninsured Americans as at 2016 stood at 28 million, most of them
people of color (Hispanics, Asians and black Americans). These health care disparities result in
an increased burden of disease for the disadvantaged population which makes the economic

UNIVERSAL HEALTH CARE-MEDICARE-FOR-ALL 5
situation worse for affected groups (Tillow 2012). Tied to the issue of healthcare disparities is
the social issue of exclusion. In a country where the disparities between the insured and the
uninsured are so evident, this is a real concern. People of color who make up the highest
percentage of the uninsured in the US experience a feeling of social exclusion in the society
(Stark 2016). The uninsured rates among the people of color are still high despite the gains made
by the Affordable Care for All (ACA). 17 % of Hispanics are still uninsured, the percentage of
uninsured Asians stands at 8%, while for the no elderly blacks, it is 12%.
Political Issues
There are a number of political issues that are pertinent to the quest for universal health
care in the US. The Medicare-for-All bill was drafted and proposed by Sen. Bernie Sanders
(independent from Vermont). Before the bill was proposed, Americans in 2010 were introduced
to the Affordable Care for All Act which later became famous as Obamacare. Although ACA has
yielded laudable results in increasing the percentage of Americans with access to health
insurance, it is not a universal health care plan (Pollack 2015). Since the Trump administration
came to office in 2017, GOP senators and congressmen have fought to have ACA repealed for
the same reasons that they are now opposing Medicare-for-All. Despite this opposition from the
GOP legislators and the presidency, Medicare-for-All now has the support of 52% of republicans
and 85% of democrats (Jenkins 2017). There are two facets to this: firstly it could be that a
compromise position has been struck between democrats and republicans given that the
proponent of the bill is independent. Alternatively, this is a reaction to the up-coming mid-term
elections in the US and both democrats and republicans are trying to stay on the right side of the
citizens who badly need healthcare.

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Cultural and Ethical Issues
Ethical and cultural concerns regarding Medicare-for-All today have a lot of similarities
to the kind of issues that existed around ACA a few years ago. Proponents and supporters of
Medicare-for-All hold the ethical position that public resources ought to be utilized to cushion
the poor, unemployed and disadvantaged in society (Singleton 2018). They hold the value that as
many as cannot afford health care insurance should be entitled to government money (public
money) to guarantee them access. The opposing ethical perspective is that entitlement to public
money cannot and should not be the remedy to individual problems. Concerns have been voiced
that when access to universal health is granted, people are likely to take it for granted and misuse
it (Pollack 2015). Those who hold this view argue that patients will see no harm in missing
doctor’s appointments because they are free after all. Similarly, it is arguable whether or not it’s
right to allow patients with detrimental behavior to occasion long waiting hours for specialized
services at the expense of deserving patients. The ethical question of whether it is morally right
to make healthy individuals to pay for the medical expenses of the unhealthy population also
arises.
Stakeholders
Virtually all citizens who are taxpayers in the US are stakeholders in the Medicare-for-
All bill. However it portends more for the high income earners because if it passes, their taxes
will have to go up: high income earning households will have to pay more to finance the health
care of low income earners and the unemployed (Seidman 2015). Insurance companies also have
a stake; with Medicare-for-All, healthcare providers and doctors will have to deal with the

UNIVERSAL HEALTH CARE-MEDICARE-FOR-ALL 7
government agency, contrary to the current practice where they deal with health insurance
companies. This has potential to reduce business for health insurance firms. Healthcare providers
are major stakeholders in this process too. If passed into law, Medicare-for-All is going to
transform the way the sector which has largely been profits driven performs (Longman 2017).
The bill gives the government considerable power over the pricing of medical services and the
quality of services. As the last stakeholder, the government through Medicare will be able to
deliver universal healthcare to its citizens.
Conclusion
The Medicare-for-All is a bill drafted in pursuit of universal healthcare for all in the US.
It has been subject of debate since its introduction to in September 2017. As discussed in the
paper, it has potential to remedy the disparities in healthcare provision by taxing the rich more to
pay for the medical expenses of the poor. As Medicare-for-All provides reprieve for low income
earning households, it places burden on the high income earners. This in part occasions the
political, socio-economic and cultural-ethical issues raised in the debate. Ultimately the poor are
the biggest gainers while healthcare providers and high income earners are the biggest losers.

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References
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