If you’re unconvinced, here are some facts to hammer it home.
The next presidential election will take place in a post-COVID19 world. If healthcare was already going to be centerstage, one can only imagine how big a role it will play now that everyone in the country has had an intimate conversation with their own mortality. So here are some answers to arguments against Medicare For All we’ll certainly hear in the next few months.
If the Coronavirus pandemic has taught us one thing it’s that there’s a reason it’s called public health: if you want to be able to do something as bold and fundamentally American as say, leave your house, the health of your neighbors matters a great deal.
I come from a country where Medicare for All is a reality. A country the World Health Organization once named as having the best-performing healthcare system in the world. A country known for many things, but not necessarily for being ahead of the curve on things. I come from France, the land of “socialized medicine.” Since I moved to the United States 10 years ago, I have never been able understand why so many Americans, even on the left, were so forcefully against the idea of universal healthcare. I mean who actually wants to max out a credit card to save a loved one’s life or spend $500 for the hemorrhoid cream that can actually help?!
Thanks mostly to Elizabeth Warren and Bernie Sanders, people, pundits and politicians, are now actually talking about the idea of Medicare for All and what it would entail. And now that people are talking, I understand better where the resistance comes from. Not to sound like the stereotypical French snob, but it appears that the idea of universal healthcare is so foreign to what Americans are used to, that they just don’t understand how it actually works.
“Some people love their private insurance!”
I’m sure some people are satisfied with their private insurance. Love, I don’t know. Okay, even if some people love mysterious procedure codes, endless phone games between insurers and providers, or footnotes in point 2 font informing you that your medication is actually not covered – even if you love all of that, wouldn’t you say that a system where you go to any doctor, get treatment, pay $20 and leave is better?
“So now my pediatrician needs to be vetted by the government to be in their network?”
No. In-network / out-of-network is a private insurance concept that doesn’t exist in a single-payer system like France has. A doctor is a doctor, and ALL doctors are covered. This is not about government controlling doctors. This is not about taking away a person’s choice. This is about not having to choose at all, which means you get to choose whoever you want. You know, like a free person!
“We’re not socialists!”
The concept of paying taxes for everybody to enjoy something is not central to this country’s belief system. Yet every worker in America is already contributing to the healthcare system through the Medicare tax, just like in any country with universal healthcare. The difference is that in those countries, you don’t just contribute, you also get coverage. If you get something in exchange for your money, does that still count as socialism?
“I don’t want a bigger government.”
In France, healthcare is commonly called la sécurité sociale — social security. It’s already burnt in the language that the health of French citizens is central to the country’s national security, just like the police or the army. These past few months, the Trump administration has repeatedly said we are at war against Coronavirus, calling it the invisible enemy, even trying to label it as a foreign enemy, while referring to our healthcare workers as heroes on the front line (which they are!). This language surely makes for good television, but if they were to put their money where their mouth is, then these same politicians should treat healthcare exactly like they treat the military. And I don’t think anyone would recommend the military to be privately run.
“It’s going to raise taxes.”
This, of course, is the big one. The French healthcare system is financed almost entirely by two taxes on someone’s paycheck: 13% paid by the employer and 9.2% paid by the employee. Compared to the 2.9% Medicare tax in the US, these numbers do feel high. But let’s look at some hard numbers.
In 2019, the average income in the US in was $48,672. That same year, a family health plan cost on average $14,561 to the employer and $6,051 to the employee. Put these numbers together and you realize the American employer’s average contribution equals 30% of the American average salary and the employee’s equals 12.8%. As a country, America is already paying a higher percentage toward healthcare than France, on both side of the payroll.
With 24% of its federal budget, the US government only covers 28% of all healthcare costs in the country. In France, with 36% of the national budget, they cover 78%.
“America can’t afford it.”
It would be wrong to say the US federal government isn’t spending anything on the health of its citizens. It actually spends more than any other Western country, so there’s already a lot of public money in the health industry.
Yet with 24% of its federal budget, the US government only covers 28% of all of the healthcare costs in the country. In France, with 36% of their budget, they cover 78%. Clearly there’s plenty of money, and it’s still not enough… Why?
“Because we have the best medicine in the world, it comes at a cost.”
Now, that would be a strong argument, and I’ve heard it many times: America has cutting-edge technology, highly trained doctors, world-class hospitals. People from all over the world want to come to America to get treatment. And yet, life expectancy in America in 2017 was 78.6 years old. That same year in France, it was 82.5.
It’s unclear if limiting one’s potential wealth for the greater good is an idea that can find a place in the American society. Yet, Medicare for All could be exactly what’s needed right now to bolster small businesses and keep alive the free-enterprise spirit that has always made this county so great.
Of course these are all average numbers and comparing countries with such different history, geography and populations comes with limitations. Cost of life and salaries are overall higher in the US, so it makes sense that healthcare costs more too. And the French system isn’t perfect either. Just last year, doctors went on strike complaining about a lack of resources in their hospitals.
But I have experienced both, and let me tell you what really came as a shock to me: I always saw America as the land of entrepreneurship, where taking a business risk was rewarded and encouraged. That’s one of the many reasons I chose to come live here. Yet, it was so much easier to take that leap in France. Because there, I didn’t have to worry about getting affordable health insurance for me and my family through an employer-sponsored plan.
Knowing that if you or your loved ones got sick, you will be treated properly without a one-way ticket to bankruptcy or worse, removes a very heavy layer of stress to your daily life, whether you realize it or not. And it’s not like French people are that much healthier: we drink wine at lunch, 32% of the population still smokes, and butter is the main ingredient in a lot of the things we eat.
It’s a complicated topic, and many people know more about this than me, but the bottom line seems pretty clear: the healthcare industry in America as a whole is too expensive — from medical schools to prescription drugs and everything in between. So for Medicare For All to work here, some people will have to make less money. It’s unclear if limiting one’s potential wealth for the greater good is an idea that can find a place in the American society. Yet, Medicare for All could be exactly what’s needed right now to bolster small businesses and keep alive the free-enterprise spirit that has always made this county so great. See you in November.