Published by the Students of Johns Hopkins since 1896
February 25, 2024

The current U.S. health-care system is flawed. Let’s go universal.

By MEGHANA RAVI | February 13, 2020



Ravi argues that the stratification and high costs of health care in the U.S. need to change. 

A few months ago, I was incredibly disillusioned with America. I saw my country as a garden of withering: plants dying, weeds flourishing and gaping cracks in the earth. I knew our problems were only getting worse and worse, but I saw no solutions being implemented.

Nothing seemed like it was getting done, and I couldn’t figure out why. I didn’t have the time or motivation to look for these answers amidst my hectic life at Hopkins, but then we went on winter break. 

I was incredibly bored after a few days of lounging around, so I began looking into the issues surrounding the upcoming election. The issue that immediately dug itself right into my heart was health care.

I came to a critical understanding in my political self-study that I wanted to share with my peers, especially my fellow pre-meds. By choosing medicine, we are not just choosing a career or calling — we are choosing an industry, and the behavior of that industry will deeply affect our professional lives. 

Health care is a decisive issue in not only the upcoming election, but in the everyday lives of the American people. An article from CNBC claims that 66.5 percent of bankruptcies in the U.S. were tied to medical issues. This number is somewhat controversial because bankruptcy is declared for not a single isolated reason but a network of interconnected causes. 

However, an academic study published in the American Economic Review in 2017 found that while hospital admission itself is not necessarily a major cause of bankruptcy, the permanent loss of income resulting from a medical emergency is. 

The magnitude of lost income resulting from hospital admission in subsequent years is compared to job displacement. 

Part of this is the cyclical down-spiral built into our system. The reality is that a medical emergency often begets more medical emergencies, which results in income reductions and job loss, which can be especially detrimental as health insurance is often tied to employment status. This creates a domino effect for many people, leading to bankruptcy. 

The current health-care system is almost universally agreed to be a Kafkaesque nightmare, but how did we get here, and what solutions are there for us now? In an interview with The News-letter, Associate Professor Bradley Herring from the Bloomberg School of Public Health had some answers. When asked whether our current health-care system adequately meets the needs of our country, Herring had an almost immediate response.

“My short answer would be no. I don’t think our current health-care system is that great,” Herring said. “I think too many people fall through the cracks, and I think that’s because we have a very fragmented health-care system.” 

He further elaborated on how there are different health-care systems for the employed, the poor and the elderly. Many people may not strictly exist in those categories, making it difficult to cover everyone under any insurance plan. 

“My sense is that we, as a country, could certainly do better by having a less fragmented system that covers everybody, that’s easier for everybody to understand and wouldn’t be so complex to ordinary people,” Herring said. 

But lack of coverage isn’t the only problem America is facing. Health-care prices are rising rapidly. The Journal of the American Medical Association found that health-care spending rose about a trillion dollars from 1996 to 2015. One reason for this rise is something all countries face: the development of new biotechnology. 

“Health-care spending rises more rapidly than growth in the economy because of expensive new technology,” Herring said.

While new medical technologies are definitely a significant factor in rising health-care prices, it does not fully explain the health-care gap between the U.S. and other countries. Business Insider found that America spends the most per capita on health care when compared to 20 other leading nations in the world without better health outcomes. We are paying more for essentially the same thing, but a universal system could solve that. 

“A more unified health-care system within the U.S. would be able to reduce the relatively high prices in the U.S.,” Herring said. 

Currently, there exist many different takes on a universal health-care system. The most popular plan is mimicked off of our Canadian neighbors, a single-payer national health insurance plan, or Medicare for All. 

Going forward, my column will mainly focus on this plan as it prevails in the public discourse, though many other plans do exist. I intend to analyze the benefits and drawbacks of this plan, the price and payment strategy and finally its implementation.

There are many obstacles in the path of universal health care, but I firmly believe the question is not if America will switch to a universal health-care plan, but when and how. Health care is a human right, and it is time our policies, programs and corporations start treating it this way. 

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