By Jori Hamilton

When the coronavirus came crashing through the United States, it brought with it mass layoffs. By April 2020, unemployment was up to 14.7{dfac5e6feebc182a3317a1800a78117261554ecfb6a579338c4abc2638d58697}, the highest rate in the last few decades. With the healthcare system in the U.S. almost entirely tied to employers, the flaws of such a system have never been more clear. Unemployment causes loss of healthcare, and amid a pandemic, arguably little is more important than access to quality medical assistance.

Before the pandemic had even emerged, however, the trend in national discourse towards a single-payer healthcare system made significant headway. Often referred to by names like Medicare for All, such reform would ensure that every American, regardless of status and employment, would be entitled to health coverage funded by tax dollars. With nearly every Democratic presidential candidate proposing some form of healthcare reform and some pushing a single-payer system exclusively, a reassessment of the way the United States manages healthcare appears all but inevitable.

Now, we face a pandemic that has highlighted and exacerbated the problems with our healthcare system. Mass unemployment has added to the inequalities already present making a strong case for single-payer healthcare, both in and out of emergency healthcare situations. 

The Existing Inequality

Inequality has always been an issue within healthcare systems, but in the U.S., the association of healthcare with one’s employer has created gaps in coverage. Social programs like Medicare and Medicaid exist to close these gaps, though they are often not substantial enough to provide healthcare coverage to everyone. 

As a result, we have a system in which inequality flourishes, medical debt ruins lives, and people are dying, too afraid to go to the doctor due to the associated costs. 

This inequality shows itself across many demographics. Those with quality access to affordable healthcare are disproportionately white, wealthy, and male. African Americans, for example, have an uninsured rate of 9.7{dfac5e6feebc182a3317a1800a78117261554ecfb6a579338c4abc2638d58697} compared to the 5.4{dfac5e6feebc182a3317a1800a78117261554ecfb6a579338c4abc2638d58697} rate of whites. Meanwhile, the U.S. has higher rates of poverty and income inequality than in many comparable nations, stressful factors which contribute to increased rates of high blood pressure, heart disease, mental illness, and obesity. This disparity and the associated costs have created a reality in which 28{dfac5e6feebc182a3317a1800a78117261554ecfb6a579338c4abc2638d58697} of working Americans owe over $10,000 in medical debt, with that debt being the cause of half of all bankruptcy filings. 

When it comes to healthcare, gender bias affects women all the time, resulting in the following disparities:

• Women have more medical costs
• Women face unequal representation in care and clinical trials
• Women receive poorer care
• Women experience discrimination and disbelief

At the same time, issues of reproductive rights and trans inclusion are not represented fairly and equally across the nation, with states maintaining various laws that subject people to discrimination and restrict their access to healthcare. 

How Single-Payer Healthcare Could Solve our Problems

A single-payer healthcare system can ensure that even those who lose their jobs and suffer from the effects of a pandemic can receive treatment without undue stress and life-altering financial burden. We have seen these results through existing Medicare and Medicaid programs. By adopting a fully single-payer system, we can better spread equitable solutions to all Americans.

How Medicare and Medicaid Help

Currently, Medicare and Medicaid programs provide care for members of the community who are locked-out or at risk of not being able to obtain coverage through employers. These programs, despite sound largely similar in name, differ in their intended demographic. 

Medicare exists for individuals over 65 as well as some who are dealing with documented disabilities. Medicaid, on the other hand, is targeted towards providing care for those who cannot afford insurance and are not provided insurance through their employer. These groups are often made up of those working one or more service positions part-time, industries in which women commonly represent the majority of the workforce. 

Medicaid and Medicare are programs that are both popular and already integrated into the system. And while stigma may surround those using Medicaid, little seems to exist around Medicare due to its widespread and vital nature. 

Single-Payer Solutions

But COVID-19 has proven the same necessity exists for a universal healthcare system not tied to employers. While the pandemic has forced shutdowns and mass unemployment, healthcare is essential. Without it, Americans will die and even more will go into massive debt. This should not be the future of a modern democratic nation. 

Instead, a single-payer healthcare system could reduce the levels of inequality across the board. By ensuring coverage to every American through removing the cost gap of traditional insurance, such a system can close the racial gap that exists in health coverage demographics. 

Similarly, the cost disparity would be spread evenly across taxpayers. The current system places a disproportionate burden on women. With a single-payer system, costs are covered through public funding acquired through taxation. This means higher taxes for some, but reduced healthcare costs in terms of insurance premiums, co-pays, and out of pocket expenditures. 

Additionally, federal provisions could provide an umbrella of care solutions. In many states that lack reproductive and trans-inclusive coverage, this may enable care for minority groups that are currently underrepresented, making healthcare more inclusive. At the same time, the universality of care created by a single-payer system would help end the welfare stigma for those currently on Medicaid and other healthcare assistance programs. 

Amid the pandemic, the rise in unemployment pushed millions off their insurance, leaving them to fall within the coverage gap and subjecting them to a lack of care or high medical costs. At a time when a dangerous virus threatens lives, this lack of care could mean the deaths of many Americans. Single-payer healthcare removes the need for a frantic attempt to patch the system to accommodate the dangers. With an existing social network in place, every American gets the care they need without incurring life-damaging expenses. 

Even hospitals and care providers are struggling during the pandemic. Hospital resource management requires an educated balance of predictable sources like elective procedures and routine appointments. The pandemic disturbed this balance, causing hospitals to lose revenues that help them maintain care. A single-payer healthcare system can operate to retain this balance even in emergency circumstances by funding hospitals with a network of resources. Most substantial of these is the reliability of federal payments versus the unpredictability of individual debts. If a less fortunate individual is stuck with a high medical bill, they will not be able to pay and healthcare providers will lose money. Single-payer healthcare prevents this from happening. 

A Case for Equity

Employer-based healthcare amidst the pandemic proved the need for a single-payer system that covers all Americans regardless of their situation. Long before the pandemic, inequalities ran rampant across the healthcare industry. Despite the debate about the efficacy of a single-payer system, it is a fact that inequality could be reduced with a program like Medicare for All, taking the burden from minorities, the poor, the unemployed, and women across the nation.

In the throes of a global pandemic causing both unemployment and necessary medical intervention, we should be taking every opportunity to discuss equitable solutions for the future. Single-payer healthcare is one such solution, one that is making more sense with every passing day.