Should and can the government provide healthcare for all of its citizens?

That is the question that has been at the center of the healthcare debate since it began. The modern GOP says that the less federal government interference in healthcare the better, the greater access consumers have to a wide market the better the coverage overall will be and greater freedom will be given to the consumer though a competitive market. The modern Democrats support a universal healthcare system in which the Federal Government makes sure that every American has healthcare, believing it to be a right not a privilege.

Americans are divided on the topic but not as much as one might think as in 2017 60% agreed with the claim the government is responsible to ensure health coverage as 38% disagreed. It’s becoming increasingly unpopular to hold the idea that the government has no place in healthcare and that is largely a recent phenomenon with approval for government involvement has shot up since March of last year.

The rise in popularity is especially prevalent in lower and middle class Republicans rising from 31% to 52% for the lower class and from 14% to 34% for middle class over the course of a single year. The reason for this rise is likely the same reason that Republicans who were elected in 2014 and 2016 on the promise of repealing Obamacare experienced rowdy town halls of constituents screaming at them for attempting to do just that; people realized that Obamacare provided insurance for either them or someone they cared about.

The free market is great for a lot of things, driving innovation, getting the lowest possible price to the consumer, keeping companies honest via competition. One thing it is not good at however is getting products to every single consumer in the market.

Prior to Obamacare’s implementation in 2008, a process that still took several years to fully take effect, the rate of uninsured individuals in America was around 16-18% or around 40 to 50 million people. After Obamacare was implemented that number has dropped to 10.5% or around 34 million people. A majority of those uninsured are those who either do not have employer sponsored insurance or cannot afford the premiums of insurance in the first place, employer sponsored or not.

This is where the flaw the free market of insurance comes in as companies will not provide insurance to individuals who can’t afford it, that’s basic business sense. Populations that are low income or have pre-existing conditions have poor or nonexistent profit margins for insurance companies by either getting sick too often or not being wealthy enough in the first place. Insurance makes money off of healthy people that can actually pay premiums.

This presents the United States with both a moral and financial quandary. To not have insurance is a crippling condition and degenerative condition for Americans to experience. Those without healthcare pay a larger proportion of money in comparison to their incomes “35 percent, compared with 20 percent” for their healthcare. With a larger percentage of annual income going to critical medical costs, valuable money is being taken away from household expenses such as rent, food, or utilities as the families without insurance are not those with a comfortable amount of disposable income that can be easily allocated for healthcare. Without any financial safety net uninsured individuals are “more likely than insured adults to report poor health status, delay seeking medical care, and forgo necessary care for potentially serious symptoms.”

This frugality runs an extreme danger however as “uninsured adults receive fewer screening services for cancer and cardiovascular risk factors, present with later-stage diagnoses of cancer, and experience more avoidable hospitalizations.” This lack of warning prevents “[effective] treatment of chronic illnesses such as hypertension in uninsured adults can result in substantial morbidity”.

This is the moral quandary presented as without an effort to make coverage guaranteed for all Americans, the United States perpetuates a cycle of poverty and death in those communities. And that’s not to say it makes any financial sense either. The costs of the uninsured goes far beyond the portion of the population that is uninsured. When the insured forgo preventative care and eventually need intensive medical operations they do not sit at home and merely die; they go to county hospitals for procedures they cannot afford. The costs of this uncompensated care of the hospitals is “absorbed by clinicians and facilities as free care, passed on to private insurers through cost shifting and higher fees, or paid by taxpayers through higher taxes to finance public hospitals and public insurance programs.”

People eventually get medical care but without coverage their health is still paid for by the taxpayer when they don’t have insurance. By having an uninsured population at all the United States needlessly shoots itself in the foot by forcing itself to adopt a reactive insurance model for millions of its citizens instead of a proactive one. Catching disease early is cheaper and has better return on investment than attempting to treat it in late stages as “failing to monitor or effectively treat chronic illnesses such as hypertension in uninsured adults can result in substantial morbidity and may increase the nation’s health care costs.” People don’t stop needing help just because it no longer easily offered, “public programs, including Medicare, Social Security Disability Insurance, and the criminal justice system almost certainly have higher budgetary costs than they would if the U.S. population in its entirety had health insurance up to age 65.”

The free market system selects for nothing but what is profitable for a single company, it cares little about the implications are for the country as a whole. A study by Families USA, a nonpartisan nonprofit organization, revealed “more than 26,000 working-age adults die prematurely in the United States each year because they lack health insurance” a truly horrifying and preventable statistic only made possible the hesitance of the United States to adopt a system that every other first world country in world has already.

Obamacare is by no means perfect and the same is most definitely true for it’s stripped down cousin of the American Healthcare Act but both are a dramatic improvement over the free market in the realm of healthcare. Without some government intervention Americans are going to be left behind either because of pre-existing conditions or because of their income and that is not acceptable in the richest country in the world.