Myth #1: USA has the best healthcare in the world!!
Fact: USA spends far more in healthcare (18% of gross domestic product) than any other nation in the world.1,2 Despite that, USA ranks below 30 countries for many public health indicators, including preventable deaths,3 infant survival,4 maternal mortality,5 and overall life expectancy.6
Private insurance companies maximize profit by minimizing short-term costs which inherently impedes prioritization of long-term health.7 Shortsighted cost cutting catalyzes a cascade of longer-term health and financial repercussions over the lifespan of a patient.
Canada spends 2X more per capita on prevention (6.2%) as a share of total health expenditure compared to the USA (2.8%).8 This is startling in light of elevated prevalence of chronic diseases in the USA.
US men have 28% higher mortality rate from cardiovascular disease compared with Canadian men9
- Organization for Economic Co-operation Development. OECD Health Statistics 2015. 2015. https://www.oecd-ilibrary.org/ social-issues-migration-health/data/oecd-health-statistics_healthdata-en (accessed March 27, 2019).
- Centers for Medicare and Medicaid Services. NHE Fact Sheet. April 17, 2018. https://www.cms.gov/research-statistics-data-andsystems/statistics-trends-and-reports/nationalhealthexpenddata/ nhe-fact-sheet.html (accessed June 8, 2018).
- GBD 2015 Healthcare Access and Quality Collaborators. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015. Lancet 2017; 390: 231–66.
- Central Intelligence Agency. The World Factbook. May 16, 2007. https://www.cia.gov/library/publications/the-world-factbook/ rankorder/2091rank.html (accessed June 7, 2018).
- GBD 2015 Maternal Mortality Collaborators. Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1775–812.
- World Health Organization. World Health Statistics 2017: Monitoring Health for the SDGs, Sustainable Development Goals. WHO, 2017. https://www.who.int/gho/publications/world_health_ statistics/2017/en/ (accessed March 27, 2019).
- Galvani AP, Parpia AS, Foster EM, Singer BH, Fitzpatrick MC. Improving the prognosis of health care in the USA. Lancet. 2020;395(10223):524-533. doi:10.1016/S0140-6736(19)33019-3
- Gmeinder M, Morgan D, Mueller M. How much do OECD countries spend on prevention? OECD Health Working Papers 2017; published online Dec 15. DOI:10.1787/f19e803c-en.
- Cardiovascular Disease and Diabetes: Policies for Better Health and Quality of Care | READ online. OECD iLibrary. June 17, 2015. https://read.oecd-ilibrary.org/social-issues-migration-health/ cardiovascular-disease-and-diabetes-policies-for-better-health-andquality-of-care_9789264233010-en (accessed July 2, 2019).
Myth #2: A single payer system will restrict provider selection by patient!
Fact: A single-payer system will integrate all providers under a unified financial framework.1 This restructuring will lead to:
Erasure of in-network and out-of-network distinctions and the issue of healthcare providers declining to accept individuals based on their insurance status
Dramatic expansion of patient's choice
Elimination of system fragmentation that arise from employment transition. This means patients will have access to healthcare even when they lose their employment
A single payer system will EXPAND provider selection by patient!
- Galvani AP, Parpia AS, Foster EM, Singer BH, Fitzpatrick MC. Improving the prognosis of health care in the USA. Lancet. 2020;395(10223):524-533. doi:10.1016/S0140-6736(19)33019-3 nf
Myth #3: Uninsured individuals have opted not to pay for health insurance because they are in less need of it!
Fact: Although this statement is empirically supported by the disproportionate high number of young people (who are uninsured), studies have shown that uninsured people are more likely to have undiagnosed comorbidities and conditions that requires increased use of healthcare resources when compared with insured people1
38 million Americans tend to forego necessary treatments and prophylactic treatments.2 Uninsured individuals use healthcare services at 50.1% of the rate of those with adequate insurance3
41 million Americas are termed underinsured as their insurance plans come with high deductibles and copays.4 Underinsured individuals use healthcare services at 86% of the rate of those with adequate insurance5
Underinsured people with cancer have a 17% increased risk of metastasis and 30% increased risk of death compared with insured patients6
- Berchick ER, Hood E, Barnet JC. Health insurance coverage in the United States: 2017. Sept 12, 2018. https://www.census.gov/library/ publications/2018/demo/p60-264.html (accessed Jan 14, 2020).
- United States Census Bureau. Annual estimates of the resident population for selected age groups by sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2017 2017 population estimates. Feb 18, 2018. https://factfinder.census.gov/bkmk/table/1·0/en/PEP/2017/ PEPAGESEX (accessed Jan 4, 2020).
- Coughlin TA. Uncompensated care for the uninsured in 2013: a detailed examination. May 30, 2014. https://www.kff.org/ uninsured/report/uncompensated-care-for-the-uninsured-in-2013-adetailed-examination/ (accessed March 27, 2019).
- Collins SR, Gunja MZ, Doty MM. How well does health coverage protect consumers from costs? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016. Oct 11, 2017 http://www.commonwealthfund.org/~/media/files/publications/ issue-brief/2017/oct/collins_underinsured_biennial_ib.pdf (accessed jan 4, 2020).
- Brot-Goldberg ZC, Chandra A, Handel BR, Kolstad JT. What does a deductible do? The impact of cost-sharing on health care prices, quantities, and spending dynamics. Q J Econ 2017; 132: 1261–318.
- Aizer AA, Falit B, Mendu ML, et al. Cancer-specific outcomes among young adults without health insurance. J Clin Oncol 2014; 32: 2025–30.
Myth #3: Medicare and Medicaid are both unpopular programs!
Fact: The Kaiser Family Foundation(KFF) reported in 2015 that the public viewed both Medicare and Medicaid as important government programs1
More than three-quarters (77 percent) said Medicare is a very important program, ranking just below Social Security (83 percent)
More than six in ten (63 percent) said Medicaid is very important
Surveys dating back to 1999 have found similar opinion about the importance of both programs
Support was broad among party lines among people aged 65 and older (85 percent of Republicans, 89 percent of independents, and 92 percent of Democrats favor Medicare)
- Kaiser Family Foundation. Medicare and medicaid at 50. July 17, 2015. https://www.kff.org/medicaid/poll-finding/medicareand-medicaid-at-50/ (accessed Jan 8, 2019).
Myth #4: It will be far more expensive to implement a single-payer system
Fact: Based on the 2017 federal report of national healthcare spending by Centers for Medicare and Medicaid Services, proposed changes implementing a single-payer system will ultimately save $687 Billion.1