America pays more for worse healthcare because corporate middlemen extract wealth from illness. Medicare for All offers universal care at a lower total cost.
Summary
America does not suffer from a shortage of healthcare dollars. It suffers from a wasteful financing system that diverts those dollars into corporate profits, executive compensation, marketing, billing warfare, network manipulation, and claim denials.
- The United States spent $5.3 trillion—$15,474 per person—on healthcare in 2024, consuming 18% of the entire economy.
- Private insurance spending rose 8.8% to $1.64 trillion, while families still paid another $556.6 billion out of pocket.
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Employer-sponsored family premiums reached $26,993 in 2025, with workers directly contributing an average of $6,850.
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The Congressional Budget Office found that single-payer reform would eliminate premiums, reduce out-of-pocket costs, and substantially cut administrative waste.
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Nearly two-thirds of Americans now say the federal government should guarantee healthcare coverage for everyone.
Medicare for All would not create a new healthcare bill. It would replace today’s bloated private taxes—premiums, deductibles, copays, surprise bills, and lost wages—with a smaller, fairer, publicly accountable contribution. Healthcare belongs to patients and medical professionals, not Wall Street.
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Medicare for All Is Not Radical—Paying More for Less Is Radical
America must stop debating healthcare as though the country has not already conducted the experiment.
The experiment has lasted for decades. It placed private insurance corporations between patients and medical professionals. It allowed investors, executives, consultants, pharmacy benefit managers, hospital conglomerates, and corporate middlemen to extract money at nearly every point in the healthcare process.
The result speaks for itself.
In 2024, the United States spent $5.3 trillion on healthcare. That equals $15,474 for every person in the country and 18% of the entire American economy. Private health insurance spending alone climbed 8.8% to more than $1.64 trillion. Americans then paid another $556.6 billion directly out of pocket.
That is not efficiency. That is organized economic extraction.
The United States pays more than every comparable wealthy nation, yet the Commonwealth Fund continues to rank the American system last overall among the wealthy countries it studies. America performs particularly poorly on access, equity, administrative efficiency, and health outcomes. Patients and physicians face some of the heaviest billing and payment burdens in the developed world.
Private insurance defenders want Americans to believe that the market creates efficiency. But the structure of the industry makes that claim absurd.
A private insurer must collect premiums, evaluate risk, design multiple plans, negotiate separate networks, advertise its products, pay sales commissions, maintain proprietary databases, compensate executives, reward investors, challenge claims, process appeals, police prior authorization, and preserve a profit margin.
None of those activities gives a patient an examination.
None sets a broken bone.
None performs surgery.
None discovers a cure.
None comforts a frightened family.
The insurance company does not deliver healthcare. It finances healthcare while charging patients and medical providers for the privilege of standing between them.
A universal public plan would still process claims, detect fraud, maintain records, establish payment rules, and manage budgets. But it would not need hundreds of competing corporate bureaucracies duplicating the same functions while fighting one another over networks, formularies, market share, risk pools, and profit margins.
That duplication infects the entire system.
Every private insurer maintains its own contracts, rules, codes, forms, provider directories, drug lists, appeal procedures, and authorization requirements. Hospitals and doctors must hire armies of workers simply to determine what each insurer will cover and how each insurer wants the bill submitted.
Medical professionals did not enter healthcare to become insurance negotiators. Yet the American system forces them to spend time and money navigating a maze deliberately built around corporate fragmentation.
The Congressional Budget Office reached the obvious conclusion: under illustrative single-payer systems, household premiums would disappear, out-of-pocket expenses would fall, and administrative spending would decline. CBO estimated that lower healthcare administration could free resources equal to roughly 1.8% of gross domestic product.
That is the real Medicare for All dividend.
The opposition immediately shouts, “Your taxes will rise.”
That sentence constitutes one of the most dishonest arguments in American politics because it discusses the public payment while hiding all the private payments that the public payment replaces.
A worker with employer-sponsored insurance already pays a healthcare tax.
Part of it appears openly as a payroll deduction. Another part hides inside the compensation the employer sends to an insurance company instead of placing it in the worker’s paycheck. The worker then pays deductibles, copays, coinsurance, uncovered services, out-of-network charges, prescription costs, and sometimes medical debt.
In 2025, the average employer-sponsored family insurance premium reached $26,993. Workers contributed an average of $6,850 directly from their paychecks, while the employer paid the remainder as part of the employee’s compensation package.
Call it a premium. Call it a benefit. Call it an employer contribution. The money still comes from the economic value created by workers.
It is a private tax collected by an unaccountable corporation.
Under Medicare for All, most families could pay a smaller, progressive public contribution and eliminate the larger private extraction. The relevant question is not, “Will someone pay a tax?” The relevant question is, “What will the family pay in total, and what will the family receive?”
Will the family pay more or less after premiums disappear?
Will the family pay more or less after deductibles disappear?
Will the family pay more or less after copays disappear?
Will the family gain the freedom to visit any qualified doctor or hospital?
Will workers keep their healthcare when they change jobs, start a business, get laid off, move to another state, or develop a serious illness?
That is the honest comparison.
Private insurance also imposes a destructive contradiction. The insurer promises access to care while maximizing profit by controlling the money spent on care. Every dollar paid for treatment becomes a dollar the company cannot retain for administration, executive compensation, reserves, acquisitions, or investor returns.
That does not mean every insurance employee acts maliciously. It means the institution gives decent people an indecent assignment: protect corporate finances by restricting payment for healthcare.
Investors expect growth. Executives promise earnings. Analysts demand margins. But a human body does not produce quarterly growth on Wall Street’s schedule. The system therefore raises premiums, narrows networks, increases deductibles, shifts costs, consolidates markets, pressures providers, and develops new techniques to manage—or deny—utilization.
The prices patients encounter often bear little relationship to the underlying cost of producing care. They reflect negotiated leverage, market concentration, administrative complexity, and the need of multiple corporate actors to extract revenue from the same illness.
That is the healthcare price circle of death.
Prices rise. Premiums rise to cover the prices. Deductibles rise to restrain use. Patients delay care. Their conditions worsen. More expensive emergency treatment follows. Employers absorb higher benefit costs. Workers lose wage growth. Government subsidies rise. Corporate revenues continue growing, and the cycle begins again.
Meanwhile, nearly half of adults say affording healthcare is difficult. Even among insured adults, 42% report difficulty paying healthcare costs. About one in twelve adults carries medical debt from care received by themselves or their families.
This is not an abstract policy dispute. People skip medication. They delay tests. They ration insulin. They remain in jobs they hate because a child needs coverage. They postpone retirement. They drain savings. They use credit cards to pay hospital bills. Some discover that the insurance card in their wallet does not guarantee affordable care.
In 2024, almost 39% of uninsured adults delayed, skipped, or went without needed treatment or medication because of cost. Even 17% of privately insured adults reported doing so.
Insurance without affordable access is paperwork masquerading as security.
The public understands the broader principle. Gallup reported in late 2025 that 64% of American adults believe the federal government bears responsibility for ensuring healthcare coverage for everyone—the highest level since 2007.
Still, reformers must explain Medicare for All more effectively.
They must stop allowing opponents to compare a visible public tax with an invisible mountain of private charges.
They must present the complete ledger.
On one side: a progressive, transparent contribution based on the ability to pay.
On the other: premiums, employer contributions, deductibles, copays, coinsurance, out-of-network bills, medical debt, administrative waste, denied claims, restricted doctors, and fear.
Medicare for All does not mean that government would employ every doctor or own every hospital. It means the public would finance medically necessary care through one universal system, much as Medicare already pays private doctors and hospitals today.
Patients would still choose medical professionals. Doctors would still practice medicine. Hospitals would still provide care. But the insurance gatekeeper would lose its power to monetize illness.
Healthcare is not a normal consumer product. A person having a heart attack cannot shop calmly among competing emergency rooms. A parent whose child has cancer cannot walk away from the market until prices decline. A patient under anesthesia cannot negotiate.
The patient needs care. That need creates enormous power for whoever controls access. A civilized society must place that power under democratic rules—not hand it to corporations legally obligated to advance their own financial interests.
The excuses for maintaining the present system have become morally indefensible.
A structure that predictably blocks necessary care, bankrupts families, burdens doctors, suppresses wages, and wastes national wealth should not receive endless protection merely because powerful companies profit from it.
Medicare for All represents fiscal discipline.
It represents economic freedom.
It represents labor freedom because workers would no longer depend on an employer for medical security.
It represents entrepreneurial freedom because people could start businesses without gambling their family’s healthcare.
It represents medical freedom because doctors could treat patients instead of wrestling with hundreds of corporate rulebooks.
And it represents human freedom because no person should face financial ruin for getting sick.
America already pays for universal healthcare. It simply does not receive it.
The country must stop paying Wall Street prices for rationed care and start financing healthcare as a public good. Replace the private tax with a fair public contribution. Eliminate premiums, deductibles, copays, restrictive networks, and medical bankruptcy.
Take the money already in the system, remove the profiteering middlemen, and deliver healthcare to every person. That is not radical. That is rational.
