Why are we the only developed country without universal healthcare?
If you’ve been following U.S. politics at all, you’ve probably heard the terms “Medicare for All” or “Universal healthcare (UHC)” at least once. Progressive politicians and activists promote it while Conservatives and establishment politicians demonize it.
The Facts
Almost 45,000 Americans die every year because they lack access to health insurance.
The United States is the only developed country that does NOT provide universal healthcare for its citizens.
The U.S. could provide universal healthcare if corrupt politicians didn’t take money from or own stock in private health insurance and drug companies. Pharmaceutical companies pay members of Congress not to change our healthcare system.
So what is Universal healthcare? How has support of the change progressed? (If you’re a progressive, you already know all of this. This page exists to educate people who aren’t familiar with the concept of universal healthcare).
People may have been exposed to it by media pundits or podcasters who bash it for being “woke” or who lie about it “costing too much,” when, in reality, Medicare for All would save the country billions of dollars every year.
Let’s talk about where it started and where the movement is now.
The Birth of an Idea
While universal healthcare might seem like a new “woke” concept, it has existed in American politics for over a century. President Theodore Roosevelt included it in his platform way back in 1912!
He believed a ‘strong country requires healthy people.’
The modern Medicare for All movement kicked into high gear during Bernie Sanders‘ 2016 presidential campaign, when he made it a cornerstone of his platform.
His idea builds on Medicare, the popular government health insurance program for seniors that’s been around since 1965.
The basic concept? Expand Medicare coverage to everyone, regardless of age. Treat healthcare as a basic human right. We have over 40,000 people dying every year in this country because they don’t have access to health insurance.
In the wealthiest country in the world, with state-of-the-art medical facilities, citizens are dying only because they don’t have health insurance.
In America, you can’t get, or afford, medical care without insurance. The amount of medical debt crippling American households is staggering.
The U.S. also ties health insurance to employment—possibly to force Americans to remain in the workforce until they have access to Medicare at age 65 (Republicans are working to raise the retirement age).
So, if you don’t have a job and can’t afford the high premiums for private health insurance, you’ll die if you get a terminal illness or are seriously injured.
Because health insurance is required to access medical care, it should be a basic right of all Americans: access to healthcare. That’s where Medicare For All comes in.
Sanders made the concept less complex and hassle-free by combining universal healthcare and a government health insurance program that already exists. The government simply has to give all Americans access to Medicare, not just people who are over age 65 or have certain disabilities.
This simplification is perfect for a government that likes to deny progressive policy proposals with the excuse that they’re “too complicated. ” There’s already a fully staffed department of federal workers managing Medicare plans (2025 update: not after DOGE) and a national network of doctors that accept the insurance.
The switch to a universal healthcare system would be as simple as announcing, “All citizens have Medicare now”.
The problem: federal employees are currently using antiquated computer systems and procedures that might not be prepared to handle the sudden increase in Medicare recipients. Centers for Medicare & Medicaid Services (CMS) would need to update the outdated equipment and procedures prior to the switch.
What Would Medicare for All Actually Do?
Picture this: You wake up feeling sick. Instead of wondering whether you can afford to visit the doctor or if they’re “in-network,” you just…
GO. No premiums, no deductibles, no copays. That’s the core concept of Medicare for All.
Here’s what that would mean in practice:
Every American would have comprehensive health coverage.
All essential medical services would be covered (think doctor visits, hospital stays, prescription drugs, mental health care, dental, vision – the works).
Private insurance companies would be largely eliminated from the healthcare equation.
Healthcare would be funded by our taxes instead of paying premiums and out-of-pocket costs.
(I should tell you this: In countries with universal healthcare (and other great policies), citizens pay higher taxes. However, people living in those countries say that it’s worth it when you consider how much money you save on doctor visit copays, prescription copays, and health insurance premiums).
Where Are We Now?
Here’s the truth: Universal healthcare faces some pretty steep hurdles. While polls show that a majority of Americans support the basic concept of universal healthcare, getting there is complicated.
The healthcare industry makes up about one sixth of the U.S. economy, and changing that system in a capitalist country is like trying to turn a cruise ship around in a swimming pool – it’s not exactly easy. Insurance companies, some healthcare providers, and many politicians have pushed back hard against the idea.
As of 2025, we’ve seen some movement at the state level. States like California and Vermont have explored their own versions of single-payer healthcare (another term used for universal healthcare), though they’ve run into funding and implementation challenges.
At the federal level, while Medicare for All legislation has been introduced in Congress, it hasn’t made it to the floor for a vote.
What’s Next?
The conversation surrounding Medicare for All isn’t going away anytime soon. More Americans are struggling with medical debt than ever before, and healthcare costs keep rising. In 2021, Americans had at least $220 billion in medical debt. While full Medicare for All may not be right around the corner, we’re seeing growing support for expanding healthcare access through other means:
Lowering the Medicare eligibility age.
Creating a public option to compete with private insurance.
Funding Medicaid and Medicare by lifting the cap on people making over a certain amount per year who are no longer taxed. Billionaires are able to avoid paying Medicare taxes.
Expanding Medicaid coverage The federal government will sometimes send funding to states for them to expand access to health insurance. (Some Republican governors refuse to expand Medicaid in their states. Instead, they send back the federal funding that would have given more people access to health insurance. (It makes absolutely no sense to refuse to implement programs when you’ve been provided with the funding to do so).
Republican governors aren’t refusing to expand access to Medicaid because they don’t need it. Red states have the highest number of uninsured citizens in the country. Yet, people continue to vote for a party that is actively refusing to provide health insurance to the most vulnerable.
Why do they do this? It’s nuanced, but it boils down to two main reasons: Republican governors and legislatures don’t want to accept anything from the federal government when a Democrat is in the White House (petty and childish) and they also don’t want to interfere with the conservative agenda: Keep them stupid and poor. A poor, sick, and uneducated population is much easier to control.
Americans pay taxes to the government. Members of Congress will refuse to implement certain policies meant to help the American people because they don’t want to spend our money on anything that will benefit us.
Remember Senator Kirsten Sinema’s thumbs-down “curtsy” when she voted against a bill that would raise the minimum wage to $15?
It’s our money the government is using to fund everything.
When it comes to foreign wars or the Defense budget, they will approve trillions of dollars in funding. They only complain about spending when it’s something that will improve the lives of the average American.
In a democracy, the people are supposed to make decisions about what they want, and their wishes are relayed to Congress through their state and local representatives. They’re called Representatives because Americans elect the person they want as their voice in Congress.
That’s obviously not the way it’s working when you see that 70% of the country supports universal healthcare.
Republican-led states have the highest rates of uninsured people living in the state.
Yet those people continue to vote Republicans back in charge.
Strengthening the Affordable Care Act (Donald Trump and Republicans have been trying to repeal it for years, especially the policy barring health insurance companies from denying someone coverage because of pre-existing conditions. Speaker Mike Johnson told a crowd that Republicans would definitely get rid of the ACA if Trump won the 2024 election. And he did.
The Bottom Line
Whether you’re all in on Universal Healthcare or skeptical about making the change, one thing’s clear: our healthcare system needs work.
The debate over Medicare for All has pushed important questions about healthcare access and affordability into the spotlight. Luigi Mangione ignited a national debate about the current state of healthcare in the United States.
So what happens next? That’s up to voters, activists, and politicians to figure out. But at least now you know what everyone’s talking about when Medicare for All comes up at the Thanksgiving dinner table.
Want to learn more? Check out official government sources or healthcare policy research organizations for the latest developments in healthcare reform.
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