A Ferrari in Every Driveway

Medicare for all won't work. Throwing cash at health insurance can't give us healthcare.

Abandoned hospital in Alamedia, CA | David Lee, Unsplash

And like clockwork, we’re already starting to hear the reasons why Medicare for All will not work. We’re starting to hear people say that we need to back off of Medicare for All. I want to be clear about something here: Medicare for All will not work. It’s a policy that’s akin to providing every American with a coupon for a free Ferrari.

The fact is, we don’t have enough Ferraris for every adult in America. At Ferrari’s current annual output of 14,000 units per year, it would take 20,000 years or so to produce enough. It wouldn’t matter if they had a coupon, because the supply of Ferraris and the capacity to build more simply don’t exist.

On Tuesday I asked you to help keep this PAC on the field, and you’re getting us closer to the $100,000 we need this week. If you haven’t thrown in yet, here’s where.

The same is true with the American healthcare system. Even though we’re projected to spend $72 trillion in the next ten years (between 2025 and 2034), we don’t have enough supply for everyone in this country. Nowhere close, in fact.

We don’t have enough doctors, dentists, nurses, phlebotomists, anesthesiologists, mental health professionals, hospitals, clinics… The supply simply does not exist. We have fewer doctors than the rest of the advanced world, 2.7 for every 1,000 people while our peers are at 3.7, and we have fewer hospital beds too. Doesn’t matter how many billionaires we tax. It doesn’t matter how many checks the government writes. Doesn’t matter how much we expand Medicare or Medicaid.

Supply isn’t there for three reasons. First, the goal of the system we have is to extract profit. It consolidates providers, makes ungodly profits for corporations and insurers, and leaves shuttered hospitals in its wake.

Second, private suppliers will always jack up costs. I’m basically paying $10,000 for a toilet seat every time I go to the doctor. Have a look at your bill, see what a Band-Aid costs, see what an aspirin costs, see how much they charged for those diapers they put on your newborn. The only way to keep these gougers in line is through competition.

Third, private organizations in the middle want low supply. Like the people at the American Medical Association who work feverishly to make sure there aren’t enough doctors in this country in order to charge higher prices. The current system is some horrific hybrid of publicly funded, privately owned monsters that are good at nothing but making money.

There is no solution that provides high-quality, highly accessible, affordable care to every American without a complete restructuring of the current system. A restructuring that ensures a production capacity high enough to meet the demand. Now, you might be thinking, “Well, that’s impossible. It’ll cost too much. We’d go bankrupt.” But that’s what is happening right now anyway. We’re on track, as I said, to spend $72 trillion over a 10-year period on healthcare alone.

And we’re already subsidizing more than half the healthcare system from our government coffers, without getting the benefits. Medical corporations reap their profits using medicines, equipment, and technology we develop with our tax dollars.

And these insane health care costs don’t just affect our access to health care. They affect our economy in so many ways. They make benefits expensive. They make retirement for workers expensive. They make companies less profitable. Most importantly, millions of us are sick because we have to choose between doctor visits or medicine and paying our bills.

I often hear people, especially conservatives, say that we should run America like a business. If any company spent 20% of its budget in such a pathetic way, they’d go bankrupt in short order.

Conservatives also like to say we’ve got the best healthcare in the world, and you’d think for our trillions we’d have a Ferrari-level system. Or at least Cadillac. But what we’ve got is a Pinto.

Sure, there are a few really high-dollar, high-value doctors, and there are a few really amazing clinics, but the overwhelming majority of us have zero access to it. None. The thing is, this disaster is so unnecessary. The healthcare system we have is not written in the Constitution. There is nothing that forces us to keep it this way other than political will and better ideas.

We can just decide to do better. We can look at every other country in the developed world and see an obvious solution: singlepayer healthcare. Prices are much more stable and affordable. Their citizens are dramatically healthier.

In Denmark and all these other places, the people also own massive portions of their healthcare delivery. Norway, Sweden, the United Kingdom: these places don’t just have a single-payer healthcare system. The people own and employ the doctors and nurses. The NHS is the largest employer in Europe, and in Denmark 97% of the hospital beds belong to the public. That way they can guarantee they have enough supply to get their people care when it’s needed.

We can choose to spend our money far more wisely and ensure access to high-quality, highly trained, highly efficient healthcare. We get to make that choice, but we can’t make it if we get stuck arguing about how we pay for it. We’re already paying for it in so many ways.

What we need to focus on is how to train enough doctors and nurses and build enough hospitals, clinics, and rural clinics. How do we make sure people aren’t driving an hour to get dialysis or two hours to give birth?

The simple answer is we build those things and run them ourselves. We pour the concrete. We lay the brick. We put in the tile. We build medical schools, training facilities, hospitals, and clinics. Much of this country was built by massive public investment in public services that were owned and operated by the government. Not by writing checks to private middlemen and self-interested corporations. It wasn’t magic. We decided what was important to us and did it. We can take back control over our own lives, if we come together and demand it.

This is the argument we’re taking across the country, on television, in mailboxes, and in the polling we field ourselves. Every dollar this week goes to keeping that machine running.

Medicare for all is the wrong solution, or only a partial solution, to the right problem. We’re going to end up with another failed attempt. We might get some compromise if we’re lucky, like a public option for health insurance, but it won’t get us a real healthcare system. Because there aren’t enough hospital beds or doctors, period.

So when you ask yourself, “What’s the solution for a better healthcare system?” understand that it’s producing the things that make that healthcare system better. The answer is good old-fashioned, “Roll up your sleeves and build it.” We have to build hospitals and train doctors ourselves.

The supply problem isn’t just limited to healthcare. It goes for housing, for childcare, for all the things we need: infrastructure, energy, transportation. If the market has failed to deliver it, our only option is to make it happen ourselves, like an Amish community raising a barn. We can raise hospitals, we can train doctors, we can build medical schools. It can be done, and you might say, “I don’t trust the government to do that. They’re too bureaucratic, they’re not fast enough or efficient enough.” But we trust the government with our foreign policy. We trust the government with nuclear weapons. We trust the government to ensure planes are safe. We trust the government to get to our house in time to put out a fire. We trust the government to protect us from being robbed. If we put our efforts into building a healthcare system that meets our needs, I assure you we can get it done.

Corbin Trent

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