America’s healthcare crisis is no longer a mystery, and it is certainly not a problem of insufficient wealth. We are spending enough to cover everyone, yet Americans still go bankrupt, postpone treatment, remain reluctant to leave jobs because doing so could mean losing health insurance, and die because care is priced beyond their reach. The real scandal is that we know how to build a better system, and yet we continue choosing not to.
A Yale-led preprint modeled a national public insurance program similar to Medicare for All and estimated that it could reduce annual national health expenditures by $1.04 trillion, or nearly 20 percent of 2024 spending. The model projected that universal coverage itself could avert about 62,900 deaths annually. Its central projection is eye-catching: the researchers estimate that America could provide universal coverage while spending less overall than it does today.
According to Centers for Medicare & Medicaid Services (CMS) data, national health expenditure reached $5.3 trillion in 2024, 0r 18 percent of GDP. The American Hospital Association estimates that administrative staff and technology account for 25 percent to 35 percent of all healthcare spending. Critics argue that this fragmented system can prioritize corporate interests over patient care, leaving many working-age adults underinsured and leading many to delay or forgo needed medical care due to high out-of-pocket costs, which can contribute to preventable deaths every year.
That should infuriate every American, regardless of party or ideology. And healthcare is only one part of the larger emergency. You cannot create a healthy society while people lack nutritious food, stable housing, quality education, worker rights, or the economic security necessary to live with dignity.
Even the finest healthcare system will be forced to treat the consequences of a society that keeps making people sick. This is why I have grown increasingly frustrated with the way our movements operate. Organizations fighting for healthcare, housing, food security, education, labor rights, and democratic reform too often work in separate silos, competing for scarce resources while the profit-first medical industries continue to expand their stranglehold on our healthcare system.
Meanwhile, corporate and billionaire money exerts extraordinary influence over both major political parties, narrowing the boundaries of what elected officials are willing to fight for. Bold reforms are routinely dismissed as unrealistic, not because they cannot work, but because they threaten entrenched power. If we accept that arrangement, the future is not difficult to predict.
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