Suddenly, In Plain Sight

Ironic, isn’t it, how an invisible enemy can make a chronic weakness so plainly apparent?

If ever there’s a time when it is obvious how unwise it is to have health insurance for American families tied to employment, now is that time. Here we are in the midst of the coronavirus pandemic, and millions of Americans are losing their jobs. Economists predict 20 percent or more of the workforce could be unemployed before long. When the cause of job loss is a public health crisis, insurance coverage is disrupted right when it’s needed most.

It’s nuts to hold on to a system that puts the health of millions of Americans—especially those working in retail, the service sector and the gig economy—at the mercy of harsh new economic realities, one of which is the need to change jobs much more frequently than in the past.

It’s nuts to keep a system that puts American manufacturers at a profound competitive disadvantage because they have health insurance costs on their ledgers and so many of their overseas rivals do not. It’s nuts that the system we have now adds thousands of dollars to the cost of making cars in this country. It’s nuts that more of the cost of each of those cars is health insurance than steel.

It’s nuts to preserve a system that traps people in dead-end jobs they can’t afford to leave because that’s how their families get health insurance, even when they have lifelong dreams of starting their own businesses that could employ countless others and boost the economy.

It’s nuts to stubbornly stick with a system with administrative costs twice as high as the global average.[1] It’s nuts that compared to the rest of the world, more of our health care dollars pay for paperwork, and less of the spending goes for patient care. That’s because we have a multi-payer system forcing health care providers to submit claims for payment to dozens of different insurance companies, which profit from the transactions. This is why the U.S. has the least efficient health care system among 11 of the world’s richest nations.[2]

It’s nuts that we spend more on health care and get less.[3] It’s nuts that we refuse to replace the multi-payer system we have now with a single-payer system like Medicare for All when doing so would save $2 trillion over 10 years according to one study[4] and more like $5 trillion according to another analysis.[5]

All Americans should be allowed to benefit from the fact that Medicare does a far better job of controlling costs and is much more administratively efficient than the rest of the U.S. health care system.[6] All Americans should have affordable and high-quality health coverage, whether we are between jobs or have no choice but to change occupations or have fallen on hard times. Hard times brought on, for example, by a pandemic.

It’s nuts that it takes something we can’t see to finally bring these realities into plain sight.

Mike McCabe

March 31, 2020

[1] Alanna Petroff, “U.S. health care admin costs are double the average,” CNN Business, January 11, 2017,

[2] Ryan Gamlin, “Administrative costs are killing U.S. health care,” Medical Economics, May 21, 2016,

[3] Lisa Du and Wei Lu, “U.S. Health-Care System Ranks as One of the Least-Efficient,” Bloomberg, September 28, 2016.

[4] Charles Blahous, “The Costs of a National Single-Payer Healthcare System,” Mercatus Center at George Mason University, July 30, 2018,

[5] Jake Johnson, “‘Easy to Pay for Something That Costs Less’: New Study Shows Medicare for All Would Save U.S. $5.1 Trillion Over Ten Years,” Truthout, December 1, 2018,

[6] Diane Archer, “Medicare Is More Efficient Than Private Insurance,” Health Affairs, September 20, 2011,