Should the US Adopt a Nationalized Health Care System?

Government Health Care Shopping Websites Failing to Help Consumers. Adam Berry/Getty Images

Should the United States adopt a nationalized health insurance plan or universal Medicare, in which doctors, hospitals, and the health care delivery system would be under the control of the federal government?


Health insurance remains an unobtainable luxury to over 43 million U.S. citizens. Millions more live on the edge with only minimal, limited coverage. As health care costs continue to soar, and the overall health of Americans remains relatively poor compared to similar industrialized nations, the masses of the uninsured will continue to grow.

Health care spending increased 7.7 percent in just one year during 2003 -- four times the inflation rate.

Seeing their health insurance premium costs grow by about 11 percent yearly, many U.S. employers are dropping their employee health care plans. Health coverage for an employee with three dependents will cost an employer about $10,000 per year. Premiums for single employees average $3,695 a year.

Many suggest that America's health care solution is a nationalized health plan, under which medical care for all citizens would be paid for by the federal government and provided by doctors and hospitals regulated by the government. What are the good and not-so-good points of nationalized health care? 


  • Nationalized health insurance would reduce the cost of American-made consumer products. Employers naturally pass the soaring costs of providing employee health insurance on to consumers. The result? U.S. consumers pay more and the nation's ability to compete in global trade is reduced. Products from countries with nationalized health care simply cost less.
  • Nationalized health insurance would be good for U.S. employees. The resulting reduction in the cost of American-made goods would help U.S. companies compete in global trade, thus keeping more jobs at home. Workers would gain job mobility. Too many Americans stay in jobs they dislike or hesitate to start their own businesses out of fear of losing their health insurance. Employer-provided health insurance tends to stifle innovation.


  • Nationalized health insurance does not ensure equal access to the health care system. Elderly people in Canada and the United Kingdom report much more difficulty in obtaining health care than U.S. seniors. While New Zealand's guidelines for treatment of end-stage renal failure imply that age should not be the sole factor in determining eligibility, they state that "in usual circumstances, people over 75 should not be accepted." To the terminal misfortune of that nation's elderly renal failure patients, New Zealand has no private dialysis facilities.
  • Removing the medical sector from the free enterprise system tends to reduce the overall quality of health care. Study-upon-study has shown the quality of health care is typically higher in the U.S. than in any other nation, including those with nationalized health insurance. The United States has lower breast and prostate cancer mortality rates than New Zealand, the United Kingdom, Germany, Canada, France, and Australia.
  • Germany, Sweden, and Australia are now establishing free-market alternatives in an attempt to alleviate problems caused by their nationalized health care systems. Indeed, these countries are learning that the best course for the provision of quality health care is not more patient power rather than more government power.

Where Nationalized Health Care Stands

A recent national survey conducted by the American Consumer Institute showed that American consumers are split in their support of a nationalized health plan in which doctors and hospitals would be under federal government control. According to the survey, 43% would favor such a plan, compared to 50% who would oppose the plan.

The survey showed that Democrats are more likely than Republicans to favor a nationalized plan (54% vs. 27%). Independents mirror the overall numbers (43% favor). African Americans and Hispanics are more likely to favor a nationalized health plan (55%), compared to just 41% of the Caucasians and just 27% of the Asians. The survey also suggests that affluent consumers (31% for households earning over $100,000) are less apt to support a national health plan, compared to lower income consumers (47% for households earning below $25,000). According to Anne Danehy, an expert for the Institute and President of Strategic Opinion Research, "the survey reflects wide differences of opinion among consumers, suggesting that policymakers will struggle to find consensus on how best to deal with these important national issues."

The Medicare for All Act of 2019

On February 27, 2019, U.S. Rep. Pramila Jayapal [Democrat, WA] introduced the Medicare for All Act of 2019. If enacted, the would place all Americans, regardless of age or medical condition under a Medicare-like health insurance plan within two years.

The Medicare for All plan would ban employers from offering their employees private insurance plans to compete with Medicare. While there would be some government subsidized charges for prescription drugs, there would be no out-of-pocket cost for medical care. Along with all other existing Medicare benefits, the plan would cover long-term home nursing care and prep- and post-abortion care. Existing Medicare and Medicaid enrollees would also be transitioned onto the new plan, but the Veterans Health Administration and the Indian Health Service would continue to offer their own health care plans.

Various House Democrats had introduced the Medicare for All Act every year since 2003 but garnered a record number of Democrat co-sponsors in 2017. While the 2019 version has little immediate chance of passing, especially in the Republican-controlled Senate, it will inevitably help mold the future reformed U.S. health care system.  

Congress has taken no action on the Medicare for All act since December 10, 2019, when it was referred to the House Energy and Commerce Subcommittee on Health, meaning it is unlikely to ever come to the floor of the House. 

However, on July 1, 2021, almost 80 House members, led by Texas Democrat Rep. Lloyd Doggett, introduced the Medicare Dental, Vision, and Hearing Benefit Act (H.R. 4311), which would add those benefits to Medicare. 

In the Senate, Majority Leader Chuck Schumer had earlier issued a directive to the Senate Finance Committee to expand Medicare “to include dental, vision, hearing benefits.”

In 2019, the House had passed the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), which sought to add dental, vision, and hearing benefits to Medicare Part B.

According to the Kaiser Family Foundation, 47% of all Medicare beneficiaries have no dental coverage. Almost half of them did not have a dental visit within the past year, with that rate being much higher among lower-income beneficiaries.

Currently, traditional Medicare also suffers from a lack of hearing health benefits. While about 30% of seniors between 65 and 74 years of age have some degree of hearing loss, that number jumps to over 50% for those older than 75, according to the National Institutes of Health. With hearing aids costing between $1,000 and $5000, they are out of reach for many.

Most seniors who have some form of dental, vision, and hearing coverage get it through Medicare Advantage plans, which are administrated by private insurance companies but funded by government money. According to the Kaiser Foundation, nearly 34% of all Medicare beneficiaries were also enrolled in Medicare Advantage plans in 2019, while the rest had only traditional Medicare.

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Your Citation
Longley, Robert. "Should the US Adopt a Nationalized Health Care System?" ThoughtCo, Oct. 5, 2021, Longley, Robert. (2021, October 5). Should the US Adopt a Nationalized Health Care System? Retrieved from Longley, Robert. "Should the US Adopt a Nationalized Health Care System?" ThoughtCo. (accessed October 25, 2021).