How the Economic Crisis Presents Opportunities to Advance Single-Payer Healthcare

During Healthcare-NOW’s 2008 National Strategy Conference, Dr. Arthur MacEwan outlined how the current economic crisis presents opportunities to advance single-payer healthcare in the US. Dr. MacEwan is a Professor Emeritus of Economics and Senior Fellow of Center for Social Policy at the University of Massachusetts in Boston. He has been a faculty member of the UMass Economics Department since 1975.

The economic crisis, explained Dr. MacEwan, is a direct result of income inequality, power inequality, and deregulation of markets. Single-payer healthcare confronts all of these problems. It will help reduce inequality by taking the burden of high healthcare costs off of the American public. It will take power away from private health insurance companies that dictate what doctors we see and what procedures we need. And it regulates the healthcare market so that prices don’t continue to grow increasingly out of control.

Dr. MacEwan stressed the importance of the following arguments the single-payer movement can now use.

Social Programs are Necessary to Recovering the Economy

Instead of cutting social programs, Dr. MacEwan argued that increasing funding for social programs would be a better response to the economic crisis. “Pundits have picked up on the idea that we will have to forgo social programs because of the economic crisis. From a strictly economic perspective, reality is exactly the opposite. That is to say, dealing with this recession is going to require a massive stimulus program, and there’s no better way to stimulate the economy then to pay for much needed social programs. So in fact, the needs for the crisis and the needs for social programs work together.”

Employer-Based Healthcare Doesn’t Work

Economic downturns result in massive layoffs and job loss–meaning less people will be covered by their employer-based health insurance. When people are without health insurance, they’re more likely to forgo regular visits to the doctor, resulting in more costly visits to the emergency room.

“The crisis of this sort shows the failure of the employer-based healthcare system,” says Dr. MacEwan. “As people lose their jobs, they not only lose their income, they lose their healthcare. Not only is this a problem in itself, but it places a strain on government finances because people will still try to get healthcare. If they don’t have insurance, they go to emergency rooms, and that has to be paid for, ultimately, someplace.”

Free Markets Are Not the Answer to America’s Healthcare Crisis

“The most important opening, created by the current crisis, is that it discredits the idea of free markets in finance. It’s not that it only discredits it in finance, it discredits it in general,” explains Dr. MacEwan. “When we go out and argue for single-payer, people will respond by saying, ‘Well, single-payer will mean more government involvement in healthcare, and government involvement is bad. End of argument.’ Well, it’s not the end of the argument anymore.”

Crises Bring Opportunities for Change

“When a crisis takes place, that is a total disruption of the economy, there are opportunities for political change that did not exist before,” says Dr. MacEwan. “When people are met with major financial strains, they are more willing to make bigger changes.” This, of course, Dr. MacEwan notes, can work both ways. So we still have plenty of work to do before HR 676 is passed.

Listen to the full speech (click the little triangle):
Dr. MacEwan


  1. Shannon Brown on January 12, 2009 at 8:09 am

    It is very clear that now is the time to get our health care in the US on track so that more Americans do not have to fear a trip to the doctor and what that will do to their budget.
    How we are going to make this happen I am unsure since it seems we are too far down the path we have chosen.
    For myself I am one of those Americans who fork over $400 a month to be privatlely insured and then I only go to the doctor once a year. While on the other hand I know people who have insurance through welfare and go to the doctor every other week. At what point and time should I be awarded for being healthy.