Making the case for Expanded and Improved Medicare for All

En español

Numerous studies show that a publicly funded, privately delivered healthcare system can cover everyone, improve public health, and save money. (Yale study, Peri study, Mercatus Study)

We call on legislators and voters to acknowledge the following problems with our healthcare system so that we can act quickly to implement life-saving solutions.  

The Problems Preceding COVID-19:

  • Uncontrolled costs: The U.S. currently has the most expensive healthcare system in the developed world. We pay twice per capita what other countries pay, yet 87 million people are uninsured or underinsured. Much of the excess cost stems from the inefficiency of our complex, redundant, often for-profit, multi-payer system, with ever-rising administrative costs & little ability to negotiate prices. 
  • Unnecessary middlemen: We are also the only country that allows for-profit middlemen, also known as insurance companies, with a monetary incentive to deny us care and to intervene between us and our doctors. 
    • Unavailability of care: In North Carolina and across the country, our rural hospitals, as well as health centers for low-income patients, are struggling financially and even closing, leaving millions of people without nearby medical treatment. Even where there are hospitals, cost remains an obstacle to care. One-third of Americans said they would not be able to pay for healthcare in the coming year. Too many people forego care due to cost or face financial ruin or bankruptcy to get treatment, resulting in a sicker, less productive population. 


  • Pharmaceutical price-gouging: Because of Big Pharma greed, people are increasingly forced to ration or do without life-saving medications. More than one-third of Americans age 18-64 reported asking their doctor for a cheaper prescription (19.5%), not taking the medication as often as prescribed (11.4%), or skipping the prescribed medicine in favor or “alternative therapies” (5.4%) Although the National Institutes of Health pours $40 billion into health innovation annually (and will spend billions more for COVID-19), the American people don’t receive the benefits of these taxpayer investments ( Our system of granting pharmaceutical companies exclusive licenses and forbidding Medicare to negotiate drug prices allows drug companies to enjoy a monopoly and charge exorbitant prices for treatments developed with public funds. Even well-established medicines, such as insulin and EpiPens, are becoming increasingly unaffordable for many, resulting in unnecessary deaths. Moreover, due to our current for-profit model and lack of regulation, we have no guarantee that an eventual COVID-19 vaccine will be available to all without cost barriers. 


  • Poor health outcomes: The United States has the worst maternal and infant mortality rates in the developed world, particularly in the African American Community.  Also, over the past few years our life expectancy has declined, due to drug overdose, suicide, and illnesses related to poverty. 
  • Massive medical debt: Medical debt is an enormous issue impacting the physical and economic health of our population. 1 out of three 3 GoFundMe campaigns are to pay for medical treatment or medical debt, and each year over 500,000 Americans file for bankruptcy in part due to medical debt. This includes many who actually have insurance, but are underinsured.
    • Strains on U.S. businesses and constraints on entrepreneurship: Employer-based insurance places the cost burden of healthcare partially on American business, cutting into their bottom line and putting them at a competitive disadvantage with companies in other countries that offer publicly-funded universal healthcare. Employer-based healthcare also reduces entrepreneurial spirit and innovation, forcing people to stay in dead-end jobs just to keep their insurance. We are seeing the serious flaws in this system with massive unemployment in the midst of a pandemic. Just when our fellow Americans need health insurance the most, they are losing both their jobs and their coverage.


  • Untenable alternative: Some lawmakers offer up an alternative solution- using our public dollars to fully subsidize COBRA insurance plans to cover people who have lost their employer-based insurance. Why use our money to pay for the most expensive insurance on the market instead of covering all uninsured people with Medicare at a fraction of the cost?  


Please consider these critical questions in this moment of crisis:

  •     How reliable is employer-based insurance when millions are laid off during a public health crisis?
  •     How can a country contain a pandemic when 87 million (and rising) people are either uninsured or underinsured?
  •     How do deductibles, co-pays, and other out-of-pocket costs cause people to delay or avoid needed care? 
  •     How does the fear of medical debt impact people’s decisions to seek needed treatment?
  •     Why weren’t we better prepared for this pandemic, given that we spend about twice per capita what other countries pay for healthcare?
  •     How have racial inequities resulted in higher COVID-19 death rates for African Americans? (

The answers to the above questions tie directly to our choice to place profits at the center of care instead of public health. Please stop accepting that more than 68,000 people are dying because of our healthcare system every year and that one’s bank account or zip code determines access to care rather than one’s need. We must create a universal, single-payer healthcare system, as outlined in HR 1384, the Medicare For All Act of 2019, to protect public health, begin to deal with racial health inequities, and save more than 68,000 lives per year (Lancet, 2020).