America Is Not Too Poor for Universal Healthcare
The System Is Simply Not Built to Serve Ordinary People
The American healthcare debate is full of fake arguments. People are told universal healthcare is “too expensive,” “too complicated,” or “not realistic.” That story has one purpose: to make the status quo feel inevitable.
But other developed countries already solved this. Not perfectly, but functionally. The United States is not failing a math test. It is refusing to take it.
So the real question is not “Can America do it?” The question is “Who loses money if America does?”
A Small Comparison Exposes a Big Lie
No need for a long global tour. A quick comparison is enough to show what’s going on.
In universal systems, most people contribute a predictable share of income into a public healthcare pool:
UK: roughly 4-5% of personal income supports the NHS through taxes and national insurance
Canada: roughly 8-10% through general taxation, no separate “healthcare tax”
Germany: workers pay about 7-8% of wages into mandatory public insurance, with strict out-of-pocket caps
Japan: around 10% into compulsory insurance, with cost-sharing but real ceilings
Australia: a 2% Medicare levy, plus a small surcharge for high earners without private insurance
Different countries, different mechanics. Same baseline guarantee.
You pay in, the system must treat you.
That obligation is the whole point. Not “free care.” Not a slogan. Certainty.
The U.S. Doesn’t Have a Spending Problem
It Has a Value-Extraction Problem
Americans are trained to fear taxes. Meanwhile, they already pay more than everyone else. Just not into a public system.
When you add it all up, the typical American household effectively loses around 18-20% of income to healthcare costs. That includes:
premium payments
the employee share of employer plans
deductibles before coverage even starts
copays and coinsurance
drug costs
out-of-network bills and “not covered” surprises
It is expensive, but the bigger issue is instability. These costs rise faster than wages. They change when jobs change. They disappear when you lose employment. And even after you pay, you are still not guaranteed care without a fight.
That is the U.S. model: pay constantly, and still worry constantly.
The Most American Part of American Healthcare
Is How Uncertain It Is
In Canada or the UK, healthcare is a public guarantee. In the U.S., healthcare is a contract with loopholes.
That difference is not abstract. It shapes daily life.
In the U.S., people can lose coverage because they changed jobs, missed paperwork, picked the wrong plan, or discovered that their doctor “left the network.” Claims get denied over coding disputes. Treatment gets delayed until a deductible is met. A person can do everything “right” and still get hit with a bill that makes no sense.
This isn’t a glitch. It’s how private insurance protects profit. Uncertainty is leverage.
And the cruel irony is obvious: the moment you need healthcare most is when the system becomes most conditional.
Why Universal Healthcare Keeps Losing in the U.S.
People blame government incompetence. That’s too easy.
The U.S. government can move fast when it wants to. It can rescue banks. It can fund wars. It can stabilize financial markets in days. So the obstacle isn’t capacity.
The obstacle is power.
Here are the three reasons universal healthcare can’t cross the finish line in the U.S.
1) Too many middlemen are paid to keep it fragmented
The American healthcare system is an ecosystem of intermediaries: insurers, drug companies, PBMs, hospital chains, billing firms, and private equity roll-ups. They don’t just “provide services.” Many of them profit by sitting between you and care.
Universal healthcare threatens that business model. It would unify payments, negotiate prices, and cut administrative chaos. That means less room for extraction. Less profit. Less control.
So the middlemen fight it like a life-or-death issue. Because for them, it is.
2) Lobbying turns reform into an endless hallway
Universal healthcare doesn’t die because it’s unpopular. It dies because it gets trapped in procedure.
Commissions. Studies. “Bipartisan panels.” Pilot programs. Delayed votes. A thousand reasons to wait. Every step is a chance to water it down. Every compromise protects the status quo. This is how a captured political system kills reform without taking responsibility for killing it.
3) Employer-based insurance is a worker-control mechanism
This is the part Americans are rarely encouraged to say out loud.
When healthcare is tied to your job, it disciplines you. It makes quitting riskier. It makes striking harder. It reduces labor mobility. It pushes people to tolerate lower wages and worse conditions because losing insurance feels like stepping off a cliff.
Universal healthcare would loosen that grip. Workers would have more freedom to move, organize, and bargain. That’s not just a policy shift. That’s a shift in power.
And power is the one thing the system protects above all.
This Isn’t a Broken System
It’s a System Doing What It Was Built to Do
The American healthcare system isn’t “failing.” It’s functioning for the people it’s designed to serve.
It extracts income from the working class. It turns insecurity into profit. It uses that profit to influence politics. Then it tells the public universal healthcare is impossible.
That isn’t incompetence. That’s a loop.
Call it late-stage capitalism if you want. The label doesn’t matter. The mechanism does.
The Only Question That Matters
Other wealthy countries prove universal healthcare is doable. The U.S. proves something else: it is willing to spend more money to get worse results, as long as the money flows upward.
So the question is not whether America can afford universal healthcare.
The question is whether a system built to protect capital will ever be allowed to protect people.
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Another of your informative, detailed, in-depth, and clearly stated article on why the propaganda we receive in the US concerning Universal Healthcare is bullshit. Though your article states it far more eloquently than I ever could, including why it keeps failing and what we can do to remedy it. Brilliant and bravo. Thank you.
I notice Grumpy that you use the words by design in a lot of your articles, and it sounds so right. Capitalism as Colonialism is a monstrosity of control and each means of production is profit. Therein lies the rub.