At a high level, we would become more like other English-speaking countries that have universal healthcare and higher taxes (ie., all of them): the UK, Canada, Australia, New Zealand.
Except we would have more guns and violence. In other words, not much would change in terms of national character.
But there are a few specific changes that are predictable:
- Medical bankruptcy would be eliminated. Estimates of the prevalence of medical bankruptcy in the US vary widely [1] [2] , because bankruptcy is rarely caused by just one factor and is sensitive to the overall health of the economy. But there is no question that it is a significant problem, and one that is unique to the US among developed countries.
- Workers would have greater negotiating leverage. Many workers, particularly those with health issues, are essentially locked into their jobs. They are afraid if they leave or are terminated, that they will be unable to get health care.
Employers can be quite frank about exploiting this situation. A friend of mine – a liberal Democrat on the board of Chipotle – was bitterly opposed to Obamacare. He wanted his employees to feel locked into their jobs and thus be unable to negotiate better wages.
Universal healthcare would make it easier for employees to risk unemployment and look for better jobs. The upside of this for the economy is that greater employee movement leads to better matches between skills and job requirements. That yields greater productivity and thus prosperity in general. - As a corollary to higher employee movement, more small businesses would form. The US lags most developed countries in new business formation [3] . There is no one reason for this, but healthcare risk surely is a factor. When I left my job at SomaLogic to start my own company, the biggest source of anxiety not the loss of income — we could plan for that. Rather it was the loss of a very good insurance plan, with no guarantee that we could replace it with one we could afford. And our family was in good health. This kind of uncertainty has to be a drag on entrepreneurship.
- More speculatively, the US’s per-capita spending on healthcare would begin to approach that of other developed countries. As it stands, we are a ridiculous outlier, spending the most money and getting mediocre results:
Not only that, but we have gone from being the tallest people in the world to the middle of the pack among developed countries:
From Dutch men are the tallest on the planet, a new study has discovered
This just won’t do.
An often-invoked potential downside of creating a more-efficient healthcare system is that funding for miraculous new medicines would dry up. I think this concern is misplaced on many levels, see here and here and here and here.
In short, we would have
- Higher taxes (but no insurance premiums)
- No medical bankruptcies or debt
- More employee mobility and new business formation
- Better access to healthcare leading to a general improvement in health
- More efficient healthcare spending (but lower healthcare industry profits)
- Taller people with plenty of guns
Sounds like mostly upside to me
Footnotes
[1] Do Medical Bills Really Bankrupt America’s Families?
[2] Myth and Measurement — The Case of Medical Bankruptcies | NEJM
[3] Think We’re the Most Entrepreneurial Country In the World? Not So Fast