Jumbo shrimp, only choice, affordable healthcare–oxymorons all. In the United States we have been struggling with the best way to pay for illness and accidents through insurance since 1850. Contending with the “affordable” part has been a major topic of discussion, both political and personal for 60 years.

The United States isn’t alone with this issue. Every country around the world has dealt with how to keep its citizens healthy without causing personal bankruptcy along the way. Today, out of 33 industrial, developed countries, 32 have some form of universal healthcare insurance. Many have single-payer systems in which the government, through taxes, pays for all health issues. There is a faction of U.S. citizens that would like this system in place here as well. We have a form of universal coverage for everyone over 65-years-old. There is a small premium and it covers about 80% of costs. That is Medicare, which began functioning in 1965. Also, with a 1965 birthday is Medicaid, which is government supported insurance for low income and chronically ill citizens. Eight million kids whose families made too much money to qualify for Medicaid, but were too poor to afford family medical insurance began qualifying for the Children’s Health Insurance Program (CHIP) in 1993. CHIP remains the grand legacy of Hillary Clinton who, along with Sen. Ted Kennedy (D. Mass.) got the bill through Congress after her attempt at a more universal program failed. Along with the Affordable Care Act, which was passed in 2010 and went into effect in 2013, it is clear the U.S. government understands healthcare insurance is an important issue. Even with the array of government sponsored and assisted programs, 67% of Americans have private health insurance and, disturbingly, after all our efforts, 8.6% (about 27.3 million) are still uninsured.

Those 32 developed countries found it unacceptable to leave any percentage of citizens uninsured and cause another cache of people to struggle to pay for ever more expensive coverage. Over the years, they all legislated to do something about that. As stated above, many have chosen to use tax money to pay for everyone’s health insurance. That doesn’t make it free, but does make it owned and sponsored by the people, which is part of the definition of socialism; a redistribution of wealth, which is a tenet of any insurance program; and the major factor causing descent and push-back in getting universal care legislated in the U.S.  

Private health insurance is expensive and getting more so–thus the keen interest in reducing costs. Taking profit out of the equation would (and has in those 32 other countries) reduced costs to a manageable amount. But with the unwarranted stigma of socialism, no matter how much cost effectiveness is involved, staunch free market capitalists will have nothing to do with it.

Yet, affordable healthcare doesn’t have to be an oxymoron–even if one is against government-managed medical payments and advocate profit-minded corporations being in charge. There is another way to reduce costs without eliminating private insurance companies. Switzerland has universal healthcare and still uses private enterprise for a lot of coverage. The Swiss have low deductibles and co-pays with all the coverage and preventative care included in our Obamacare laws. 

Why don’t we do that? The answer comes in tandem with fear of a single-payer system. The Swiss system requires massive government regulation of the health insurance industry. Those same “socialist-phobes” also deny any government-imposed regulation of free trade.

The Swiss manage their costs and maintain universal coverage by mandating every citizen buy insurance (a lead balloon in the U.S.) and requires basic insurance policies be issued by companies for zero profit while maintaining minimum standards of coverage. Companies may sell for-profit supplemental coverage to cover the 20% not covered by the standard, required policy, and they may sell lower deductible and lower co-pay policies to those who can afford them and wish more complete coverage. The government also subsidizes insurance companies to help with policy administration. Citizen purchase mandate, required extensive coverage, and basic policies sold as non-profit–what’s not to like?

Free-market capitalists who freak out over every government regulation and creeping socialism conspiracy believers all tend to be from the Republican party. They will not support either cost-saving program–the only cost saving programs found to work by 32 major countries. If we are ever to get affordable healthcare off the oxymoron list, it seems like Democrats will have to go it alone. At least for a couple of election cycles, Americans need to elect a majority of Democratic candidates to both the executive and legislative branches of government, let them hash out which universal system is best for America, pass it into law (much like they did with Medicare, Medicaid, and the ACA), and then get the new system up and running with care, support, and a watchful eye (that did not happen with the ACA). Next, we need to be prepared to listen to Republicans whine and complain about it, try and fail to vote it out of existence multiple times, and ignore huge public approval ratings while we finally enjoy healthcare insurance that doesn’t discriminate and doesn’t send us into bankruptcy at the first sign of illness. To quote a large, capitalist company, “Just do it.”

Terry Donnelly is a retired teacher. He taught in public schools in Kentucky, Michigan, and Colorado. He was an adjunct faculty member instructing teachers and teacher trainees at Michigan State University, University of Colorado, and Adams State College in Colorado.