Specialisation: Affordable Care Act

Affordable Care Act’s Replacement With the Single Payer Plan


Throughout history, many groups in the United States have tried to push and lobby for universal healthcare, but their plans have always fallen short; only Medicare and Medicaid. The Obama administration enacted the affordable care act, which was viewed as a significant healthcare reform (Longest, 2016). The Supreme Court legitimized the act’s subsidies after litigation challenging their legality was placed before it. Despite the affordable care act being fully actualized, 27 million Americans are still uninsured by 2025 (Liu, 2017). Most insured Americans are underinsured (Liu, 2017) due to the decreased number of health insurer networks which has limited people’s choices. The act has given the power to large healthcare insurance companies and institutions since they are the ones who can implement it effectively at a minimal cost. America’s healthcare system has always been known for its bureaucracy which has led to wastage of time and money, leading to low morale among patients and providers; the affordable care act has only exacerbated the situation. The act has not solved numerous issues facing America’s healthcare system, including; low coverage, poor accessibility, inflation, and high medication costs. This paper supports replacing the Affordable Care Act with a single-payer plan as it possesses economic, social, and philosophical advantages.

Philosophical Argument

The profit motive in healthcare has been terrible, and the affordable care act has not solved this concept. Every society believes healthcare is a human right, and no one should be denied or priced out from accessing it. The market for profit mainly controls the United States healthcare. The rationale behind this system was that increased number and competition among private health insurance organizations would drive down healthcare costs. However, this thinking has been proven to be false over the years. According to a study, the profit among top healthcare insurance companies has grown tremendously to surpass even S&P 500 companies. In the same period, the number of uninsured Americans is rising to millions; healthcare insurance payments are increasing (Liu, 2017). The sad part is that most of the growing uninsured are American-born citizens, not immigrants, contrary to beliefs.

The current condition is healthcare insurance companies are minting money as more Americans are struggling to pay their premiums. The profit motive has incentivized health insurance companies to raise their premiums for growth continuously; more Americans are being priced out of insurance. The American privatized system will provide a good product but only for people who can afford it. The single-payer plan is a better alternative as it ends the profit motive ensuring healthcare is universal. Under the single-payer plan, every American is insured within the same umbrella, promoting equality and accessibility. The plan ends the unnecessary increment in insurance premiums, contributing to lowering healthcare costs.

Economic Argument

The single-payer plan will save money and lower and control healthcare costs. The United States healthcare administrative costs as always been viewed as an atrocity with considerable operation costs, payments, and documentation that do not make sense. Billions are being spent on insurance overhead, staff costs who manage health benefits, and institution administration (Liu, 2017). The affordable care act has increased electronic documentation and operation costs as funds are needed to ensure payments from various insurance networks are well-managed (Blumberg & Holahan, 2019). The single-payer plan comes with economies of scale, which will reduce costs as third-party administrators used to cater to the growing operations are removed. Limiting patients to a single insurer will lower administrative costs in healthcare institutions, ensuring cost control.

Experts argue cost control mechanisms will help address the growing healthcare expenses and inflation in the United States. The affordable healthcare act has failed in solving this issue. It is easier to implement cost control since the administration is centralized. It is difficult to institute cost control in the United States since the most significant part of the healthcare system is privatized by numerous private institutions with different rules and goals. These companies will likely refuse to implement cost controls if it affects their profitability. The single-payer plan will have only one insurer with the same guidelines adopted throughout the system. For example, one technology can be deemed cost-ineffective by a study in the current system; the government cannot stop institutions from utilizing it. Under a single-payer plan, if technology is identified to add unnecessary costs, it is completely removed from the system. A single-payer can also negotiate better prices for products and services due to economies of scale, especially medication which is high in America (Blumberg & Holahan, 2019). Cost control in healthcare will massively help various groups.

Social Argument

The single-payer plan will help various groups’ universal coverage, equitability, portability, accessibility, and affordability of healthcare. The uninsured Americans will receive the needed coverage. The coverage status will be continuous even when they have lost their jobs or changed residence, income, and age. Most current insurance coverage is linked with job status, so moving around for work disrupts health coverage (Blumberg & Holahan, 2019). The portability of a single-payer plan ensures disconnecting of healthcare insurance from employment. It allows people to pursue new ventures without fear of losing their health coverage. There will be equity in healthcare as everyone is under the same insurance, addressing the racial, class, and income disparities witnessed in the United States (Blumberg & Holahan, 2019). The single-payer plan will make healthcare more affordable by eliminating the increasing insurance and out-of-pocket payments. Those individuals will not have to pay more premiums to secure coverage as costs are distributed across the taxpayers. Affordability will ensure Americans do not suffer from financial burdens due to healthcare costs. As the single-payer plan reduces costs, lower and middle income will have the financial ability to access healthcare. Services such as dental appointments, eye check-ups, and health screening previously reserved for the rich will now be accessible to the rest of the population (Blumberg & Holahan, 2019). Every American will access the medical personnel they want. The improved accessibility to such vital healthcare services will ensure better health among Americans.


Despite the implementation of the Affordable Care, Americans are yet to see any improvement in America’s healthcare systems. The problems include the ever-increasing healthcare expenses and costs of medicinal drugs; millions are still uninsured. The profit motive in healthcare ensures that stakeholders are reluctant to make any radical changes. They prefer the status quo to be maintained so that they continue to make a killing financially. The above arguments depict how and why the single-payer plan is the way for the United States. It solves many problems, including universal coverage and reduced healthcare costs. The plan ensures equity and accessibility in the healthcare system.


Blumberg, L. J., & Holahan, J. (2019). The Pros and Cons of Single-Payer Health Plans. Washington, DC: Urban Institute. https://www.urban.org/sites/default/files/publication/99918/pros_and_cons_of_a_single-payer_plan.pdf

Liu, J. (2017). Exploring single-payer alternatives for health care reform (Doctoral dissertation, RAND). https://www.rand.org/content/dam/rand/pubs/rgs_dissertations/RGSD300/RGSD375/RAND_RGSD375.pdf

Longest, B. B. (2016) Overview of the Patient Protection and Affordable Care Act. In Health policymaking in the United States. (Appendix 1, pp. 337-343) Chicago, IL: Health Administration Press.