Currently, about 78 countries have universal healthcare, but the United States isn’t one of them (Oyster). For a country known for leading the world in medicine, technology, and economics, this is shocking. Join me as we explore the reasons why universal health coverage hasn’t been adopted in the United States and what can be done to change this.
The conversation around healthcare coverage may be difficult to visualize when your parents pay for your healthcare; however, this is a very real issue. According to the ILR Scheinman Institute at Cornell University, approximately 100 million Americans carry medical debt—about 1/3 of our nation’s population. Furthermore, 14 million Americans have medical debt over $1,000, and medical debt is responsible for about 2/3 of bankruptcies (August). If medical debt drives so many of these struggles, why hasn't universal healthcare been implemented in a country with the world’s leading economy?
There are two primary issues at the forefront of the lack of healthcare coverage. Dr. Rainer Gruessner, Professor of Surgery at SUNY, identifies these two issues as the reluctance to dismantle the current healthcare system and the overall costs of universal healthcare (Mathews Open Access Journals). Regarding the first issue, the current health insurance system in the United States comprises a mix of government programs and private insurance companies. Unfortunately, private insurance companies act as a major roadblock to universal healthcare. As Dr. Gruessner explains, “[the] current health system as well as most for-profit stakeholders are the greatest objectors and preventers of Universal Health Coverage”. Universal healthcare advocates build their case on this exact principle: healthcare should not be driven by profit. Looking back at the numbers, one in every three people across the nation bears the weight of medical debt, and for-profit healthcare is largely responsible. The second issue highlighted by Dr. Gruessner is the projected cost of coverage, with estimates suggesting that Medicare for All could cost just shy of $50 trillion over 10 years.
With these obstacles in mind, is universal healthcare even possible, and if so, how?
Universal health coverage is achievable, though complex. One path forward is expanding Medicaid. Currently, about 73 million people are enrolled in either Medicaid or Children's Health Insurance Programs (Medicaid.gov). By broadening Medicaid eligibility, more individuals can join and obtain essential health coverage. Another viable option is integrating universal health coverage into the existing American insurance system. Establishing a framework where every citizen is guaranteed coverage—whether through private plans or government programs—would bring the United States much closer to achieving universal healthcare.
In conclusion, universal health coverage is not only possible, but profoundly necessary. With over 100 million Americans burdened by medical debt, this crisis can no longer be delayed or ignored. As public support grows and policymakers increasingly rally behind reforms like Medicare for All, the United States stands at a critical crossroads where real, lasting healthcare change is within reach.
References
Gruessner, R. W. (2023, October 20). Why does universal health coverage not exist in the United States? A physician’s perspective. Mathews Journal of Case Reports. https://www.mathewsopenaccess.com/full-text/why-does-universal-health-coverage-not-exist-in-the-united-states-a-physician-s-perspective
Healthcare insights: How medical debt is crushing 100 million Americans. The ILR School. (2024, October 21). https://www.ilr.cornell.edu/scheinman-institute/blog/healthcare-insights/healthcare-insights-how-medical-debt-crushing-100-million-americans
June 2026 Medicaid & Chip Enrollment Data highlights. Medicaid. (n.d.). https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights
Parente, S., Stephen ParenteHealth Care ExpertStephen T Parente is the Minnesota Insurance Industry Chair of Health Finance in Carlson School of Management at the University of Minnesota and Associate Dean of the Carlson Global Institute., Lowering the Medicare Eligibility Age to 62: Cost and Coverage OutcomesStephen Parente, Trump’s Potential Coal Tariffs: Overview and ImplicationsJacob Jensen, Jensen, J., The New Section 301 Tariff RegimeJacob Jensen, What Happens When the Social Security Retirement Fund Goes Bankrupt?Jordan Haring, & Haring, J. (2026, August 25). Medicare for all: An updated coverage and budget analysis. AAF. https://www.americanactionforum.org/research/medicare-for-all-an-updated-coverage-and-budget-analysis/
Rakshit, S., Rakshit, S., Twitter, M. R., Claxton, G., Amin, K., & Twitter, C. C. (2024, February 12). The burden of medical debt in the United States. Peterson-KFF Health System Tracker. https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united-states/
Top countries with Free Healthcare in 2025: Oyster®. RSS. (n.d.). https://www.oysterhr.com/library/countries-with-free-health-care
World Health Organization. (n.d.). Universal Health Coverage (UHC). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)