Healthcare is deeply personal to millions of Americans, including myself. Our ability to access prescription medications and critical treatments is bound by the greed of the pharmaceutical industry—and all the politicians in their pockets—as well as our for-profit health system that upholds the belief that healthcare is something earned rather than deserved. Everyone deserves healthcare, and we can make it happen; just look to nearly every other developed country in the world for recommendations. 

A liberal push on the impending infrastructure bill seeks to expand Medicare benefits to incorporate dental, vision and hearing services—no, those aren’t already considered “essential” parts of healthcare. The bill initially also sought to pay for Medicare expansion by permitting the federal government to negotiate prescription drug prices with pharmaceutical companies. 

However, some Republican and Democratic Senators oppose these measures, including the infamous Senators Joe Manchin III (D-WV) and Kyrsten Sinema (D-AZ), making them unlikely to stay in the legislation. It quickly gets interesting when you learn that Sinema received over $120,000 from pharmaceutical companies in the 2019-2020 cycle alone. Furthermore, Manchin’s daughter used to be the CEO of Mylan—or better known to me as the company that holds such a powerful monopoly on EpiPens that they’ve been able to increase the cost of the life-saving device by over $500 in less than a decade. 

Every day we are at a turning point: will we choose care or profit? We see this battle not only in healthcare but also in incarceration and the climate crisis. Pharmaceutical companies—and lobbyists in general—do an excellent job of manipulating politicians and the public to create false dilemmas and prevent robust social programs from being enacted. Over my next three columns, I will be discussing 10 reasons we desperately need universal healthcare. For today, I will propose three, starting with the need to address the exorbitant costs of medications. 

1. Public negotiation of prescription medications to curb price gouging by Big Pharma. 

Americans spend $858 per capita on prescription drugs each year, compared to an average of $400 in nearly 20 other industrialized nations. As a result, nearly 30% of 19- to 64-year-old Americans report that they have to go without prescribed medications due to cost—leaving them deprived of drugs needed to control blood pressure, treatments for diabetes or life-saving medications like my EpiPens. 

The pharmaceutical industry fabricates a false dilemma, suggesting that people have to choose between low-cost medications or innovation. In reality, reducing pharmaceutical revenues would result in only two fewer drugs in the next decade, and these are not likely to be new innovations. Federal government negotiations would not only pave the way for reducing the burden of cost but also start to cap the power and excess wealth of the pharmaceutical industry. Further, many of Big Pharma’s “innovations” start out with funding from the federal government—our taxpayer dollars—in university laboratories.

2. Private, employer-based insurance breaches confidentiality, preventing adolescents from accessing sexual and reproductive healthcare, gender-affirming treatment or generic checkups. 

The American Civil Liberties Union (ACLU) produces a health and law guide for teens to learn what they have a right to and how they can access and promote their own health. A vast number of children, however, have insurance through their parents’ employers. While an adolescent can consent to receiving a pregnancy test, STD treatment or substance use counseling, the hospital will bill the insurance company, which sends an explanation of benefits (EOB) to the parents, including a breakdown of the costs. The ACLU advises that a teenager can contact the insurance company to find out if the EOB will include treatment details—but anyone who has spent any amount of time trying to contact insurance companies surely knows how inefficient this would be. Universal healthcare would ensure that everyone—including adolescents—can access high-quality and necessary care, in some instances without parental consent. Many adolescents need sexual and LGBTQIA+ healthcare, but access is severely limited when parents are unsupportive and out-of-pocket costs are unaffordable. So instead, we have rampant rates of undiagnosed or untreated conditions such as sexually transmitted illnesses. 

3. Promotion of preventive care over reactionary treatment.

 The United States’ market-driven health system emphasizes the revenue and potential loss in profit as justification to include or exclude treatment options. One in 10 Americans have diabetes, and one in three have prediabetes, leaving many suffering from or predisposed to a debilitating and life-threatening condition. As cases continue to increase, we ought to consider what drives high rates of diabetes in the first place. If people seek physicals yearly instead of only when they’re sick, doctors can catch prediabetes earlier, possibly delaying or preventing the full-blown disease. Universal healthcare could cover yearly physical and mental health preventive appointments and appropriate screenings by age, such as cervical, breast, prostate and colorectal cancer screenings. By changing the larger healthcare structure to be universally accessible, we are shifting the narrative to promote taking control of our health and well-being. Promoting health, of course, is not solely on the individual, but on all our systems to address the health inequalities that result from systemic racism and discrimination. Individuals, especially from disadvantaged communities, will not be able to stave off diabetes without access to quality and affordable produce in place of fast food or microwavable meals.  

I’m not naïve enough to believe that implementing a universal healthcare system will happen immediately or all at once, nor will it mend all that is wrong in our world. But it’s a start, and that’s what we need right now. We first need recognition that pharmaceutical companies have a tight hold on our legislators, preventing us from caring for ourselves and our loved ones. It is outrageous that anyone in this country is forced to weigh the importance of their medication against the cost of rent or food.