Letter to the Editor: Medicare for All as a Labor Market Remedy
With each day that passes, more individuals in the United States receive a medical bill they will not be able to pay, choose to forego needed health care due to lack of coverage or fear of cost, struggle to receive health coverage through their employer, and are denied necessary treatment by an insurance provider. The United States spends more on health care per person than any other high-income, comparable country, yet does not offer a comprehensive system of care guaranteed for all of its citizens and experiences many worse health outcomes despite this spending.1 For this reason, and other economic needs, the push for Medicare for All needs to be advocated at a much larger level by social workers and other fields in the helping professions.
Forms of universal health coverage, particularly Medicare for All, have been debated in the United States for some time, but are more prominent in policy discussions since the onset of the COVID-19 pandemic. In addition to the primary health benefits of all individuals having health insurance and access to care, this policy would create large, positive impacts on the economic status of a wide range of individuals and businesses.
First, implementing Medicare for All would create a large cut in costs for small businesses and employers in general. Health care coverage is, on average, the largest employee-related expense after payroll in the United States, and compensation paid through health insurance premiums by employers has steadily increased over the years.2 If Medicare for All or any other kind of universal health care system was in effect, businesses would not have to worry about the burden of paying these high costs. Since small businesses are impacted more by these expenses than larger employers, Medicare for All could act as a stimulus for small businesses by allowing for more funds to be spent on wages, salaries, and other necessary expenses for maintaining operations. Employees should financially benefit from this as well, as businesses will have more available funds that may be used to increase pay and keep up with the demands and growth of the labor market.
While this policy change would cut expenses for employers, it would also improve the condition of jobs that are not considered to be “good.” Currently, many people would argue that a “good” job includes fair pay and benefits, like paid time off and health coverage. Many jobs do not offer health insurance, with around 47% of workers not having an employer that contributed to health care costs in 2016.3 Medicare for All would make this consideration obsolete and allow individuals to have more flexibility in looking for a job, while also easing the hiring process for employers. This issue is more relevant than ever with the growth of the gig economy, where contract, short-term, and other forms of nontraditional work are increasing. In 2021, about 31% of individuals who engaged in gig work did so as their main job.4 These workers lack basic protections, namely benefits like health coverage that are imperative for employee health and safety.
Medicare for All is a policy that would be integral to improving the labor market for the above reasons, but would particularly have strong effects on fields like social work and the nonprofit sector. Those earning historically low wages would be able to choose and stay at jobs more so on what they are passionate about, and not have to worry about whether benefits are available to supplement low pay. Employers in this field often struggle to pay their employees what they deserve, which can be remediated by not needing to pay medical benefits, freeing up large amounts of funds to better compensate hard-working employees. Thus, social workers should be at the front advocating for this policy, as it will not only impact them but most likely their clients and/or constituencies as well.
For this issue, social workers are in a unique position, as they may struggle to be paid a living or deserving wage or salary in many contexts, while also working to increase the quality of life for others in a similar situation. More social workers are turning to contract work, which again highlights the need to improve our social safety net and detach the availability of health insurance to job status. This offers an opportunity for social workers to advocate and organize for this policy together with their constituencies and clients to bring much needed change to the way we deliver health care. We must begin to not just rely on our community organizers who have been fighting for Medicare for All, but to actively and openly discuss and advocate for this policy in our everyday work.
— Max Robinson, MSW, is a recent Master of Social Work graduate from Temple University in Philadelphia.
2. Managing health care costs. Society for Human Resource Management website. https://www.shrm.org/resourcesandtools/tools-and-samples/toolkits/pages/managinghealthcarecosts.aspx
3. Bivens J. Fundamental health reform like ‘Medicare for All’ would help the labor market. Economic Policy Institute website. https://www.epi.org/publication/medicare-for-all-would-help-the-labor-market/. Published March 5, 2020.
4. Anderson M, McClain C, Faverio M, Gelles-Watnick R. The state of gig work in 2021. Pew Research Center website. https://www.pewresearch.org/internet/2021/12/08/the-state-of-gig-work-in-2021/. Published December 8, 2021.