2020 Hot Topic: Healthcare


We are just six days away from the 2020 Presidential Election — arguably the most controversial one yet. And Generation Z might just be able to seal it. This year alone, twenty four million new Gen Zers will be eligible to vote, meaning our generation represents on in every ten ballots. So, which issues do we care enough about to vote on? The biggest topics in the media cycle this time around include the economy, climate change, Covid-19, the Supreme Court, discrimination, and healthcare reform. Let’s talk about healthcare, which according to the Pew Research Center, 68% of voters say is critical for their vote.

What does US healthcare look like today?

Unlike every other developed country, the US does not have a universal healthcare system. Instead, our system is fragmented across thousands of insurance providers. While we do have government programs — like Medicaid (which provides health insurance to low income individuals) and Medicare (which covers people over the age of 65, regardless of income) — two thirds of Americans have private insurance. 

Another difference between the United States and other industrialized countries is our role in price negotiations. Other countries, like France and the UK, have strict price controls on the pharmaceutical industry, aimed at keeping drugs accessible. However, because government intervention in the US is rare, the US has the highest drug costs in the world.

What’s the problem?

Compared to just 4% of Baby Boomers, 24% of Gen Z patients dislike the current US healthcare system. The reasoning is simple: care is too expensive.

Let’s start with insurance. Right now, there are 45 million uninsured Americans. This is because they can’t afford companies’ high fees. Premiums — for example — are the costs you must pay every month just to have an insurance plan, and deductibles are how much you must pay out-of-pocket before insurance kicks in. For instance, if my treatment costs ten thousand dollars and my deductible is two thousand dollars, I must pay those two thousand dollars on my own before my provider covers the rest. The problem is that the majority of Americans live paycheck to paycheck, so they can’t afford their deductibles. In fact, Clozel of the Wall Street Journal writes that one third of Americans can’t afford a $400 emergency expense. This has left an additional 40 million Americans underinsured; they have insurance, but since they can’t afford their deductibles, their care doesn’t get covered.

America’s insurance problem goes hand in hand with its second problem: a lack of price regulations leaves Americans paying the highest drug prices in the world. As a result, both uninsured and underinsured Americans have outrageously expensive medical bills.

This gives them two options:

  1. Forgo treatment 
  2. Go into debt  

Unfortunately, these are very common scenarios in the United States. A 2017 Prescription Justice report quantifies that 45 million Americans forgo their much-needed medicine because of high costs. That’s nine times the rate in the UK, where the government covers insurance. This medical non-adherence causes 125,000 deaths each year. The alternative option isn’t great either. Since the majority of Americans live paycheck to paycheck, they must take out a loan for medical treatment. Unfortunately, these loans often don’t get paid back. That’s why Konish of CNBC writes that 137 million Americans are trapped in medical debt.

So yes, healthcare is too expensive, and Americans need reform. Thankfully, both parties seem to agree that costs must go down. However, their approaches are vastly different.

What does Joe Biden’s healthcare plan look like?

Biden’s healthcare plan consists of three key parts. First, he wants to expand Medicare. Right now, Americans become eligible for Medicare when they turn 65. If Biden is elected, he will lower the Medicare age to 60, which will make 20 million Americans newly eligible for health insurance. Second, Biden seeks to expand the Affordable Care Act, or the ACA. The ACA was passed by President Obama in 2010. It expanded Medicaid eligibility, prevented insurance companies from denying coverage or raising prices due to preexisting conditions, and allowed children to remain on their parents’ insurance plan until they turn 26. Third, Biden wants to install a government-run public option. This is his most controversial plan. A public option would allow everyone — regardless of how they currently receive insurance — to enroll. Moreover, it would grant the government the ability to negotiate drug prices down, to make healthcare more accessible.

What does Donald Trump’s healthcare plan look like?

Similar to Joe Biden, President Trump’s healthcare plan largely revolves around the ACA. However, his intentions are the exact opposite. While Joe Biden wants to build on the ACA, Donald Trump wants to cut it. He believes the ACA created more problems than it solved. Trump’s strikes at the ACA have already begun, as his administration removed the individual mandate, which required that all Americans either have health insurance of pay a large penalty. Trump believes he can build an entirely new and better program. However, he has not released any details for what this program would look like.

What will Election Day look like?

It goes without saying that Generation Z can be the game changer in the 2020 Presidential Election. And with the pandemic only highlighting the strain in the current health care system, reform is one of our biggest priorities. Now, the question is this: which candidate do we trust to fix our broken healthcare system? Is it the one who wants to expand the programs that already exist, while adding an entirely new — but controversial — one? Or is it the one who wants to tear down our current system and build a new — but vague — one? Unfortunately, both scenarios are somewhat unknown. But, with millions of Gen Zers reaching ages where they must take healthcare into their own hands, we need answers, and we need them quickly.