We can and must do a better job of ensuring ALL Americans get the care they need. I support universal healthcare, but the focus on healthcare has been almost exclusively on insurance, and this is only one piece of the complicated healthcare puzzle.

The full picture includes insurers, hospital systems, doctors, allied health, pharmacists, pharmaceutical and device manufacturers, and public research and development. Much of this system is not competitive, which drives up costs and lowers access. We must focus on the entire system if we are going to lower costs and increase access to care:

PUBLIC OPTION: Millions of Americans are still without health insurance and access to the care that they need, even after the expansion under the ACA. There are many options that I support, from adding a traditional public option that increases competition, to Medicare for All, and Medicare for America. Any one of these are better than the current system because they increase access and I support any of them over the current system.

PHARMACEUTICALS:  The US market is simply not competitive. As a result, costs are unnecessarily high, especially compared to other countries. One way to increase competition is to allow Americans the option of purchasing prescriptions across international borders. Since the same or similar quality prescriptions can be obtained at considerably lower prices this way, it should compel US companies into lowering their prices to stay competitive.

HEALTH CARE SHORTAGE: The Association of American Medical Colleges predicts that there will be a shortage of up to 120,000 doctors by 2030. Federal funding for residency programs has been capped since 1997 and has not kept up with population growth. Fixing this will allow qualified healthcare professionals to get to work.

In addition to residency programs, the number of slots in medical schools has failed to keep pace. Long-term, we must work with states and universities to increase the number of programs/slots to keep up with demand. In the short-term, reversing the Trump administration’s immigration cuts will ensure that we meet our needs.

RESEARCH: Pharmaceutical companies rely heavily on scientific literature that comes from publicly-funded research. Unfortunately, these companies have found they cannot always replicate those findings. This costs them time and money, and consequently, they pass these costs onto the consumer. We should fund more public replication studies to keep costs down. We can then expect these savings to be passed on to the American consumer.

COMPETITION: In some parts of the country, there is only one healthcare system for a hundred miles in any direction and only one insurer on the exchange. This lack of competition drives up prices and leads to poorer care. We can increase competition in these cases by providing public options, breaking up healthcare monopolies, and adding access to competitors through innovative technologies such as telemedicine.