Clinton vs. Sanders: The Future of Healthcare in America

As a current medical school applicant, I’ve spent innumerable hours prepping for the challenging questions I may be asked during interviews. Most of them are straight forward, but there’s one question that gives me anxiety nearly every time it’s asked – “How do you envision the future of healthcare?”

By this point, I have a well-rehearsed answer beginning with a discussion of the recent paradigm shifts in healthcare, and how the future will depend on the success or failure of these program changes. I then go on to discuss specifics within the Affordable Care Act (being careful to not accidentally call it “Obamacare”) and explain what I believe is working: the coverage of pre-existing conditions, and the expansion of Medicare for states that have accepted the funding and what I believe still needs work: underinsurance, and the outrageous prescription drug costs.

I would be lying if I said I whole heartedly believe my answer. I put towards an optimistic vision, but I worry about the future of healthcare.

To honestly answer the question, I wish I could say that I’m dumbfounded as to why healthcare is considered a privilege and not a right in America.

That I’m astonished as to why a country as developed as America has families who have to choose between going bankrupt or affording cancer medication. That I’m stunned when I hear a child I tutor didn’t go the hospital for an ear infection because mom couldn’t afford the co-pay. I wish I could say that to deny someone their heath is denying them their dignity.

Considering the close race between the top two democratic candidates, Hillary Clinton and Bernie Sanders, it’s critical now more than ever to consider one of the major distinctions between them – their vision for the future of healthcare.

Clinton’s grim perspective undoubtedly reflects her years of handling the harsh realities of politics in Washington, DC. She puts forward a pragmatic approach of creating further provisions to the ACA to reduce healthcare costs and expand coverage. Sanders, on the other hand, calls for a “political revolution” and the complete replacement of ACA with a single-payer system of healthcare. His proposal would ensure healthcare as a right to all U.S. citizens, and would require for-profit insurance companies solely for supplemental coverage.

Clinton proposes two major arguments against Sanders’ plan, one – a single-payer system would raise taxes on the middle class, and two – the plan is politically unrealistic. The plan proposed by Sanders would indeed raise taxes on the middle class, but that’s not the complete picture. By not paying private insurance premiums, middle class families would actually be saving more money overall, even with the tax increase. Gerald Friedman, a professor of Economics at U. of Mass at Amherst, crunched the numbers and calculated overall savings for working Americans under Sanders’ plan.

Another notion put forth by Clinton’s campaign, specifically by Chelsea Clinton, suggests that if Sanders fails to pass the new single-payer legislation, America will be back to where we were before the ACA. This is largely misguided thinking; Sanders may be an optimist, but he’s not foolish. If unable to pass Universal Healthcare legislation, Sanders would most certainly continue to defend ACA, and work with members of Congress to create more comprehensive additions. In ’08, Clinton herself asked “Since when do democrats attack one another on Universal Healthcare?” Clinton certainly considers universal healthcare a progressive objective, but to say it’s a strong idea that would benefit Americans long-term, and not pursue it because it would be difficult to legislate, is cowardly and a shame on American democracy. Giving people of color equal rights, or having a minimum wage was also at one point a radical idea, and it took those willing to defy the status quo, and act upon their beliefs to create the improvements seen today.

I deeply respect Clinton and her years of experience in Washington, but with the future of healthcare at stake, I question her commitment to create real change for the millions of families still without affordable insurance in the United States. According to a study done by STAT News, Clinton accepted $164,315 in the first six months of her campaign from drug companies, far more than the rest of the 2016 field. Although Clinton has proposed a plan to reduce rising drug costs, it’s difficult to imagine the extensive financial contributions to her campaign from big money pharma having no sway on her future decisions as president, if elected.

Bottom line, Clinton is entirely too close to the same businesses that are suffocating American families in need with massive price hikes on live-saving medications. Compared to Clinton’s sensible plan, Sanders’ single-payer healthcare system is indeed radical, but with the power of pharmaceutical lobbyist and private insurers in a broken American healthcare system, it’s perhaps necessary to be radical in order to be heard.

As a hopeful future physician, I yearn for a system where I never have to consider the ramifications of a service or medication for a person in need because of finances, and my vote will go towards which ever candidate can provide that peace of mind.