Why America Rejects Public Healthcare: Propaganda, Profits, and the Price of Misinformation
The United States remains an outlier among developed nations in its rejection of a nationalised healthcare system. Public opposition is often framed as a defence of personal freedom, choice, or fear of government inefficiency. Yet these arguments rarely withstand scrutiny when compared with the reality of the current system, which forces people to pay exorbitant amounts for often inadequate care. The root of this resistance lies not in reason or evidence but in the influence of a profit-driven system that manipulates public perception to maintain its dominance. Corporate-controlled media, heavily funded by pharmaceutical and insurance giants, perpetuates a narrative designed to sow fear of public healthcare alternatives. These narratives rely on cherry-picked examples of perceived failures in other countries, notably the UK’s National Health Service, whilst ignoring the systemic inequities and inefficiencies of the American system. This resistance is not about safeguarding freedom but about protecting the profits of a privileged few, while the majority overpay for care that frequently fails to meet even basic needs.
The Corporate Propaganda Machine
Corporate-controlled media plays a pivotal role in shaping American attitudes against public healthcare, driven largely by the financial interests of its sponsors. Cable news networks rely heavily on advertising from pharmaceutical companies, private insurers, and healthcare middlemen, creating an inherent conflict of interest. These sponsors ensure that public discourse is skewed towards maintaining the status quo. Viewers are inundated with fearmongering narratives warning of the supposed dangers of nationalised healthcare: rationing, endless waiting lists, and the loss of individual freedom. These scare tactics deliberately evoke images of helpless patients languishing in overcrowded hospitals, ignoring the fact that millions of Americans already face similar struggles, often without any care at all.
A favourite target of this propaganda is the UK’s NHS, which is routinely held up as a cautionary tale. Critics point to its current challenges, such as staffing shortages and extended wait times, whilst conveniently ignoring their root causes: decades of underfunding and the corrosive effects of neoliberal reforms, particularly under Margaret Thatcher. Instead of acknowledging how these issues stem from deliberate policy choices, media narratives use them to discredit the very idea of a public health service. Similarly, the successes of other systems, such as those in Sweden or Denmark, are rarely discussed. These countries demonstrate how well-resourced, publicly funded healthcare can deliver exceptional outcomes. By obscuring these realities, the media ensures that Americans are steered away from considering viable alternatives, preserving the profits of the private healthcare industry at the public’s expense.
The Reality of the Current System
The reality of America’s healthcare system is a harsh one for most, defined by spiralling costs and inequitable access. Americans pay more for healthcare than any other population in the developed world, often without realising how deeply they are overcharged. Between premiums, deductibles, out-of-pocket expenses, and taxes that still subsidise healthcare programmes, the average American household spends an exorbitant portion of their income on medical care. Yet, despite these costs, the outcomes remain deeply inadequate. Per capita healthcare spending in the United States far exceeds that of countries with nationalised systems like Sweden or Denmark, but with far worse outcomes in terms of life expectancy, infant mortality, and overall public health.
Whilst patients and families struggle under the weight of these costs, the system itself is engineered to benefit a small elite. Insurance companies rake in billions in profits each year, whilst pharmaceutical giants charge extortionate prices for life-saving medications. Adding to this inequity, middlemen such as pharmacy benefit managers—CVS Caremark being a notable example—ensure profits remain concentrated by reducing what is covered and limiting provider reimbursements. Meanwhile, executive salaries in these industries reach obscene heights, with CEOs earning tens of millions annually, even as their companies deny care to patients.
The human cost is devastating. Medical debt remains a leading cause of bankruptcy in the US, with families losing their homes or livelihoods to cover medical expenses. Stories abound of patients skipping necessary treatments or rationing medication because they cannot afford them, leading to preventable suffering and death. In a system designed to extract wealth rather than provide care, the tragedy is that these outcomes are not anomalies—they are the inevitable result of a profit-driven approach to healthcare.
How a Public Health Service Would Work
A national health service (NHS) offers a transformative alternative to the fragmented, profit-driven model of American healthcare. Unlike “Medicare for All,” which seeks to expand the existing, flawed Medicare system, an NHS would treat healthcare as a public good, entirely nationalised and free at the point of use. It would eliminate private insurance middlemen and directly fund care through progressive taxation. This approach mirrors systems in countries like the UK, where hospitals and clinics are publicly owned and healthcare providers are government employees, and in nations like Sweden and Denmark, which pair public healthcare with decentralised management to ensure equitable access and efficient care delivery.
Such a system would fundamentally reimagine healthcare spending. Currently, Americans pay into an inefficient private insurance market where vast sums are siphoned off for profits, executive salaries, and administrative overheads. Instead of spending thousands annually on premiums and deductibles, this money could go directly toward funding care for all. For most Americans, this would result in substantial savings, as progressive taxation would replace regressive out-of-pocket expenses. Furthermore, by negotiating drug prices, as NHS systems in other countries do, the US could drastically reduce pharmaceutical costs, freeing up additional resources for public health initiatives.
However, building a functioning NHS in the US would require addressing another critical system: higher education. The current American model of college places immense financial burdens on students, leaving them to shoulder the risks and costs of training for professions like medicine, nursing, and allied health. Most students never break even, relying on programmes like Public Service Loan Forgiveness (PSLF) to manage debt—a system constantly under political threat. Without reforming higher education, the pool of skilled workers necessary for an NHS will remain unattainable. In Europe and the UK, where college is heavily subsidised or free, healthcare training is treated as an investment in the future workforce. Students graduate without crippling debt, allowing them to focus on patient care rather than financial survival. If the US were to follow suit, the creation of a publicly funded higher education system would go hand-in-hand with the NHS, ensuring that workers are adequately prepared and fairly compensated.
Moreover, making college a public good would address long-standing inequities in access to education. This is particularly crucial in fields like medicine and nursing, where a lack of diversity among practitioners perpetuates healthcare disparities. By removing the financial barriers to higher education, an NHS-supported model could foster a healthcare workforce that reflects the population it serves.
The vision for a national health service goes beyond fixing healthcare; it redefines how society invests in its people. A nationalised healthcare system paired with public higher education would create a foundation of equity and opportunity, allowing the US to prioritise the wellbeing of its citizens over corporate profits. It is a bold vision, but one rooted in common sense and proven success abroad. Instead of pouring billions into a system that lines the pockets of a few, the US could invest in its people, building a healthier, better-educated society for generations to come.
The Role of Neoliberalism in Shaping the Narrative
Neoliberalism, championed by figures like Margaret Thatcher and Ronald Reagan, has left a profound mark on public discourse around nationalised healthcare. Thatcher’s policies in the UK, often misrepresented in both British and American narratives, systematically undermined the NHS, turning it into a shadow of its original vision. Far from safeguarding the public purse, her government paved the way for privatisation and profit extraction. The introduction of internal markets in healthcare, designed to mimic private-sector efficiencies, instead fragmented the NHS, prioritising cost-cutting over patient care. Simultaneously, her administration reduced public funding, fostering a climate of perpetual crisis within the service. The promised “trickle-down” economic benefits never materialised, whilst corporations and private contractors flourished at the expense of public welfare.
Reagan, Thatcher’s ideological counterpart, executed a similar strategy in the US, slashing social programmes and allowing corporate interests to dictate public policy. Together, they spearheaded an era of neoliberalism that valorised individualism and demonised collective solutions, including healthcare as a public good. This shared legacy of privatisation and austerity continues to shape conservative ideology, where both leaders are deified. Within these circles, their policies are lauded as economic masterstrokes, with little acknowledgement of the widespread social harm they caused. Ironically, the erosion of the NHS is now used as a cautionary tale by American media and politicians opposed to nationalised healthcare, conveniently omitting Thatcher’s role in its decline.
The US media plays a critical role in perpetuating this selective history. Conservative commentators frequently highlight issues within the NHS—such as long wait times or staff shortages—as inherent flaws of public systems. These narratives are stripped of context, ignoring the chronic underfunding and privatisation pressures that have created these challenges. Similarly, the successes of other public systems, like those in Scandinavia or Canada, are barely mentioned, despite their strong performance in patient outcomes and cost-efficiency. Instead, the myth of Thatcher’s and Reagan’s economic genius continues to dominate, shaping a discourse that equates public healthcare with inefficiency and private profit with freedom.
This deification of Reagan and Thatcher obscures the tangible consequences of their policies and reinforces resistance to transformative healthcare reform in the US. The media, beholden to the same corporate interests that benefited under their neoliberal regimes, ensures that these narratives persist, steering public opinion away from considering healthcare as a collective right. To break free from this cycle, it is essential to confront the myths surrounding these leaders and expose how their policies, far from securing prosperity, entrenched inequality and undermined public welfare. Only then can the US begin to envision a healthcare system that prioritises people over profit.
Changing Minds: Reframing the Debate
Changing minds about nationalised healthcare in the United States requires dismantling decades of propaganda and reframing the debate around equity, morality, and collective benefit. The first step is to combat the pervasive misinformation that paints public healthcare as inefficient or inferior. Public education campaigns must spotlight the successes of nationalised systems worldwide, such as the NHS in its prime, or Scandinavian models that consistently outperform the US in health outcomes, life expectancy, and patient satisfaction. Americans need to see how these systems operate: free at the point of use, funded fairly through taxation, and designed to serve everyone equally, not just those who can afford it. This is not an abstract concept but a moral imperative—healthcare should be a right, not a privilege. Framing healthcare as a public good, like education or infrastructure, shifts the focus from individual cost to collective responsibility.
The economic and social benefits of a healthier population provide a compelling argument for change. Nationalised healthcare reduces financial barriers, ensuring people seek preventative care instead of waiting for emergencies, which are both costlier and deadlier. A healthy workforce is a productive workforce—free from the stress of medical debt or untreated illnesses, people can contribute more effectively to the economy. Moreover, equitable access to healthcare reduces systemic inequalities, lifting up marginalised communities that are disproportionately harmed by the current system. Studies have shown that societies with universal healthcare experience lower rates of poverty and greater social cohesion, benefits that extend well beyond individual health.
Reframing the debate also requires challenging the narrative that nationalised healthcare is unaffordable. The reality is that the US already spends more per capita on healthcare than any other country, yet millions remain uninsured or underinsured. Redirecting these funds from private profits to public care would provide better outcomes for less money. Americans must understand that their current system forces them to pay more for less, enriching executives while families struggle. Showing how their money could instead fund equitable, high-quality care reframes the conversation from fear to possibility.
Ultimately, this is a battle for values: the prioritisation of profits or people. Advocates must emphasise that healthcare is not just a policy decision but a reflection of what kind of society we want to build. A system that values every life equally and ensures no one suffers or dies needlessly isn’t just feasible—it’s necessary. By shifting the focus to collective wellbeing and shared prosperity, the path to a truly equitable healthcare system becomes not only imaginable but inevitable.
Sen. Rand Paul’s Objections Addressed
The argument, often voiced by far-right figures like Senator Rand Paul, that a NHS in the United States would “enslave” doctors is a startling distortion of reality. The idea hinges on the claim that government employment would strip doctors of their autonomy and force them into servitude. This rhetoric ignores the fact that doctors in an NHS are still salaried professionals—highly trained, respected, and fairly compensated for their work. The fundamental change is not their autonomy or professional standing but the source of their paycheck. Instead of navigating the profit-driven bureaucracy of insurance companies and battling for reimbursement, doctors would be paid directly by the government, allowing them to focus on patient care.
In fact, a nationalised system would likely improve the working conditions of healthcare professionals. Doctors in the current US system are burdened with administrative tasks, spending countless hours appealing insurance denials and managing billing codes, detracting from time spent with patients. An NHS eliminates much of this inefficiency, streamlining processes so that doctors can concentrate on medicine rather than paperwork. Far from “enslaving” doctors, it liberates them from the corporate interests that often dictate care decisions based on profitability rather than necessity. In countries with NHS models, physicians report high levels of job satisfaction, particularly because they are no longer beholden to insurance companies whose primary goal is cutting costs at their expense.
Moreover, transitioning to an NHS in the US could make medicine a more equitable and accessible profession. Currently, American medical education is among the most expensive in the world, often leaving new doctors saddled with debt reaching hundreds of thousands of dollars. This financial barrier disproportionately excludes students from lower-income backgrounds, reducing diversity in the medical field and limiting opportunities for talented individuals who cannot afford the cost of entry. By coupling an NHS with publicly funded higher education, as seen in many European countries, the US could remove these barriers, ensuring that anyone with the talent and dedication to become a doctor has the opportunity to do so, regardless of their socioeconomic background.
Such a system would benefit not only healthcare workers but society at large. Increasing equity in medical education would diversify the workforce, creating a healthcare system more reflective of the population it serves. It would also ease the physician shortage currently plaguing the US, as more students could pursue medicine without fear of crushing debt. These changes would elevate the profession, ensuring that doctors are valued not just as economic commodities but as vital contributors to public health.
The “enslavement” narrative crumbles under scrutiny. An NHS would not strip doctors of their autonomy or dignity—it would enhance their ability to practise medicine without interference from profit-driven entities. Pairing this with a public investment in medical education would improve equity, attract a broader range of professionals, and strengthen the entire healthcare system. Rather than fearmongering about government control, the far right should confront the real source of servitude in healthcare today: a system that prioritises profits over care.
Final thoughts …
The current American healthcare system is a glaring example of profit prioritised over care, forcing individuals to pay more than any other population in the developed world for outcomes that consistently fall short. It is a system designed not to heal but to extract wealth, benefiting insurance companies, pharmaceutical giants, and corporate executives while leaving millions uninsured or underinsured. Meanwhile, the myth of freedom under this model masks the reality of medical bankruptcy, denied care, and preventable deaths.
The path forward is clear: the United States must embrace healthcare as a public good, not a private commodity. A national health service, fully funded through progressive taxation, would eliminate the inefficiencies and inequities of the current system, guaranteeing care for all while reducing costs overall. It would also ensure that healthcare workers can focus on their patients, not on navigating the labyrinth of billing codes and profit-driven gatekeeping. Paired with publicly funded higher education, such a system would break down barriers to medical training, fostering a more diverse and equitable healthcare workforce.
It’s time to rethink the propaganda that has shaped public perception for decades. The question is not whether the US can afford a national health service but whether it can afford to continue with a system that fails so many for the benefit of so few. If every dollar spent on premiums, deductibles, and out-of-pocket expenses could instead fund guaranteed care for all, why wouldn’t we demand it? The answer lies in choosing fairness, efficiency, and humanity over the greed of the status quo.