Creating a Free Health Care & College System Without Breaking the Budget

In 2020, the U.S. government spent $1.9 trillion dollars for public health care, and $83.68 billion in student loans in 2021, bringing the total federal student loan debt to $1.74 trillion dollars.

Health Care

In fiscal year 2020, UMass Medical System spent $2.8 billion in costs while New York’s Presbyterian/Weill Cornell Medical Center spent $7.2 billion for expenses.

Averaging these together brings us to $5 billion dollars each. This would be a respectable hospital and could be expected to provide a wide range of high quality services.

If the entire fiscal budget of U.S. government health care spending was allocated to a system of free hospitals and medical clinics around the country, $1.9 trillion dollars would support 380 facilities at $5 billion each.

Entire hospitals could target a segment of the region’s demographics — children, pregnant mothers, trauma centers, medical schools, ambulatory, long-term care, elder care, 55 to 64, 65 and older, etc.

However, it is unlikely that either party would agree with dismantling Medicare, Medicaid and other existing federal health care programs and the sheer logistics would prove a herculean task for any government rendering the possibility nonexistent.

Instead, two options could be employed.

1. Reduce spending on federal health programs including Medicare and Medicaid by 20%. This would generate $380 billion dollars in annual funding for a free health care system. $380 billion dollars would create 76 free hospitals and medical centers around the country. The top 20 major metropolitan centers of the U.S. would be covered, and smaller hospitals and health care centers could be created to cover the top 76 cities in the U.S. with no less than one full-service health care facility in each state.
2. The tax code could be amended to include a tax credit made to the free federal health care system. Because donations to non-profit organizations are currently tax deductible, a tax credit plus a 101% tax deduction would incentivize corporations to apply their taxes to the free federal health care system. If just 10% of annual corporate income taxes could be diverted in this manner, another $25 billion dollars would be added to the health care budget bringing the total to $405 billion dollars and adding 5 more full-service hospitals for a total of 81 full-service hospitals and medical centers.

These funds could be further allocated to create a handful of major hospitals and medical centers around the country, another 30 or so slightly smaller health care facilities scattered strategically across the country and a bevy of ambulatory care centers. The country could have well over 100 free health care centers around the country providing free health care and prescriptions for every person and every need.

Free College and University System

As is true with our medical expenses, college expenses are out of control.

Many of current graduating students matriculate with average debt of $16,000 while law students and medical students are apt to be burdened with debt of $100,000 to $300,000 or more.

In the most prosperous country in the world, this is nothing less than preposterous.

We are enslaving our young adults to a system that will keep them in debt for the next 10 to 40 years of their lives. How can we expect them to be successful, contributing members of society with such extreme debt tying them to a life of utmost frugality and extreme budgeting finesse with the commensurate stress that coexists with money issues?

We can’t.

The federal government spent $83.68 billion dollars on student loans in fiscal year 2021 bringing the national total student debt to over $1.7 trillion dollars. This is a burden which is not only too great for our students and young adults to bear, it is also unworthy of the greatest nation on Earth.

In 2021, Harvard University’s operating budget was $5.2 billion dollars, the University of Massachusetts operating budget was $2.6 billion dollars operating 6 campuses, the California State College system had a budget of $12.4 billion dollars for fiscal 2021–2022 operating 23 separate colleges, the University of Texas had a budget of $13.5 billion operating 13 institutions and the State University of New York had a budget of $11.9 billion dollars operating 64 campuses.

Averaging all these together would equal 107 colleges with an annual operating budget of $434 million dollars each.

As with the health care system we could create a handful of world-class universities, one in each of the 20 largest metro areas of the country and one college in each of the largest cities of each state (50) and one community college in each of the 100 largest metro areas of the country.

If we surmise budgets of $4 billion dollars for each of our 20 world-class universities, we have $80 billion dollars in total expenditures.

If we spent $380 million a year on each of our 50 state colleges and $100 million a year on each of our 100 community colleges we would have a free college and university system delivering extraordinary education through 170 campuses across all 50 states for an annual budget of $109 billion dollars a year.

Because the United States currently spends $83.68 billion dollars a year on student loans we have a shortfall of $25.32 billion.

The department of Education, who’s stated goals are to make secondary and post-secondary education more accessible and more affordable is clearly not doing its job. By eliminating the Department of Education with its budget of $235.7 billion, not only could we cover the gap of $25 billion dollars, we could add 80 world-class universities for a total of 100 world-class free universities and add 100 colleges for a total of 150 colleges with a handful located in U.S. territories and we could add 200 community colleges spread throughout the nation providing quality education to millions of Americans.

And we still would have $97.7 billion dollars remaining from the former Department of Education’s budgets which could be used to pay down the national debt or allocated to fund other programs.

Conclusion

A free nationwide health care system and a free nationwide college and university would achieve three goals:

1. Provide free health care and free post-secondary education to all Americans.
2. Provide debt-free health care and post-secondary education to all Americans freeing them from the stress of burdensome debt generated by traditional health care and college education.
3. Increase competition thereby lowering costs at all remaining institutions.

This will generate a great deal of blowback from entrenched interests on both sides of the aisle and from the vested interests of the institutions affected.

We can do this, but it will require extensive bipartisan cooperation. Moreover, it is a plan that is long overdue, and the benefits would far out way any disadvantages of the implementation and political consequences resulting from such bipartisan cooperation.