Things No American Should Have to Pay For


Wherever you fall on the political spectrum, you almost certainly don't enjoy paying for health care costs -- there's nothing worse than getting that doctor bill, not knowing what it might contain. And while it would be nice to dedicate your life to maintaining a perfect, illness-free body and mind, with work weeks upwards of 50 hours and rising out-of-pocket health care expenses, it can feel impossible to find the time or money needed to invest in what some people call a "temple," others "the bag of bones that shuttles them to and from the office every day." 

There's no good reason for it to be this way. Despite being one of the richest countries in the world, the United States ranks 31st in life expectancy, below Greece, Portugal, and Slovenia. Slovenia, people, and Greece's economy is in shambles! America should support every effort you make to stay healthy, not ask you to turn over an arm and a leg every time a major health issue arises. Besides, prosthetics are expensive, too. 

Who's going to pay for this free stuff?

Lest you think this is just a whining plea for the gubment to give you some free condoms (though, stay tuned) in exchange for crippling taxes and probably Communism and all the bad dance music that comes with it, consider the following:

The United States already spends way more per capita on health care than any other nation in the Organization for Economic Co-operation and Development, even ones where income levels are similar -- like Switzerland, where they spend about $2,300 less per person, per year on health care. Switzerland has the second-highest life expectancy in the world, by the way.  

"OK, but those other countries all have shitty public insurance, whereas America has private insurers paying for a lot of the costs." Well, America does spend a lot of money in the private sector on health, but even public spending per capita is third highest, behind Norway and the Netherlands. In short, your taxes are already funding a massive public health system, whether you realize it or not. 

So where's that money going, and how can it be more effectively used? Those are huge questions that probably aren't going to be solved while reading on your phone, but one problem area is pharmaceuticals: America spends way more on them -- partially because we don't allow Medicare to negotiate prices -- than other countries with large public health systems. Instead, private insurers do the job, and they are, after all, for-profit companies that have the bottom line, rather than health outcomes, as the primary objective. Those profits are considerable -- even with insurers griping about losses they're taking by participating in Obamacare exchange plans, they're still doing OK, with UnitedHealthcare reporting profits (again, profits, not revenue) of just under $1billion in the third quarter of 2015. Imagine what could be done with just some of that money!  

Even if you're not a fan of taking away or limiting profits in favor of investment in public health, policy changes within the current system could free up money. If Medicare, under its Part D program, were allowed to negotiate drug prices with manufacturers, for example, a substantial amount of money could turn up, though the estimates vary -- safe to say that Donald Trump, who actually supports drug price negotiations, isn't quite on the mark with his $300 billion claim, but it's certainly in the billions. Medicaid, which is allowed to negotiate these prices, delivers drugs at 20% to 30% lower costs than Medicare

The point is that we already have the money, and are spending it; if America could invest it in making key goods and services available for free, especially those geared toward prevention -- perhaps, given the USA's love of public-private partnerships, a contracting system similar to that of the Department of Defense could award, say, Durex or Trojan the right to make government condoms -- it just might lower longer-term costs of care, as you'll see in the first suggestion below. Here are a few places to start.

birth control

Birth control

Birth control is one of the most common health care-related expenses. Women tend to bear the financial burden, but the truth is that everyone benefits from saving on costs related to unwanted pregnancies and abortions.

When Colorado began an experiment in 2009 offering free IUDs to teenage and uninsured women, it saw huge decreases in the teen birth rate and abortions. Colorado’s health department estimated that every dollar spent on the program saved $5.85 spent on Medicaid, which covers most teenage pregnancies and births in Colorado -- in essence, the state was buying $5 for just a buck of up-front expense. Oh, and there should be free condoms, like, everywhere, right? Obamacare has made a lot of progress on this front, but there's still a long way to go. A healthier, wealthier America is just a few million free condoms away!

Gym access

It's well known that America faces one of the worst obesity epidemics in the world, with 38% of the population battling the condition. That's a nice way of saying Americans are fat, increasing the risk for diabetes, cardiovascular disease, and stroke. Making sure all Americans have a safe and supportive space in which to exercise is essential to reversing this trend.

Unfortunately, gym memberships are expensive, especially if you have medical costs related to your weight. How are you supposed to break out of that cycle when you're worried about an extra monthly expense, not to mention initiation fees? If gym memberships were subsidized by the government, how many more Americans could take advantage of -- and reap the health and psychological benefits associated with -- physical activity? 

Realizing the potential for saving on costs related to diabetes and cardiovascular risk, health insurance companies are already taking the lead on this, offering reimbursements on gym memberships for those they cover. America can do the same! The government should help us exercise the right to… exercise.



Dealing with menstruation on a monthly basis is already a struggle. There's no reason women should throw down extra money on tampons, sanitary pads, or DivaCups, a cost unique to anyone with a uterus -- when you take a shit in a public bathroom, you don't get charged extra for toilet paper because "you're dirty." It's a fact of life you can't change, and one sex shouldn't be economically penalized for biology. 

This has some activists calling for feminine products to be tax-free, alleging the "tampon tax" unfairly burdens women. In the state of California, women pay an estimated $20 million annually in taxes on feminine products. $20 MILLION -- and that's just on the taxes.

But why make tampons tax-free when we could just make them FREE? Women already pay the price of having to use feminine products with questionable ingredient lists, including potential carcinogens. The least we can do is make sure women aren’t unduly financially burdened by their anatomy. Nobody wants to pay for a tampon. Nobody should have to pay for a tampon. Period.

Toothbrushes and floss

Medical care can feel like a breeze compared to dealing with dental insurance. Even among people with health insurance, 45 million don't have dental coverage. What with the high-sugar American diet and lack of preventative dental care, thousands of Americans end up in the emergency room every year due to complications from bacterial accumulation on their teeth. These infections even result in some deaths.

Dental care should be accessible and affordable to all, but as we all know, preventative dental care starts at home, with regular toothbrushing and flossing routines. Toothbrushes and floss are just two more items every American should be guaranteed to have for free. Smile, America! 

STD testing
Alexander Raths/Shutterstock

STI testing

If you're sexually active, getting regularly tested for HIV and other sexually transmitted infections (STIs) is one of the most important ways to take care of your body. The bloodwork and anxiety surrounding these tests are unpleasant enough. Getting hit with a giant bill from the lab is just one more reason to put off your STI testing until next year, which could come at a high price to your partners and the American people.

After New York City shut down its most visited free STI clinic, the city saw a significant uptick in cases of syphilis, gonorrhea, and chlamydia. Over the past five years, after three free clinics were closed, visits to NYC STI clinics dropped by 40,000 visits per year. That’s 40,000 missed opportunities to identify and treat an STI! And nobody wants a city full of syphilis, right? 

In an age where Pre-exposure prophylaxis treatment (PrEP) is available for HIV and treatment is readily available for syphilis, chlamydia, and gonorrhea, we're medically at the forefront of STI prevention and treatment. However, testing remains essential to keeping you and your partners healthy. 

Flu shots

Ah, the flu, the pesky little seasonal virus that kills 36,000 people a year. Many people consider the flu shot optional each year, and the very young and the very old are most vulnerable, but you don't have to have the worst version of the flu to be hit hard by its symptoms, missing days or even weeks of work and fun.

As with all vaccines, flu shots work not only by protecting the individual, but by protecting the group. If enough of the population receives the vaccine, the virus is more likely to die out and the entire population is less likely to suffer that year's most prevalent strain of the flu. If you work as an educator or in health care (where you can easily contract and spread the virus) it’s especially important to protect yourself (and by extension, all those you interact with). 

Speaking of vaccines: shouldn't they all just be free? Doctors and researchers have worked tirelessly to find cures for devastating diseases, but they come at a cost to individuals? If we started distributing them for free, literally everyone would win (except measles, mumps, rubella, polio, hepatitis A and B, tetanus, diphtheria, pertussis, typhoid, and HPV).

William Perugini/Shutterstock

Ambulance rides

There might be nothing more essential to receiving emergency care than a trip to the hospital, but the staggering costs of an ambulance ride can make what should be a simple phone call that much tougher to make. Ambulance rides often cost well over $1,000. Even if you have insurance coverage, emergency rides are billed separately from emergency care, so you're almost always looking at an ambulance copay on top of an emergency bill copay. Should anyone ever have to think twice about calling 911?

Speaking of calling 911, shouldn't all emergency medicine be covered as well? In fact, shouldn't access to affordable basic health care just be a given, especially for those living in the richest country in the world? Why stop at ambulance rides and toothbrushes?

Of course, the obvious response might be, "How are we going to PAY for all this?" If there's one thing Americans hate, it's the specter of more taxes and a nanny state; the thing is, we're already paying more for health care than most other nations, spending 17% of the GDP on health care. Compare that to Greece, which spends 8% of its GDP, or Slovenia, which clocks in at around 9%.

No American should have to pay for primary care visits, mental health visits, or vision and dental care. We’re already one of the richest countries in the world. It’s time to invest in making this country the healthiest in the world.

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Jamey Frieden is a freelance writer for Thrillist and longtime believer in all things free and cheap (especially when it comes to YOUR health). Follow Jamey's overly photographed adventures in healthy cooking: @freejamfit