In the modern era, the federal government’s involvement in healthcare has been defined by the creation of Medicare and Medicaid in 1965 and the passage of the Affordable Care Act (ACA) in 2010. Under the Biden administration, ACA subsidies were enacted and are set to expire by the end of the year. Congressional disagreements over extending these subsidies contributed to a failure to pass necessary appropriation bills, ultimately triggering the longest government shutdown in U.S. history.
We ask the Vanderbilt community to answer the question: What role should the federal government play in funding healthcare in the United States?
Any Vanderbilt student is welcome to contribute to this conversation by submitting a paragraph response to VPR Editor in Chief Alícia Isasi ([email protected] ). Please refer to VPR’s CrossTalk policy via the “About VPR” page.
Student Responses
Contribution #1
The federal government’s involvement in healthcare funding is imperative for the well-being of millions of Americans. Rising healthcare costs and private insurance issues have left a great portion of the population struggling. Healthcare is a basic necessity that should be supported by the federal government, in light of our country’s founding values of life, liberty, and the pursuit of happiness. Decent personal health is the key to achieving the latter three virtues. Globally, many countries have universal healthcare, which can result in longer life expectancies, lower infant mortality rates, and fewer cases of obesity. Many Americans today struggle to afford healthcare– including doctors’ visits and prescription medication, which should be routine aspects of care. It is the federal government’s responsibility to ameliorate these disparities and provide greater financial assistance to public healthcare programs or broaden eligibility for the general public.
- Shaila Fogarty
Contribution #2
The federal government absolutely should take the lead in funding healthcare, because access to medical care directly shapes a person’s ability to live safely, work consistently, and contribute to their community. When people skip doctor visits, delay treatment, or avoid medication because of cost, it is not just their personal health at risk. It affects workplace productivity, school attendance, family stability, and even national economic performance. A universal federal system would create a stable foundation so that every American, no matter their background or employment status, can receive essential care without facing financial panic. It would reduce health disparities, strengthen public health, and make the system more predictable and fair.
But this system must be fiscally responsible. The goal is to make healthcare accessible without putting unnecessary strain on taxpayers or adding to national debt. The federal government can do this by negotiating drug and treatment prices, limiting redundant administrative costs, and investing in preventive care to reduce expensive emergency interventions later. When funding is organized, transparent, and focused on long term outcomes rather than short term billing, healthcare becomes both more affordable and more effective. That is what a sustainable, universal model should look like.
- Saadika Salauddin
Contribution #3
The federal government should play a central and consistent role in ensuring that every American has access to healthcare by transitioning to a universal, federally funded system. Healthcare is an essential human need, yet the United States continues to rely on a fragmented, market-driven model that leaves millions uninsured or underinsured and drives some families into medical debt, negative health outcomes, and bankruptcy for basic care. While critics point to the significant upfront cost and the likelihood of higher taxes needed to fund universal coverage, a government-run system would likely streamline spending by eliminating the inefficiencies, administrative waste, and profit motives that inflate prices in our current structure. Other developed nations show that universal healthcare—funded and guaranteed by the federal government—can deliver better outcomes at lower per-capita costs, with taxes effectively replacing the premiums, deductibles, and out-of-pocket expenses Americans already struggle to afford. The recent debates over expiring ACA subsidies underscore how unstable and politically vulnerable our patchwork approach to coverage remains. Instead of repeatedly negotiating temporary fixes, the federal government should guarantee healthcare as a right by establishing a durable, universal system that covers all residents regardless of income, employment, or political circumstance. - Eloise Beckwith
