Thailand was able to accomplish universal health care and found it to improve the life expectancy to 74 years of age, which is considerably high for a third-world country. Other countries look at the United States to effortlessly be able to afford universal health care as a first-world country but realize that their political complexity is what obstructs its establishment.

The Republican's possible solution to the health care costs is by maintaining private insurance and health care transparency. However, this transparency merely allows the impending expensive costs of healthcare to roll over onto patients who had to seek emergency care in life or death situations. There is no citizen satisfaction in surprise billing when around 22% of the patients received surprise billing from out-of-network Emergency Departments ranging from around $600 to $20,000. This does not alleviate the debt healthcare faces if the patients cannot pay off their absurd medical bills.

The billion-dollar healthcare debt still stands and there needs to be new methods to help dismantle the expense. The report on The Regulation of Private Health Insurance by the Robert Wood Johnson Foundation gives an overview of the role of private health insurance in health care reform and states that "Perhaps the most promising approach to reform would be to develop uniform national minimal standards for health insurance enforced primarily at the state level.". At the time when private health insurance was created, it was beneficial to the public, but for the current day health care costs the system has become outdated.

US health care costs are out of an appropriate range that can be maintained for the future of public health and private insurers. The sporadic health care costs have become out of control due to the lack of regulations and are considered "waste" in our health care system. The study Eliminating waste in US health care has defined waste into six categories: over-treatment, failures of care coordination, failures in the execution of care processes, administrative complexity, pricing failures, and the last category is fraud and abuse. According to financial accounting, twenty percent of the total health care expenditures consists of the sum of the lowest available estimates. This serves to show that the real total is most likely greater than the total estimates.

Another perspective as to why the healthcare system has created a situation where many Americans of poor, middle-class and even wealthy are using Medicaid to fund their long term health care needs is the reason for healthcare itself. In other words, healthcare is an exponentially innovative field where the purpose is to find any means possible to prolong life. The goal to beat life itself could go on for as long as possible. Innovative healthcare has created a longer lifespan for us humans, which yields to the need for long-term health care needs. With an increasing need for long-term health care, we face an increased cost for medical care.

2020 will have to be the year for healthcare reform towards universal benefits.