By Marvin Malek, M.D., M.P.H.
The Barre-Montpelier (Vt.) Times Argus, March 5, 2026
On Feb. 22, President Trump announced plans to send a U.S. hospital ship to Greenland to address unmet health needs.
If the goal were to showcase American medicine in full, one ship would not be enough. We would need additional vessels carrying insurance administrators to process prior authorizations, review claims, issue denials, and manage billing disputes. It would hardly be an authentic demonstration of U.S. health care without the paperwork and surprise bills.
Perhaps, however, Trumpās intention was likely to create a mini-single-payer system: U.S. taxpayers would fund the care and there would be no deductibles, copays, network restrictions or other insurance-related hassles that impede care and add expense. Under such a system, the ship could sail alone.
If the U.S. had a single-payer system, our nationās taxpayers would all contribute ā just as in Trumpās Greenland offer ā but instead of our taxpayers funding care for citizens of another country, we would be taking care of our own people here in the U.S. and eliminate all the cost, stress and aggravation of dealing with multiple insurers.
Greenlandās prime minister, Jens-Frederik Nielsen, declined the offer. Greenland already has a single-payer system that covers its entire population. Residents receive care without deductibles or copays. Universal access is not debated; it is assumed.
The contrast with the United States is sobering. In 2024, 28 million Americans lacked health insurance. Millions more carry high deductibles that discourage them from seeking routine care. Onerous medical debt is widespread. The United States spends more per capita on health care than any other developed nation, yet leaves millions uninsured and burdens providers with mind-boggling administrative complexity. Hospitals employ large billing staffs simply to navigate multiple insurers and payment rules.
But Greenland goes beyond simplifying and streamlining its financing and payment systems. It carefully evaluates the health needs of its population, and works to meet them as efficiently as possible. Consider air ambulances, a necessity given Greenlandās dispersed population and the near absence of a highway system for ground transport. Air ambulance transports are essential. In the United States, the median charge for air ambulance transports exceeds $35,000, a figure that has risen sharply after we allowed predatory, private-equity capital firms to acquire much of the industry. In Greenland, where the government treats air transport as an essential public service, the median cost is about $4,850 ā despite harsher geography and turbulent weather.
Sending a hospital ship abroad may generate goodwill. But it also underscores a deeper question: If we can imagine providing streamlined, publicly financed care overseas, why not at home?
Dr. Marvin Malek is an internist and former president of the Vermont chapter of Physicians for a National Health Program.
