Here is a key point -- " the government would have much more control over the medical system." Someone in the federal government is going to make decisions about your well-being. In other words, a bureaucrat may tell the provider, no that procedure is not covered and unnecessary. That's the downside to Bernie's grandiose plan.
13
There are multiple reasons why Sweden like national health insurance would cost a lot more in the US -- (1) Much of our healthcare costs [more than 25%] are tied to obesity, and about 38 percent of the US population is obese -- more than twice as much as that of Sweden. (2) Drug, opioids and related care are epidemic in the US. (3) Gun, violence, and firearm related injuries are extensively higher. (4) Doctors are much highly compensated, partly to account for higher educational expenses. You can't lower doctor's salaries and not expect to have a physician shortage or lowering of quality, as MBAs and some other professions make even more than doctors.
Medicare for all MAY lower overall medical expenditure in the US, but a lot can also go wrong. In any case, medical expenditure per person may still be twice as high as Sweden.
A much better model is a system like Kaiser in California and some other western states. It is a not-for-profit fully-integrated system, with no surprise costs, waiting, bloated administrative costs by insurers or middlemen, or incentives for doctors to perform needless surgeries. Needed are multiple systems like this competing with each other that can be "seeded" by the government.
11
One thing never mentioned is where the enormous premiums now paid by employers would go . Would the law require that these be given to the employee in the form of salary? Could the employers just keep these as a reduced expense?
7
I would like to hear a reasoned analysis of HOW Medicare for All can be achieved in the next ten years without a wave election that gives a majority to the progressive wing of the Democratic Party. Supporters of M4A have only been elected in safe Blue districts. The democrats who re-took the House by winning in contested Congressional districts are not supporting M4A. Of course M4A is technically possible to implement, but it is not politically possible. Johnson got Medicare and Medicaid through after capturing super majorities in the House and Senate, and having unique skills in managing legislation. Obama got ACA through with a super majority, and it cost Democrats the House and the Senate in the mid-term election. Now, we are being told that it will help Democrats retake the Senate if the Presidential candidate runs on M4A. This seems like wishful thinking in the extreme. Who are the senators and congress people that will win contested elections then vote for M4A? If Trump wins because people in Michigan, Pennsylvania and Ohio are not ready to vote for that big a change, we can say good bye to any progress in health care reform for a generation, because the Supreme Court will be in the hands of the right wing. The problem isn't the theory of M4A, it is the risks and difficulties of achieving it politically. The proponents have little to say about this, other than moral arguments. Where are the votes for M4A? The downsides of miscalculation are enormous.
7
It would be helpful and informative if this article explained the Sanders plan is a four year program of transition to medicare for all, not an overnight massive shift. The mechanics of his plan more significant than the slogan.
6
I fail to understand why none of the M4A “explainers” fail to mention that any increase in taxes is likely to be offset by the elimination of private insurance premiums, co-pays, and deductibles. And if it’s M4A, wouldn’t each working person over 18 have to pay a monthly Medicare premium, as I do now, to help pay for the system? Would Medicaid be eliminated? This is all clear as mud.
6
@BlueMountainMan Taxes are an absolute certainty. Medical deductibles aren't (healthy family spends less than $500 per year on out-of-pocket expenses).
2
@James Deductibles aren't the only cost of private insurance. Rest assured, one's employer, and likely the individual as well, is paying a premium for their insurance.
4
We are neglecting to prevent exorbitantly expensive chronic health problems in our future Medicare recipients. *25% of the Medicare budget is spent on Diabetes*. Just ONE chronic disease. As a nurse who counsels chronically-ill people all day long, I struggle to understand why we don't hear more about what I believe to be the single most important predictable outcome of universal healthcare coverage: Access to healthcare will dramatically reduce healthcare costs that result from a lack. There is no better example than diabetes, which costs us $327 BILLION a year. 30 million of us have it, and 84 million are on their way. This preventable, controllable disease leads to catastrophic and expensive events and disability when its not controlled. The bulk of the costs are on treating preventable infections, amputations, dialysis, heart attacks, strokes, nerve damage and the loss of productivity they result in. Even in people without the ability or desire to lose weight or adhere to strict dietary or exercise recommendations, these complications are preventable. I'm capable of helping almost anyone to get it and keep it under control, but not if they don't have health coverage and/or can't afford the medications. And not if their PRIVATE insurance doesn't cover management by a diabetes specialist such as myself. An ounce of prevention, people. We are the sickest of the developed nations and that's why we spend so much.
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@Kathleen Breen Well said. If you took the American population and stuck them into the Swedish or Norwegian health care system, those systems would spend a lot more.
If type II diabetes is an issue now (it is preventable), wait until there is a reduced economic incentive to maintain healthy weight & blood sugar/insulin levels.
3
@Kathleen Breen And wait until the Coronavirus hits. We want people to get treatment but a lot of people will not be able to afford to go to the doctor or the hospital and they will make the pandemic much worse than it would be otherwise.
4
Since when does insurance and Medicare pay for cosmetic surgery? My physician in the spine clinic referred me for a breast reduction but I was told that they have opted out of the Medicare program. There are many reasons that "cosmetic" surgery would be essential such as severe disfigurements from auto accidents, shootings, etc.
5
What we can say for certain about the Sanders plan is that what he is now proposing is not what the legislation will look like. Compare the Obama administration's initial proposal with what the ACA does.
I have frequently bemoaned the "Medicare for All" moniker for what should be "universal health care." Sanders has mistaken the road he is on for the eventual destination; I'm less picky, so long as we get there.
8
The cost of care in the US is far too high and will have to come down if we don't want to bankrupt the US Treasury. This means that if we adopt M4A physicians, Big Pharma, nurses, PAs, medical devices, physical therapists, etc. will all need to be paid Medicare rates which are not out of line with what these people make in many parts of the world (like in Europe). The profit motive will need to be erased from hospitals. It's ugly but sometimes the truth hurts.
13
@Anita I guess our school teachers should be paid what school teachers in Europe get paid as well? That would certainly reduce our education costs compared to costs in European countries.
1
@JTCheek Sure, if class sizes, pension and other benefits are also equalized.
3
The purpose of Medicare for All (M4A), aside from covering everyone , is to reduce administrative bureaucracy and eliminate the profit motive/ middlemen in health insurance. M4A would cost less than our current obsolete system. By funding our health insurance system with progressive taxation, people pay in using the same basis that we pay income tax now; health care services are based on medical need, not ability to pay.
The key to reducing overall health insurance costs to families is found in the elimination of greedy private health insurance industry profiteering. With new M4A, the overall cost of health insurance will be reduced for most families.
2 new bills, H.R. 1384 and S. 1129, “The Medicare for All Act of 2019”, cover all necessary med.services: primary care, medically approved diet and nutrition services, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, hearing services, long term care, palliative care, podiatric care, mental health services, dentistry, oral surgery, eye care, chiropractic, and substance abuse treatment. Patients have their choice of physicians, mental health and other professionals, hospitals, clinics, and practices .
By separating health insurance from health-care delivery, the need to arrange personal finances at the point of service as a condition of accessing that care is eliminated. M4A is a humane, uncomplicated system dedicated to helping everyone get health care when needed.
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@F.Douglas Stephenson, LCSW, BCD I recently read in these pages I believe a government study that showed M4A saving several billion annually.
6
1. It is important to note that M4A is an INCREMENTAL change. We have had Medicare for decades for the part of the population that needs the most care. For the most part it works exceedingly well. Just ask someone on Medicare. We know how to run it. Extending it to everyone even with Bernie's improvements would not be as complicated as the ACA was. The ACA had many new elements we did not know how to run--exchanges, penalties, subsidies, etc.
2. There have been several estimates of its ten year costs by experts, from the liberal Urban Institute thru the economists at UMASS to the very conservative Koch funded Mercatus Institute. All of them have been below $35 trillion. Is that expensive or not?
There is a simple computation that the Times refuses to publish that provides the answer. The CBO said we spent $3.65 TRILLION on healthcare in 2018. Long term medical inflation has been running at 5.25%. A simple compound interest calculation says that the cost of healthcare for the next 10 years would be over $50 TRILLION if nothing changes.
Actually asking how will we pay for it is the wrong question to ask. I will deal with that in another comment.
4. It is true that other peer countries except Canada, allow some private insurance, but except for Germany, they ALL require everyone to pay the taxes for the national plan. Thus very few can afford to duplicate the coverage in the national plan. Germany allows you to opt out if you earn more than a certain amount; only 10% do.
30
@Len Charlap Len, you are clearly well informed about health care policy. I would like to hear a reasoned analysis of HOW Medicare for All can be achieved in the next ten years without a wave election that yields a progressive majority. M4A supporters have only been elected in safe Blue districts. Those who re-took the House by winning contested districts don't support M4A. M4A may be technically possible to implement, but I doubt it is politically feasible. Johnson got Medicare & Medicaid through after winning super majorities in House & Senate, with historic legislative skills (Bernie is not LBJ or FDR in legislative skill). Obama got ACA through with a super majority, and lost the House and the Senate in the mid-terms. Now, we are told it will help Democrats retake the Senate if the Presidential candidate runs on M4A. This seems like wishful thinking in the extreme. Who are the senators and congress people who will win contested elections and then vote for M4A? If Trump wins because people in MI, PA, OH, WI, & VA are not ready for that big a change, we can say goodbye to ANY progress on health care reform for a generation, because a right wing Supreme Court will block reform. The problem isn't the theory of M4A, it is the risks and difficulties of achieving it politically. M4A proponents have little to say about this, other than moral arguments. Where are the votes to get M4A passed? Will M4A help beat Trump? The downsides of miscalculation are enormous.
2
1. It is important to note that M4A is an INCREMENTAL change. We have had Medicare for decades for the part of the population that needs the most care. For the most part it works exceedingly well. Just ask someone on Medicare. We know how to run it. Extending it to everyone even with Bernie's improvements would not be as complicated as the ACA was. The ACA had many new elements we did not know how to run--exchanges, penalties, subsidies, etc.
2. There have been several estimates of its ten year costs by experts, from the liberal Urban Institute thru the economists at UMASS to the very conservative Koch funded Mercatus Institute. All of them have been below $35 trillion. Is that expensive or not?
There is a simple computation that the Times refuses to publish that provides the answer. The CBO said we spent $3.65 TRILLION on healthcare in 2018. Long term medical inflation has been running at 5.25%. A simple compound interest calculation says that the cost of healthcare for the next 10 years would be over $50 TRILLION if nothing changes.
Actually asking how will we pay for it is the wrong question to ask. I will deal with that in another comment.
4. It is true that other peer countries except Canada, allow some private insurance, but except for Germany, they ALL require everyone to pay the taxes for the national plan. Thus very few can afford to duplicate the coverage in the national plan. Germany allows you to opt out if you earn more than a certain amount; only 10% do.
7
Won't work without a flat tax system that eliminates ALL deductions.
1
As an ER physician I don't want to know about insurance policies; I just want to treat patients to my best ability. I hate seeing patients come in to be diagnosed with end stage cancer because they couldn't afford insurance. Of course I love a terrific salary, but I earn it by working long long hours. I don't receive more than a small percent of what is billed in my name; there's a lot of profit in there for the corporation that hires me and the hospital that runs the ER.
Perhaps Sanders plan is too generous. How, though, can it cost more than we are already paying (and not receiving) when we cut out a bunch of middlemen?
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@Elwood
How, though, can it cost more than we are already paying (and not receiving) when we cut out a bunch of middlemen?
Because it is Medicare for ALL, including those approx. 25 million uninsured and 60 million underinsured, who will get care that they now forgo. But that's kinda the point, right? A good thing?
4
PS
Over 40% of Americans now enjoy a federal coverage for their health insurance. Medicare (beloved), Medicaid and VA insurance is joined by subsidized ACA options.
3
@Sara 1. Everyone on "beloved" Medicare depends on private companies that will no longer exist or who will exist in some way not explained. Private companies run all four public Parts of Medicare - A, B, C and D -- plus the private indemnity insurance and group retiree plans that seniors have to have because A and B are so bad
2. Not many people belove Medicaid or the VA. I'm sure there are some exceptions but they are few and far between
3. I'm told almost everyone on it dislikes Obamacare (something like 5,000,000 people dropped it as soon as the law allowed them to and another 5,000,000 were willing to pay a fine right from its start rather than have to sign up for Obamacare when the tax was in force)
2
@Dennis Byron Well I have Medicare and I "belove" it. Everyone I know who is on Medicare "belove" it too. And you ask anyone who lives in a state with its own ACA exchanges (where the ACA is run they way it's supposed to run) and they'll tell you that they "belove" the ACA also. Medicaid? The VA? Beloved or not, they would go away so, irrelevant. Finally, I didn't know where you are getting that private companies run Medicare Parts A, B, D. I have all three and I work directly with the government.
3
@Larry Sorry but no you do not work "directly with the government." If your legal address is NY, your Medicare Parts A and B claims and any other issues should you have any are handled by a for profit insurance company out of Indiana called Anthem.
And it is 99% certain that you also work with another private company to supplement A and B because A and B provide terrible financial protection
1
The good: universal health care
The bad: political hysteria at a big federal plan
The truth: It is far most efficient to have a single pot of money paying for health care- this eliminates profiteering (which should never be the incentive in clinical practice!) and wasteful administrative/advertising overhead as well as shareholder pressures. Current 'managed care' installed to reduce costs has mostly reduced quality of care, discounting payments, limiting benefits and cutting staffing. The current system has produced hospital empires fighting for bodies, duplicating services and cutting costs with assembly line systems designed by Risk Management & Marketing--not clinicians.
But it is likely the political spin & fear mongering will make establishing M4All a treacherous prospect in the Trump era. Many see the incremental expansion of a public option (M4All who want it) a pragmatic compromise. A trump 2nd term is reasonably seen as a catastrophe for healthcare, climate, homeland security (epidemics, disasters, infrastructure, etc.) and global democracies.
The perfect becomes the enemy of the good.
9
You ask "how to pay for M4A?" This is the wrong question.
Consider this: The federal gov can create as much money as it needs out of thin air. Because of this fact, the gov does not need your money to pay for any gov operation. It has an infinite supply of the stuff.
We do have to be careful since too much money chasing not enough stuff will cause prices to go up. We may get excessive inflation. One way to avoid that is for the gov to take some back, to tax it back, but we may not have to have high taxes.
It is true that prices are proportional to the amount of money in the economy, but they are also inversely proportional to the amount of stuff we can produce. If we spend the new money in a way that facilitates more production that will yield more money chasing more stuff which does not lead to excessive inflation.
Why is this important? Using "kitchen table" ideas, if we want M4A & it costs $X, then we have to tax $X dollars to pay for it. If we use the way the finances of our gov actually work, we have to see how much it would increase production which is probably quite a bit since it would get more money to the people who need it & will spend it which will by itself increase production. It will also provide a healthier workforce.
When we do the figures, it may turn out that if we have to raise taxes at all, it may be a lot less than $X. The right question is "How much will it increase production?"
8
Sometimes, life demands we believe our own eyes, not the distortions, distractions and lies we're told.
I encourage everyone who opposes Medicare (or Medicaid) for all take a single day out of their busy lives to visit every single hospital and urgent care facility in their area - and beyond if they're of a mind to.
The sheer walls of steel and glass atria that greet you as you enter should be your very first cue. Observe the furnishings, fixtures, floors, walls, paintings, and niceties that unfold before you.
Peek into the rooms where multi-million dollar MRI machines take pictures of broken wrists, and where pharmacies dispense untold billions in over priced drugs - drugs that were researched and developed by students and faculty at local colleges and universities.
Then amble on over to the hospital administrator's suite. Ask the staff what the compensation package is for that administrator (not doctor).
Then, go home, have a nice meal with someone you love, and share your experience...discuss with them what our current system is buying, and where costs might be cut to save lives, or simply improve the lives of the sick.
Then, take another run at swallowing the lies that our system of medical care can't survive the cuts to profit that will make healthcare accessible to all.
28
@Wally Greenwell
Next time you think college is too expensive, I invite you to tour their lush facilities, the on campus arenas and stadiums, the numerous unnecessary administrators (make sure to inquire what the football coach is making), their bloated endowments, and peruse the course offerings for applicability you the real world.
Then talk with your family about how the Democrats response is to bail out people who have student debt, thereby subsidizing these very bastions of “higher learning”.
@Rob Betsy DeVos just reversed the loan eligibility of colleges that were ripping off their students who were banned from the program under Obama. I did not know she was a Dermocrat
1
I was under the impression that Biden's and Pete's plans would allow people to choose the public option even if they are offered insurance from their employer (small or large-group).
If the public option were even modestly ambitious, surely private insurers would hemorrhage members to the new public option, which would both require considerable spending and drastically change private insurance.
1
@Jon Schmidt No, the private insurers will kick the sickest people off their plans onto the public option, and then offer reduced premiums to the remaining healthy people. The public option will then either have to be heavily subsidized or will become insolvent and collapse.
We need universal, single-payer healthcare, health insurance companies are just middlemen taking a cut while providing no value.
10
@KM
Who will deny unnecessary care? Who will you appeal to when you are denied?
Instead of having a commercial entity to appeal to you’d just have the government. I’m not sure why this is so appealing to a small segment of the population. Care will still be denied.
Folks are confidently stating ‘Medicare for All would be accepted by nearly all physicians and hospitals’.
Given that reimbursement rates will have to be cut to save money, and current physician shortages. I can easily see a goodly percentage of physicians converting to all-cash practices. Some speciality urban hospitals (hello Memorial Sloan Kettering) could also convert. And I would expect waitlisting and difficulty getting appointments at least in the initial years. We are fixated on cost-reductions, not delivery improvement. How can we improve access to primary care, rather than a free visit to the local ED for every American.
3
@Suzanne Yet in no other country on the planet that has implemented universal single-payer healthcare has that happened. And that includes Taiwan and Switzerland, which implemented their own universal healthcare systems in the '90's.
So the threat of that happening is just not credible.
17
@Sean - And these other countries have BETTER bottom line health care results than the US.
8
@Sean I paid cash to an Italian physician for services. This enabled me to get seen much faster than I would have otherwise. He didn’t give me a receipt either.
2
The author writes: "People who get their coverage from Medicare would see the smallest change. They would keep getting insurance called Medicare from the government, only with new benefits and fewer fees."
The last phrase ("only...) is debatable but the rest of what the author writes is false or unknown.
-- A small majority of people on Medicare today get their Medicare coverage (A and B and supplemental individually purchased or group retiree indemnity insurance) through private for-profit companies. Their coverage would be totally changed because these companies would no longer exist and/or would not be allowed to offer coverage
-- A large minority of people on Medicare today get their Medicare coverage (A and B and C) through private mostly non-profit health plan sponsors, mostly integrated health delivery systems such as Kaiser Permanente but also other charities such as AARP (which also offers supplemental indemnity insurance to the first group). How our coverage would change has not been addressed and we are the single largest group of people on Medicare. That's scary. I've had the same type of non-insurance coverage for 45 years and do not want it to change at 75.
-- A small minority of people on Medicare today also get Medicaid. Only for this small group would there really be better (i.e., more unitary) coverage because what Sanders is proposing is really Medicaid for All, not Medicare for All. But it would not be less costly for them because it is already free.
3
@Dennis Byron writes, "Their coverage would be totally changed because these companies would no longer exist and/or would not be allowed to offer coverage."
But you would not need these companies since Bernie's plan has no co-pays or deductibles, and allows you to see any physician and use any hospital.
" A large minority of people on Medicare today get their Medicare coverage (A and B and C) through private mostly non-profit health plan sponsors, mostly integrated health delivery systems such as Kaiser Permanente but also other charities such as AARP (which also offers supplemental indemnity insurance to the first group)."
I am not sure what you are talking about, The coverage under AARP is simply Medicare Advantage with United Healthcare, a profit making company. MA plans costs the government more than classical Medicare and have a very limited network of physicians and hospitals.
Medicaid is a program run by the states. It is NOTHING like Bernie's plan.
18
@Len Charlap You write:
1. "But you would not need these companies since Bernie's plan has no co-pays or deductibles, and allows you to see any physician and use any hospital."
A. Co-pays and deductibles are irrelevant. Who would do what those companies do today?
B. Many providers and hospitals would not accept it, just as they do not accept Medicaid today (Bernie is really proposing Medicaid for All, not Medicare for All)
2. "The coverage under AARP is simply Medicare Advantage with United Healthcare, a profit making company. MA plans costs the government more than classical Medicare and have a very limited network of physicians and hospitals."
C. Non-profit AARP offers private Medigap indemnity insurance and also sponsors public Part C Medicare Advantage health plans. The fact that AARP hires for-profit UnitedHealth to push the paperwork is no different than the fact that CMS hires for-profit Anthem (in my state) to push the Part A and Part B paperwork
D. Aggregated, it is not true that "MA plans costs the government more than classical Medicare" Look at Table II.B.2 of any Medicare Trustees Report post 2010. It was also not true between 1997-2005. It was true in between because Congress gave unions and the urban poor a special unfair deal that PPACA and the 2015 Budget Act took away. Overall people on Part C get much better care and coverage than people on traditional Medicare at a lower cost to both the Trustees and themselves
Yes, Bernie's proposal is Medicaid for All
@Dennis Byron =
A. If you mean the contractors, since they offer NO insurance, Medicare could continue to hire them if it thought it were cost effective.
B. If everyone had Medicare, the doctors and hospitals would have to take it as very few people could afford care totally out of pocket.
M4A is not Medicaid which is an entirely different program from Medicare. It run by the states with varying coverage and payments. Bernie simply proposes to take classical Medicare and improve it and extend it to everyone. It is an incremental change.
3. AARP offers no insurance. It simply sells its name to private companies. It has nothing to do with the insurance. I had its MA for a year and had no contact with AARP at all. All the rules were made by United Healthcare. Quite different from classical Medicare.
BTW I gave it up after a year since NONE of my 6 physicians (all of whom take classical Medical) would take it. They all told me tha MA pays them less then classical Medicare. MA works by having a very limited network of doctors and hospitals who will take less money.
PS I am 81 and have some experience in these questions.
6
These articles which focus on "What's It Going to Cost?" elide the fact that it will save tons in the long run.
Tons of money.
More people covered.
Millions of lives.
Lives like my brother who died at the age of 44, from high blood pressure induced congestive heart failure... because he lacked insurance.
He was a brilliant programmer, but he worked as a contractor and never in his adult life did he have proper insurance. It was never offered to him. In his 40s, before Obamacare, it couldn't be purchased for love or money. In his early 30s, circa 1995, he wrote to specifications for the "next" generation gas pump. This was back when gas pumps had 24 character LED read outs. He told me about gas pumps that would have 9"x6"color touch screens, show advertisements, let you order car washes and maybe other items. You would wave your key tag at the pump to pay.
I nodded and smiled, knowing he knew what he was talking about, but not sure I believed him.
He didn't live to see those things come to fruition. He died in 2011. Every time I fill my car at the newest gas pumps, I think of him. What would he have dreamed up NEXT?
If only Republicans and Democrats could figure out a way to get everyone insured. Instead, I face losing my insurance when my divorce is final. Will my elderly mother bury me next? Or just beggar herself keeping me insured?
27
I think it's important to focus on the Yale study that says at a minimum, we can expect to save $450 billion dollars a year. The trick will be how to rearrange the funding sources as we move from insurance premiums to taxes.
A system that protects people will be a huge improvement from a system that protects profits. Because virtually all doctors will participate, that's the end of surprise billings--those corruptions of the for profit healthcare system.
Another advantage is that our government has every incentive for Americans to be healthy--so we will stop pushing sugar, smoke and god knows what on Americans.
45
@Terry Lowman I'm looking at it now, thanks for the referral. I look forward to not being fleeced anymore by big pharma and others, when Medicare for All is implemented by President Sanders.
2
Here's what you need to know about Bernie Sanders' "Medicare For All":
First, it is founded on the premise that healthcare is a human right, not a product for profit. That brings us in line with the rest of the civilized world, and ends our "profit-is-all" system.
Next, Sanders' proposal would certainly be more generous than what we've had in the past, but would be comparable to what every other citizen of every other developed country has enjoyed for decades.
Federal "taxes" would not pay for the system; Americans would pay healthcare premiums to the federal government based on their levels of income, and the government single-payer system would pay all expenses from that. Again, it's the system that prevails everywhere else in the developed world.
The Upshot claims that it would cost "a lot." That's false. In every other country with universal healthcare, it costs half or less per person than it does in America, and a fraction of GDP that it takes up here.
And so what if it means "an enormous expansion in government spending", if we get a system dramatically cheaper, fairer, with far better health outcomes?
Last, it's false that it would require "large tax increases." It would require reduce health premiums Americans are paying now; they'd just be paid to the federal government, instead of the predatory for-profit heath insurers. And the American people would control it, not corporate CEO's.
That's what you need to know about Senator Sanders' plan.
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@Sean
Your take imagines the rosiest possible scenario if implemented, but surely you know that the rosiest possible scenario when it comes to large-scale government programs never pans out...never.
First, one reason health care costs so much in America is because Americans demand so much more of it than citizens in other countries. That won't change. In fact, as 30 million Americans suddenly gain health care, demand will go up substantially.
Second, Sanders says he'll cut provider salaries to Medicare rates. Uh-huh. He's evidently not aware there is already a shortage of physicians in several specialties in this country and a critical one in family practice, which is the specialty that will see the greatest increase in demand. So, cut salaries of providers in a time of provider shortages and in a time when demand for providers will be drastically increasing. Doubt that's going to work.
Your notion of "far better health outcomes" is pure baseless speculation. Just because other nations have better outcomes does not mean we will. We may not; Americans are still Americans.
And it will cost a lot. That's not false. More than rosy projections by partisans imagine. The left-leaning Urban Institute says 35-trillion for the first 10 years. That's probably optimistic.
You may think I'm opposed to single-payer after all that. I'm not, I favor it. I just wish those proposing were honest about costs and challenges instead of spinning fantasies about it.
13
@Jim You claim, “ when it comes to large-scale government programs never pans out...never.”
Except for Medicare. QED
22
@GO You apparently do not know how current United States "Medicare as we know it" works. It is totally 100% run by private companies (mostly but not all for profit insurance companies but also many non-profit integrated health delivery systems and other charities).
United States "Medicare as we know it" today would not exist if it were not for those companies (see sections 1816 and 1843 or the Original 1965 Medicare law).
Those companies would not be allowed to exist under Sanders' proposed Medicaid for All law and/or could not do what they do today
2