Before a crowd of left-wing politicians, interest groups, and labor unions, Senator Bernie Sanders (I-Vt.) unveiled legislation to create a national single-payer healthcare system Wednesday.
“Today, we begin the long and difficult struggle to end the international embarrassment of the United States being the only major country on earth not to guarantee health care to all its people,” said the self-described socialist senator.
Sanders’ Medicare for All Act would, over a four-year period, move all U.S. residents from their current public or private insurance programs to a single federal program with comprehensive coverage and no copayments except in the case of prescription drugs. Such a program would go far beyond Medicare, making Uncle Sam the sole source of health insurance in the nation — private insurance would be outlawed — therefore giving Washington total control over the healthcare system. Not for nothing did The Atlantic dub Sanders’ plan “the U.K.’s [National Health Service] on steroids.”
Sixteen senators — a full third of the upper chamber’s Democratic contingent — introduced the bill along with Sanders. Several are rumored to be considering a run for the White House in 2020, including Minnesota’s Al Franken, California’s Kamala Harris, and Massachusetts’ Elizabeth Warren.
In a press release, Sanders intimated that his bill would usher in a nirvana of healthcare unconstrained by the laws of economics:
The Medicare for All Act of 2017 would ensure that Americans will no longer have to delay or avoid going to the doctor because they can’t afford it; that a hospital stay will not bankrupt you or leave you deeply in debt; that you will be able to get the prescription drugs you need at a price you can afford; that middle class families will never have to spend 20 or 30 percent of their incomes on health care; and, that Americans will save billions of dollars a year in medical administrative costs.
This, of course, ignores the history of single-payer healthcare systems in other countries. In Canada or the U.K., for instance, a person may not avoid or delay going to the doctor because it costs him too much, but he may still end up with a long wait or denial of care because the system is overwhelmed by people seeking “free” care and the government can’t afford to pay for every procedure every person wants or needs. In fact, hospitals may even euthanize him to cut costs — and be rewarded for doing so. Moreover, despite Sanders’ contention that his plan would give Americans more control over their own healthcare, by ceding control of healthcare financing, people also cede control of their healthcare choices and even their very lives, as Charlie Gard’s parents recently discovered to their horror.
On top of that, the notion that Medicare should be expanded is based on a false perception of that program’s success. “Medicare can’t even ensure [low-cost, high-quality care] for the people who are currently eligible for the program,” wrote David Hogberg, senior fellow for healthcare policy at the National Center for Public Policy Research. “Expanding it to cover all Americans would only exacerbate its shortcomings for patients.” The program has distorted the healthcare market, caused over- and undertreatment of patients, burdened doctors with massive amounts of paperwork, and seen its budget balloon far beyond initial projections — to the point that it now has $58 trillion in unfunded liabilities.
With numbers like that, it’s no wonder Sanders has been cagey about the expected cost of his bill — and even more so about how to pay for it. A version of the plan he released during his 2016 presidential campaign was estimated to cost $1.4 trillion per year; this one will almost certainly be even more expensive. Sanders isn’t saying where the government will get the money for all this, but he has suggested, not surprisingly, significantly higher taxes on everyone, especially the rich.
Sanders’ bill isn’t likely to get very far in a Congress run by Republicans; but as The Atlantic observed, “It’s now a rallying point, one its creators and sponsors aim to make the center of Democratic policymaking for years to come.” Given that Democrats have won practically every healthcare battle of the last half-century, Americans ought to be very worried indeed.
(For more about about Medicare-for-all, read "Does Single-payer Signal a Solution?")