Bernie Sanders’ Medicare For all Explained (Plus the Full Bill)
Bernie Sanders’ Medicare-for-all plan improves and expands Medicare to create a single payer universal healthcare system with no out-of-pocket costs for all Americans.
That means employer coverage, private coverage, Medicaid / CHIP, Medicare, Medicare Advantage, etc (everything aside from the Veterans Affairs health system and the Indian Health Services) would transition into one single all encompassing plan that covered literally every American.
Under this system every service would be covered and there would be no supplemental insurance.
Or at least, we would transition into that system with a public option and some supplemental options in the interim.
With Bernie Sanders’ specific version of Medicare-for-all, as a trade-off for having no premiums, no out-of-pocket costs, free health services, vision, dental, drug coverage, mental health coverage, etc, most Americans would pay higher taxes than they do now.
This doesn’t mean most Americans would pay more over-all, instead it means many (but not all) would pay less in healthcare costs but more in taxes. For many the net effect would be savings.
In short, instead of paying a bunch of different costs to private insurers and having employers and the government subsidize plans directly, Medicare-for-all would cover everything using taxation (and thus taxpayers, including businesses, would fund the system indirectly).
So for seniors this would mean no expensive Medicare Advantage plans, for the average person it means no more unaffordable healthcare costs or bankruptcy, and to anyone making enough… it means paying more.
That said, there is no way to know exactly how much exactly it would all cost!
First off, this is because the exact funding mechanisms haven’t been picked yet. Second, there is no surefire way to predict the savings form things like being able to negotiate drug prices on a national level (something we can’t do now as a country, and something Medicare in its current state can’t do).
A libertarian policy center speculated a price tag of $32.6 trillion over 10 years, and on one hand that makes sense as a gross figure because our current healthcare system, which leaves tens of millions without coverage and requires out-of-pocket costs, costs roughly $3 trillion dollars now (so $3 trillion x 10 = $30 trillion; that checks out).
Comments Sanders had on that study like “This grossly misleading and biased report is the Koch brothers response to the growing support in our country for a ‘Medicare for all’ program” aside, the bottom line is there is big costs when we are talking about healthcare!
The question isn’t “is healthcare expensive,” as we know the answer is yes and we already pay for it, the question is “is Medicare-for-all a better way to pay for healthcare, cover everyone, and keep costs down?”
That isn’t an easy question to answer, but it is the question.
And it is somewhat of a subjective question when it comes to personal costs too.
The reality is, the average American family’s healthcare can cost $28,000 or more a year.
So a person has to look at their $28,000 in medical bills and plan and say “well, would I rather have the tax and Bernies’ plan, or is this $28,000 plan the plan for me?”
So if the part of the tax the family will pay is 10%, and the family makes $100,000 in taxable income a year, then for them the costs are a wash and they want to ask “is this coverage better if I consider not only this year, but all years of my life and my family’s life?”
Again, not a simple cost/benefit, but one to think about.
Of course for other families, they are likely to see savings… and in other families, they are likely to pay a lot more.
So again, not every family will see this the same way, and those who pay more may be very loud about the extra amounts they will pay. Of course! We all have self interest.
Still, for most, one benefit of this system is that you only pay a percentage of what you earn, so it is always a chunk, but never more than you can afford (and in some years may be the only thing ensuring you can afford healthcare).
Another benefit is that you can’t be dropped (so if you lose your job or your income or wealth, you don’t also risk your family’s health)… this may be important to some with the current administration going to court against the ACA (and thus against pre-existing conditions).
This improved Medicare-for-All system is notably more robust than most Medicare systems across the world, but also notable is that the US is the only very highly developed country in the world without a universal healthcare system.
So is a system that benefits the majority in terms of spending and coverage what everyone wants? No, of course not.
Some don’t believe the government can do it right, some who make more don’t want to pay extra now in the years when they are earning (it is hard to think “what if I lose my job” or what if a loved one is not covered as well as me), and some don’t think their coverage will be as good (in some cases because talking points have suggested this).
Still though, on paper, it is likely that many (not all)people will get better coverage and/or pay less.
So if the majority will be better off, and in a democracy a majority should win, why don’t we have Medicare-for-all?
Well there is the simple answer, that is we voted in Trump and not Bernie. But then there is also the answer that has to due with the confusion around what Bernie is putting on the table.
While the talking points warn Seniors against Medicare-for-all, they fail to mention that Seniors won’t have to pay their Part C and Part D premiums or out-of-pocket costs, and while talking points warn employees, they fail to mention that a large chunk of your paycheck is paid out in health benefits and that with the employee and employer’s part of expenses considered… many employees and businesses would be saving!
Likewise, when they warn of rationing, the fail to mention that we currently ration by cost and already have wait times, referrals that need insurers approval, and more… that is to say, we already have rationing!
Further, when they say “but it doesn’t work in other countries,” we can fire up Google and check and see that this is an opinion and not the actual experience of everyone in those countries or what the data shows.
In short, there are many issues to discuss, but just as many talking points to combat with facts. On paper Medicare-for-all is very interesting offering and it is worth taking the time to get to know.
Here I’m not saying it is the best plan, or that repeal now and replace later isn’t better (maybe it is). Nor am I saying the ACA isn’t our best way forward. Actually, I’m not saying much at all. All I’m saying is that if you haven’t read up on Medicare-for-all yourself, you likely don’t fully understand what Medicare-for-all is all about.
Honestly, I just hope everyone will take the time to understand Medicare-for-all, the ACA, and repeal now and replace later and make the choice that best suits them. That would of course be much better than making the choice that suits someone else.
So then, speaking of getting to know the plan…
Read Bernie Sander’s Medicare-For-All bill (and a bunch of useful resources).
- To get an overview, see this press release. The press release links off to some useful resources, I also took the snippet below from this press release.
- For a copy of the Medicare for All Act, click here.
- For a summary of the Medicare for All Act, click here.
- For the summary by title of the Medicare for All Act, click here.
- For a white paper on financing Medicare for All, click here.
- To learn about the plan, see Medicare-for-All on sanders.senate.gov [PDF].
- To learn about funding, see Options to Finance Medicare for All [PDF]
The Medicare for All Act of 2019 would ensure that Americans could go to the doctor of their choice and get the care they need, when they need it, without going into debt. It would significantly lower the price of prescription drugs by empowering the federal government to negotiate with pharmaceutical corporations. And it would expand coverage to include home and community based long-term care services, ensuring people with disabilities can receive the care they need to stay in their homes and remain part of their communities.
Under this bill, Americans will benefit from the freedom and security that comes with finally separating health insurance from employment. As is the case in every other major country, employers would be free to focus on running their businesses rather than spending time, energy and money trying to provide health insurance to their employees.
Studies from the Rand Corporation and even the conservative Mercatus Center have found that a Medicare-for-all, single-payer system would save the American people money by reducing rising health care spending and significantly lowering administrative costs. In addition to the legislation, Sanders released a paper outlining several options for funding the Universal Medicare Program.