Medicare for All?

Senators Warren and Sanders universal care plan is worth a closer look. Image credit: AFP via Getty Images.

The first draft of this post was in the spring of 2020, when DC insight meditation teacher Hugh Byrne invited thoughtful responses in an FB post to CNN's Chris Cillizza calling Senator Sanders answer on how to pay for Medicare for All (MFA) 'disastrous'. Senators Warren and Sanders' plans are a fair enough starting point to discuss how we pay for universal care, and there is plenty of room for reasonable people to disagree with him on various points of how they propose we pay for it. What does not much help is to conflate the question of whether we move forward with how—unfortunately, all the US Presidential candidates except Sanders and Warren are trying to insist on knowing the how first, and by poking holes in one idea of how or another, backpedal us on whether to do so.

The CNN headline Bernie Sanders' disastrous answer on '60 Minutes is perhaps effective clickbait, but it is anything but 'disastrous' for Senator Sanders to be humble and practical, and to say that we have some idea how we will pay initially, but that this will have such an enormous positive economic and social impact, we want to keep an open mind about how to evolve the payment model as that impact is felt. As the poor and middle class becomes less existentially threatened with death, bankruptcy, and foreclosure from healthcare costs, and enjoys greater wealth, we'll likely be able and willing to pay even more of the cost than the initial plan asks. The answer on the Sanders website does a fair job of spelling out programmatic details of how to organize socialized payment but it doesn't strongly enough make what we see as the key point: the US could see as much as a 50% or $2Tn/year saving in health costs under Medicare for All. A recent Lancet article it mentions puts the savings at $450Bn, but we think this is too conservative by not taking into account some important elements. Meanwhile, notably, the US national debt grew $1.3Tn last year.

Bernie's plan for universal care is similar to the plans already implemented in the UK, Canada, and Australia using a combination of payroll and property taxes. The average cost of healthcare as a percentage of national GDP in those three countries is about 9% whereas in the US it is 18%. We pay double, while having significantly lower, and declining, life expectancy.