Last week, Senator Bernie Sanders (D-VT) proposed a comprehensive health care plan called “Medicare for All.” If enacted, it would expand former president Obama’s Affordable Care Act (ACA) into a universal health insurance plan for all U.S. residents. Because health care has been a hot-button issue lately, the proposal has become an important piece of the overall discussion surrounding health care.
How does his plan work?No Mr. President, providing health care to every man, woman and child as a right is not a curse, it's exactly what we should be doing. https://t.co/sNeq6YZHDw
— Bernie Sanders (@SenSanders) September 14, 2017
Medicare for All is a vision for single-payer health care, which means only one party (in this case the government) pays for it. The U.S. currently operates on a multi-payer health care system, where multiple private insurance companies work with customers through their employers. However, the U.S. is one of the few industrialized countries on a multi-payer system, and we spend more on healthcare per person than any other advanced nation in the world…even though 28 million Americans still remain uninsured.
Currently, the government provides health insurance to anyone aged 65 and over through Medicare. Sanders’ bill would extend that coverage to all Americans and phase it in over four years. He would also expand current Medicare coverage to include dental, vision and hearing costs. His bill would eliminate nearly all third-party health insurance companies, and U.S. residents would neither have to pay copayments nor be mindful of deductibles when they go to the doctor. However, unlike the ACA, Sanders envisions that people’s current plans won’t be disrupted, and they’ll be able to keep seeing their current health care providers.
Where would the funding come from?Even for proponents of Sanders’ plan, how single-payer health care would be financed remains one of the biggest questions. Sanders did introduce several potential sources of funds in his proposal, such as progressive income tax rates, a 6.2 percent income-based health care premium paid by employers, and limiting tax deductions for the rich. Sanders estimates his plan will cost $6 trillion less than our current health care system over the next 10 years, but other analyses have estimated the cost of his plan to be much higher. He also estimates the typical middle-class family would save nearly $5,000 under his plan.
Is Medicare for All likely to become a reality?While it would be difficult for Sanders to get his proposal through a Republican-controlled Congress, a growing 60 percent of Americans believe it’s the government’s responsibility to make sure everyone has health insurance. Furthermore, Sanders introduced the bill with 15 co-sponsors, many of whom are frontrunners for the Democratic presidential candidacy in 2020, including Senators Kamala Harris and Elizabeth Warren. This suggests some degree of high-profile party unification behind the Senator. However, House Minority Leader Nancy Pelosi declined to endorse the bill, saying her immediate priority is to protect the ACA. Pelosi also stated that there are other proposals on the table as well, including multiple “Medicare buy-in” programs, which would provide the option of single-payer health care, but only if individuals choose to adopt it.