Bernie Sanders

Sanders' Medicare for All Delusion

Americans might love what Sanders offers in the way of more benefits for more people. What they would hate is paying for it.


Bernie Sanders has a health care plan he calls Medicare for all. He's underselling it. His proposal really should be called Medicare for all and a pony. It's everything you could want and then some.

Medicare is a giant government program that pays for health care for seniors and the disabled. Its costs are mushrooming. Over the next 10 years, outlays are expected to grow by nearly a third as a share of the economy; over the next 30 years, those costs are expected to double.

Revenues, however, will lag. The Medicare trust fund is on pace to run out of money by 2029.

It's not clear that we as a country can afford Medicare as it currently exists. Merely preserving it without significant cuts would eventually require a tax increase that working people would resent. But instead of looking for ways to economize, the Vermont senator wants to expand the program in a way that the term "vast" barely begins to capture.

His majestic vision goes beyond merely including the entire U.S. population in Medicare—which would increase the number of recipients by sixfold in just four years. Sanders wants to add coverage for dental, vision and hearing needs, which the program now excludes. And he promises "no more copays, no more deductibles and no more fighting with insurance companies when they fail to pay for charges."

He's talking about a huge change. As a study by the Kaiser Family Foundation noted, "Medicare has relatively high cost-sharing requirements for covered benefits and, unlike typical large employer plans, traditional Medicare does not limit beneficiaries' annual out-of-pocket spending." In 2010, it found, the average recipient paid $2,746 for deductibles, coinsurance and the like (not counting premiums).

Under Sanders' proposal, the government would pay all those expenses—not for 55 million people but for 325 million. Actually, it would pay all those expenses plus a lot of new ones, because relieving patients of any financial obligation would induce more people to get more care. If you reduce the price of a good to zero, the demand for it will rise—usually by a lot.

American advocates of single-payer health insurance love the Canadian system. But Sanders apparently finds it wanting. His plan would provide even more benefits than Canada's.

Democrats recently saved their Obamacare from the certain death it faced a few months earlier. The Affordable Care Act, once unpopular, gained broad support because Americans came to see it for what it is: an incremental and fiscally restrained method of expanding the number of people with decent coverage with minimal disruption.

The failed Republican effort to repeal and replace it holds useful lessons. One is the importance of caution. Americans distrust any ambitious change in the realm of medical care. They fear being deprived of something they have and value, and they stand ready to punish the culprits.

Another is the danger of overpromising. Republicans in Congress led us to believe they could deliver lower premiums with no individual mandate and without reducing the number of people covered. When it became clear they couldn't deliver, public opinion rebelled. Slogans are easy, but when it comes to health insurance, substance is hard—very hard.

Democrats have an understandable attraction to a single-payer health care system. It's conceptually simple; it's universal; and it builds on a program that is popular with those it covers. But all this is a siren call that would lead them straight to the rocks.

Americans might love what Sanders offers in the way of more benefits for more people. What they would hate is paying for it. One notable shortcoming of the plan he unveiled is that it has no price tag.

Would you like a fabulous meal? Of course. Would you order it without knowing what it costs? No.

The upshot of the ACA's survival is that Democrats are free to take credit for its benefits while blaming President Donald Trump and Congress for its shortcomings. They can press for small improvements at no political risk. If they decide to embrace Medicare for all, though, they may win votes in the short run while inviting failure in the long run.

What we should have learned from the health insurance debates of the past 25 years is that good politics often makes for bad policy. And bad policy, ultimately, is bad politics.


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  1. “The Affordable Care Act, once unpopular, gained broad support because Americans came to see it for what it is: an incremental and fiscally restrained method of expanding the number of people with decent coverage with minimal disruption.”


    1. If you think your average American cares about the implications of Federal Health care Policy even 1/16th as much as “Bachelor in Paradise”, you’re wrong.

      1. I was referring to the people in this comment section. Sadly, I didn’t anticipate Crusty turning this into a Party Thread and sucking all the wonkery out.

        1. I’m making over $12k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life. This is what I do,…Go this web and start your work… Good luck..

          1. Robo-commenter, friend, countryman: if you want people to believe you, you gotta be a little more subtle. I mean, even saying “6k a month” would be pushing it…

    2. Aside from authoritarian requirements people to buy insurance for existing and the fact that the death spiral is in effect in the exchanges, there is nothing wrong with ObamaCare.

  2. Is there a single Federal legislator who has the cojones to have ever said: “Listen up, mofos, you have absolutely no “right” to any medical care for which you personally do not pay 100% of the bill”?

    1. that is juvenile, but I laughed

    1. Organizers of a triathlon set to take place at a Trump property in North Carolina have cancelled the event days after the name was changed to distance itself from President Trump.

      The event, scheduled to be held at Trump National Golf Club, Charlotte, was originally named “Tri at the Trump.” But organizer Chuck McAllister cancelled the race Saturday days after he changed the name to “Tri for Good” following complaints about the name, The Charlotte Observer reported Saturday.

      Proceeds from the triathlon were to go to children with cancer and other life-threatening illnesses.

      Stop being awful, people.

      1. “Tri for Good”

        Sounds spookily close to “Make triathlons great again”.

        1. “And we’re also painting Trump’s face on all the golf balls to encourage people to hit them harder.”

  3. I think the problem is that Bernie really does not grasp the difference between a billion and a trillion. At some point, generally around the point you start using double digit exponents, large numbers become a hazy concept to most of us, with Bernie it starts with double digits.

    1. Bernie will be dead soon and apparently just doesn’t give a shit.

  4. OT: Gymgoer has to call firefighters to slice up dumbbell weight he had managed to get his PENIS stuck in while training in Germany

    A man who stuck his penis in a dumbbell weight spent three hours surrounded by firefighters who sliced him free with power tools.
    Angle grinders, a saw and a hydraulic rescue tool usually used to prize crash victims from vehicle wreckage were used to smash the 2.5kg disc on Friday

    Firefighters shared a picture of the smashed weight on social media with some helpful advice for anybody tempted to squeeze their manhood into tight spots, saying: ‘Please do not imitate such actions!’

    My God.

    1. Couldn’t he just take his weighted penis into the cold swimming pool and wait for shrinkage?

      1. Maybe he was soft and he just jammed it in there. In our own way we’ve all been there.

        1. In a gym, you’re supposed to climb a rope, not push it.

      2. Assuming it was an iron weight, heating it with a blowtorch would have caused it to expand, too.

    2. Found the next Harvard visiting fellow!

    3. Ha ha ha ha owww owww owww ha ha ha oww owww

    4. I had to stop at “sliced.”

  5. The False Prophets of Protest Music

    Protest music is thriving, if you want to hear it. A top-of-my-head assortment: Kendrick Lamar’s post-election self-interrogations, Sheer Mag’s resistance-minded retrofitting of Thin Lizzy, Vince Staples’s dizzying F.U. to the White House, and Lana Del Rey’s knowingly na?ve pleas for world peace. Even the slick, chart-courting likes of Fifth Harmony have anthems about building bridges and not walls. Yet if your genre tastes or tribal affiliations or overpowering nostalgia for the WTO protests disqualify the above from being taken seriously?well, today you have the thudding debut by Prophets of Rage.

    1. Rage Against the Machine and Public Enemy didn’t always talk in terms of specific policies or people either. But they did have a knack for rendering society’s longstanding injustices in vivid, even shocking terms. Zack de la Rocha, a true radical, could shake the listener’s soul with images like the one in “Down Rodeo”: “I’m rollin’ down Rodeo with a shotgun / These people ain’t seen a brown-skinned man since their grandparents bought one.” Chuck D once described black alienation with brilliant candor, calling Elvis and John Wayne “straight-up racist.” He recycled that famous verse last year for Prophets of Rage’s “No Sleep Til Cleveland,” itself a rewrite of a Beastie Boys song. The fact that the results made for the best track in the Prophets of Rage catalogue suggests that these past giants of political music are just that: the past. If revolution comes by song, it will come from elsewhere.

      Fun fact: old, wealthy people have trouble pretending their lives are shit so that they can create good art.

      1. Dead people are the new real oppressors of the modern prog. They can’t defend themselves and they lived in a completely different time.

      2. I know this isn’t really the point of the post but….

        “These people ain’t seen a brown-skinned man since their grandparents bought one.” and “John Wayne “straight-up racist.”

        fun fact- John Wayne was married to a Latino woman for 25 years.

        1. Also, the song calls Elvis “straight up racist and plain.” Then later Flava Flav says “Motherfuck him and John Wayne.” So the article misrepresents that song a bit.

          That being said, my guess is early PE didn’t particularly care about Latinos. I don’t know when all non-white started banding together as one group of people identifying as PoC, but it wasn’t quite in 1990 I think.

      3. Public Enemy is still pretty good. If Bomb Squad is producing, I’m there.

        Zach De La Rocha was always bad and we need to all wake up to that fact. He is a shit lyricist and rapper. Sconcing things in terms of baby’s first revolutionary thought doesn’t make it better.

      4. The only Cypress Hill song I like is “Insane in the Membrane”.

  6. Will Las Vegas Be ‘Amsterdam on Steroids’? Door Opens for Pot Lounges

    Earlier this week, Nevada’s Legislative Counsel Bureau gave the green light for marijuana to be permitted in public places, as long as patrons are of legal age. Citing a lack of state law, the bureau said cities and counties could create their own ordinances governing marijuana consumption in businesses.

    Pro-marijuana advocates hailed it as a logical next step for the state, which was the most recent to legalize recreational weed. Nevada started allowing adults 21 and older to buy it on July 1, but like the other four states where it’s legal, restricts its use to private residences.

    1. That’s posed a particular challenge for Nevada, where the economy is highly dependent on visitors who stay in hotels and play in casinos.

      State Sen. Tick Segerblom, D-Las Vegas, a dogged champion of marijuana legalization, sees the opinion from the state legal body as an opportunity to turn Sin City into “Amsterdam on steroids.”
      “”I think Vegas is perfect for this. That’s what we do. We regulate vices.””

      “We’re inviting 40 million people to come here and buy marijuana, but then we turn around and say there’s no place to use it,” Segerblom said of the annual influx of tourists who go to Las Vegas.

      “I think Vegas is perfect for this,” he added. “That’s what we do. We regulate vices.”

      Tick is the hero we need.

      1. The thought of free pot brownies on the casino floor makes me smile.

      2. Whatever happens in Vegas, stays in Vegas, because you won’t remember it!

    2. Obvious joke, but isn’t that redundant? I thought any place that serves pot is a lounge.

  7. “Student group must pay needed fees for ‘Free Speech Week,’ UC officials say”
    “As for contract negotiations at that time, “They’re trying to make us pay $100,000 in security deposits,” Yiannopoulos said. “We’ll negotiate it down as best we can.”…..203779.php

    Seems to me, the folks who ought to pay are the ones who make the security required, not the ones who are speaking.

    1. That’s not fair, most of the rioters don’t have the money to pay for that!

      1. But I’d bet their parents do.

      2. The one who is paying them can pay their fees too.

  8. Bernie Sanders is as full of shit as Trump is.

    1. Did you ever pay off your lost bet shreeky?

    2. At least.

    3. Palin’s Buttplug|9.17.17 @ 11:10AM|#
      “Bernie Sanders is as full of shit as Trump is.”

      So not quite as mush as you, turd?
      Go fuck your daddy.

  9. I’ve been reading Reason for about 40 years. I remember when it stood for what was possible. Now it just seems to be an intellectual extension of the right’s war on reasonable ideas.

    Don’t like Sander’s ideas? Ok fine, propose an alternative plan to address the very real problem of health care in America. But what I see is simply a denial that there is a problem at all.

    1. I can’t believe I’m defending Reason, but this is from last month:

      “Just because Congress can’t fix health care doesn’t mean it can’t be done.

      “That’s the message from the Health Transformation Alliance, 41 big American companies that have banded together to try to save money and lives on their own, without waiting for Congress to pass a new law.

      “The Alliance’s chief executive, Robert Andrews, himself a former Democratic congressman from New Jersey, had a recent New York Times op-ed reporting on three steps being taken by the companies…”

      1. “At the very least, the Health Transformation Alliance, a relatively new effort, bears watching closely. If it’s successful, perhaps more political pressure will eventually build to transfer private-sector innovation into the parts of our health care system that are more directly funded by the government.”

      2. I’ve known Rob Andrews since I was a child and he was my representative (my parents both being heavily involved in local school, community, and business affairs my whole life). The man has always been a vainglorious idiot. My father loves retelling how he drove the man to actual tears as the guest speaker at a Boy Scout outing when he tried to venture into partisan talk and couldn’t even do it correctly. There are ongoing jokes to this day about the “News You Can Use” emails Andrews used to spam locals with in the 1990s and how folks would run into him at local diners and try to avoid his attention.

    2. The law of supply and demand isn’t a “problem” with some kind of magic bullet “solution”, you stupid fucking uneducated retard. It’s as inviolable as the Law of Gravity. Grow the fuck up already.

      1. Jesus, that’s harsh! You don’t know for a fact that he’s fucking.

        My proposal is that we all wear various-colored ribbons to show that we truly care about this problem.

    3. Ok, challenge accepted.

      To start out with, let’s recognize that for decades the government has been meddling with the health care and health insurance markets, and that during that time the snake-oil salesmen of government regulation have assured us that both markets are going tomhell in a handbasket, Federal Express. Now, correlation is not causation, however when you are talking about government regulation and a deteriorating market, that has been the way to bet.

      So, let’s ashcan all regulation of healthcare and health insurance more,recent than, say, 1960, and then let things shake out for five years.mthen, just maybe, we can tell if what is wrong is an underlying problem or simply layer after layer of ill considered ‘fixes’.

      1. I like that typo, “tomhell”. Consider it stolen.

    4. MarvinG|9.17.17 @ 11:23AM|#
      “I’ve been reading Reason for about 40 years. I remember when it stood for what was possible. Now it just seems to be an intellectual extension of the right’s war on reasonable ideas.
      Don’t like Sander’s ideas? Ok fine, propose an alternative plan to address the very real problem of health care in America. But what I see is simply a denial that there is a problem at all.”

      Now, Marvin here is pretty much the poster-asshole for why the world should be rid of Marvin and all the rest of the assholes.
      Note that Marvin claims that what is regularly proposed here must not be “possible”, so Marvin has already defined the term such that Marvin gets to decide what is acceptable.
      Hey, Marvin? If you had really read Reason for that period of time, you must be one STUPID piece of shit to have avoided learning anything.
      Oh, and fuck off, slaver.

    5. No more reformulation, no more multi-billion-dollar FDA approvals with arbitrary rejections, no more AMA, no more ADA, no more lawsuits against doctors who didn’t deliberately act against the patient’s consent, no more COPN laws, no more employer mandate or COBRA, and, in all likelihood, no more “private” health insurance companies as we have known them.

      Health insurance for unexpected catastrophes, crowd-funding and charity for expected catastrophes, and HSAs for regular check-ups in a genuine free market where everything costs 1/3 as much as now.

      1. a genuine free market where everything costs 1/3 as much as now.

        That’s the key point. The health care problem/crisis/conundrum/mess is one of costs, primarily. We’ve seen enormous advances in med tech, which usu. brings costs down, yet they’ve gone up. All we need do is kick out the jams that’ve been propping them up.

        If medicine cost 1/3 of what it does now, how much concern would there be over failure to guarantee health care for everyone? Bringing medicine into line w the cost of other necessities, there’d be about as much clamor as there is over failure to guarantee clothing or xport’n or food or housing for everyone.

    6. Sanders seems to ignoring the problems already inherent in Medicare while proposing to expand the it in ways that were never contemplated for it and not having any realistic proposal as to how to pay for what he wants. You really do not have to come up with your own idea to criticize obvious nonsense.

    7. That’s easy, free market capitalism were the only function of the government vis a vis the health industry is to defend against fraud.

  10. “The Affordable Care Act, once unpopular, gained broad support because Americans came to see it for what it is: an incremental and fiscally restrained method of expanding the number of people with decent coverage with minimal disruption.”

    What planet did this come from?

    It disrupted the insurance of millions of self employed people by dramatically raising their premiums to include things that they neither wanted nor needed. Millions of jobs were reduced to under 30 hours a week to avoid the employer mandate. Job creation itself was reduced and unemployment fell primarily because people left the work force.

    The Affordable Care Act never became popular it became less unpopular because the moronic Republicans, after years of saying that they would repeal this abomination, accepted the Democrats’ ideas about medical care and couldn’t get rid of the mandates.

    Now the Democrats will bring about full government medical care because the Republicans and even Reason magazine have adopted the outright lie of “single payer”. Real single payer means that you as a single payer pay for your own health care. What is being called “single payer” is actually universal payer since everyone pays for your health care.

    1. The people who now have full government health care are veterans, the most celebrated sacred cows in America. Yet, the same government that praises the armed forces above all other individuals, lets them die for want of medical care in the VA system. If veterans can be left to die on waiting list what do you think your chances of getting live saving treatment is once the government is in charge of your health?

    2. That is from planet Chapman. Reason seems insistent on keeping a progressive authoritarian on the payroll I guess with the intent of chasing away any potential donors.

    3. “What planet did this come from?”

      Planet Chapman. In a galaxy far far away.

  11. It free man, it’s free why do you want people to die? We should all be able to get in on this free shit and leave the bill for our children! Bernie has a good shtick and it pays well! You know it isn’t going to happen anytime soon, but heck it sounds so easy.

  12. I’m all for it, the sooner we bankrupt this bitch the better.

  13. RE: Sanders’ Medicare for All Delusion
    Americans might love what Sanders offers in the way of more benefits for more people. What they would hate is paying for it.

    Comrade Bernie wants the taxpayers to pay for all sorts of shit, and the sad part is there are a lot of morons out there who believe all the drivel he speaks.
    Fortunately, the sane outnumbers the nut cases following this socialist idiot…for now.

  14. It does not have to be payed for, it is free. Aren’t you listening to Bernie?
    And how can you be so cruel as to deny all those ponies the love of all the little children?

    Of course, the EPA might have a comment or two about creating more horseshit than congressmen do.

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