Medicare for All

The Contradiction at the Heart of Bernie Sanders' Medicare for All Plan

The democratic socialist from Vermont wants to radically expand coverage and benefits—while paying far less for health care services.


There is a huge contradiction at the heart of Bernie Sanders' Medicare for All plan.

On the one hand, Sanders not only wants to expand government-provided coverage to everyone in the country, he wants that coverage to be significantly more generous than Medicare, private insurance, or comparable government-run systems in other countries. On the other hand, he wants to drastically cut payments to hospitals, many of which lose money on Medicare right now, making up for the program's relatively low payments by charging much higher prices to private insurers.

What Sanders is proposing, in other words, is that the government finance a significant increase in government services while also radically reducing the amount it pays for those services. Even making generous assumptions, it's almost impossible to see how his plan could work.

Let's start with the promises Sanders makes about Medicare for All. No networks, premiums, deductibles, or copayments. Under his plan, essentially all non-cosmetic services would be free at the point of care for everyone.

Sanders calls this Medicare for All, but what he's describing isn't Medicare as we now know it. As The New York Times noted earlier this year upon the release of a Sanders-inspired Medicare for All bill in the House, the new program would "drastically reshape Medicare itself," changing both what it pays for and how. In many ways, it would be a completely different program. Medicare for All, in other words, isn't really Medicare.

And that program would be far more expansive and expensive than nearly any other comparable system. It would cover more, and require less direct financial outlays (not including taxes), than either today's Medicare or typical private insurance plans in the U.S.

It would also be substantially more generous than the national health systems set up in other countries. Sanders likes to unfavorably contrast America's mixed public-private health care system with foreign systems where the government is more directly involved. When he announced the 2017 version of his Medicare for All plan, for example, he bemoaned the state of affairs in the United States "a time when every other major country on earth guarantees health care to every man, woman, and child." Discussions about health care policy on social media often include some variant of the question, "If every other country with a developed economy can do it, why can't the United States?"

The problem with this line of questioning is that what Sanders is proposing isn't what other countries do. Canada, for example, has a single-payer system, but it doesn't cover dental care, vision, drugs, or any number of other services. A majority of Canadians carry private insurance in order to cover those services. In Britain, which offers a fully socialized medical system where health care providers are government employees, many resident still buy private coverage. Sanders, on the other hand, would effectively wipe out private coverage in the space of just four years.

There are similar limitations on coverage in other countries, like the Netherlands. It's also true in Australia, where patients typically pay a percentage of the cost of specialty services. It's true that in these countries, government plays a more central role in health care financing. But their systems have also reckoned with costs and tradeoffs in a way that Sanders, after so many years, has not.

Indeed, the main trade-off that Sanders seems willing to discuss is the elimination of insurance companies, which he portrays as greedy middlemen driving up the cost of health care. Wiping out the industry in one fell swoop, as Sanders has proposed, would be a unprecedented and disruptive move that would have significant economic repercussions, including the probable loss of thousands of insurance industry jobs. But it still wouldn't do much to bring down the cost of health care, because so much money in the nation's health care system is tied up in provider payments, especially hospitals.

And therein lies the contradiction.

Most people probably think of hospitals as places where you go to get health care services. Politically and economically, however, they also fulfill another role: They are hubs for stable middle-class jobs, paying reasonably good wages to thousands of highly trained workers, most of whom are not doctors or specialists earning stratospheric salaries.

To acquire the revenue to pay for all these jobs, hospitals rely on a mix of private and public payments. Public payments make up a somewhat larger share of total hospital budgets, but private payers are typically charged much higher prices.

Hospitals like to argue that Medicare and Medicaid payments are too low to cover their costs, and that as a result, higher private payments effectively subsidize public health coverage. Critics (with some evidence) often respond that hospitals either overstate or don't really understand their own costs, and that this is just a ploy to extract more money from government health programs and private payers.

But when considering Medicare for All, the particulars of this debate are largely beside the point, because there is simply no question that eliminating private insurance and payment for all services would drastically reduce the amount of revenue for hospitals.

Yet that is exactly what Sanders wants to do. His plan calls for paying for health care services at Medicare rates, which means that, practically overnight, hospitals would end up with far, far less revenue. Exactly how much is unclear, but one estimate indicated that payments could drop by as much as 40 percent.

That would leave hospitals with a couple of difficult choices. They could eliminate services. They could try to force some employees to take pay cuts. They could fire large numbers of workers. Or they could simply shut down. As a recent New York Times report on how Medicare for All would affect hospitals noted, rural hospitals—many of which are already struggling to stay afloat—would be particularly at risk of closing.

Whatever ended up happening, there is simply no way most hospitals would or could continue operating as they do now under the payment regime that Sanders envisions. Lots of middle class jobs would disappear. Services would be eliminated or cut back. 

Yet Sanders not only imagines that hospitals would continue to operate as they do now, but that they would expand their services to even more people, since more people would have coverage. And since he also imagines a system with no deductibles or copays, those people would almost certainly end up dramatically increasing utilization of hospital services.

Studies of health insurance have consistently shown that expansions of health insurance result in increased demand for (and use of) health care services; more people with coverage means more people lining up to get care. (Relatedly, introducing even very small copays—on the order of just a few dollars—can reduce the number of visits to doctors and hospitals.) Greater utilization of health care services does not necessarily translate into measurably better physical health outcomes. But it does increase the strain on the health care delivery system—which is to say, it puts a huge amount of pressure on hospitals.

So what Sanders is proposing is a massive reduction in funding for health care services at the exact moment that the system experiences a massive increase in demand. It would be difficult to do either. Sanders wants to do both at the same time. 

It is a recipe for disaster—and a contradiction that Sanders has so far barely acknowledged, much less resolved.

NEXT: N.J. Gov. Phil Murphy Wants To Raise Gun Permit Fees by 2,000 Percent

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  1. I’m having a hard time figuring out who the biggest idiot is in the democratic party: Sanders, Ocasio-Cortez or Pelosi.
    There’s so much to choose from.

    1. You can’t overcome the tragedy of the commons with policy, but you can with guns. Bernie and his ilk are well aware of that fact and so they display great contempt for the idea that anyone other than the state should possess guns.

      Socialism is evil. Bernie Sanders is evil.

      1. Never ascribe to “evil” what can be adequately accounted for by “stupid.”

        1. Both.
          The correct answer is: both

    2. Pelosi is a genius compared to them…

      1. The elderly madam who hasn’t been able deliver a coherent sentence in the last fifteen years?

  2. The last time we let these assholes screw with our healthcare system it was quite a disaster.

    1. Yeah, but what, 10 million or so were added to Medicaid? Big success!

  3. Ice cream… lollipops… and all free today! Bernie is the creep from Chitty Chitty Bang Bang.

  4. The democratic socialist from Vermont wants to radically expand coverage and benefits—while paying far less for health care services.

    It’s not a contradiction for supporters of his plan. This undoubtedly stems from the Zebras to Apples comparison Universal Healthcare-supporting people do with other healthcare systems.

    We’re repeatedly told (and shown) that Country X has Universal Healthcare and pays far less for their healthcare system than we do.

    Bernie really believes that we can institute an English-style NHS with the stroke of a pen and voila! America has cheaper and more comprehensive coverage. The irony of all this is the LAST people that would put up with an NHS style system are the very supporters who want it.

    1. “”Bernie really believes that we can institute an English-style NHS with the stroke of a pen and voila! “”

      A while ago I saw a report that mentioned England spends a little over $3,000 per patient per year and the US spends a little over $8,000 per patient per year. I don’t think you can cut the patient per year amount in the US by 50%.

      1. If you dramatically reduce coverage and access, you could probably do it. But again, no one would stand for it. There’s this idea in America that if we had an NHS, you’d just waltz into any healthcare facility and you’ll get bukaked with medical care and drugs with no limitations in time and scope to either.

        1. Exactly.

        2. Well, presumably the US would implement something like the UK has in the form of National Institute for Health and Care Excellence (NICE).

          I don’t know if in the US, we will set the price for one Quality Adjusted Life Year (QALY) the same as the UK (which, as I recall is between $40K and $50K) — perhaps we would set it higher or lower, but I doubt it will be half or twice that the UK has arrived at.

          Once the government is making these decisions, it should cut down on health care costs because private insurers fear consequences of their actions (such as an employer switching to a different insurer or health care insurance administrator or lawsuits by patients based on denial of coverage decisions) while the government has little concern for such things — being a monopoly in Sanders’ plan.

          If we implemented the type of system the UK has, there would likely have been little public coverage or outrage over Cigna’s initial coverage decision in the case of Nataline Sarkisyan.

          Of course, there is the fraud issue that may offset some of this savings by eliminating care. I very much doubt that any major insurer wouldn’t have detected and acted quickly on many of the massive Medicare scams that have successfully defrauded the government in the past — most recently “braces”, before that it was “scooters”, before that it was pop-up doctors/clinics that quickly disappear (the law then required Medicare to pay, even a newly minted facility, before they had a chance to investigate – I believe that has been at least partially fixed), before that it was $fraud-of-the-year. Medicare seems to be bound by regulations, laws, and bureaucracy that prevent it from being agile (and, why would Medicare care much — they don’t have to compete and can just demand more money from Congress).

      2. I read a study that pointed out a decently large amount of our healthcare costs are just due to the fact that shit costs more in the US. We tend to have higher per capita earnings than the rest of the world, and so we spend more on things like hospital visits.

        It amazes me that we live in this age of exploding college education and exploding housing prices, and nobody draws the line that these industries are examples of what happens when you remove price sensitivity from the consumer. With easy access to loans for college and housing, the sellers do not compete on price, but on other things like services and perks. The same is true with healthcare- our laws going back to the wage controls encouraged the rise of “all you can eat” insurance policies, and our health care costs have been going up ever since.

        1. The phrase you’re looking for is pricing signal. Insurance removes that signal as currently implemented. Loans that are artificially reduced because of government interest rates do also experience some of that signal loss as well. But much of the housing cost issues is because of different government interference, namely housing controls.

          But you’re also right about that pricing signal being even more broken with free healthcare. I’ve watched all of the grandparents in my family and other older folks go from massive aversion to anything resembling a doctor, because of money, to hypochondriacs simply because it’s “free!”

          Not putting some penalty or payment requirement on those visiting is a recipe to bankruptcy.

      3. “I don’t think you can cut the patient per year amount in the US by 50%.”

        Of course you can. Take it from the MDs at gunpoint. That’s where this inevitably leads. The good news is that MDs overwhelmingly don’t have their own guns to defend themselves.

  5. I wonder if the “Democratic Socialists” intend to force people to become doctors and nurses. I don’t see how else they would be able to increase the numbers of caregivers, which will be necessary if they plan to give out more care.

    1. Yes, half of all of us will be enslaved as doctors and nurses, paid in cans of dog food per day… THEN this scheme MIGHT work!

    2. Probably.
      The “irony” being that the AMA already artificially restricts the number of residencies to something like 100k/year to protect doc wages.
      Cutting costs could easily begin with eliminating the AMA monopoly on supply, but they pay some of the most lobbyist money in the country.
      F “healthcare” providers and their lobbies, legislators, bureaucrats, insurance companies, and Democrats of all classifications

      1. There are 1.1 million doctors in the US. At 100k residencies a year, that would replace them all in eleven years. Somehow I don’t think that’s happening.

        Add to that the fact that a quarter of doctors practicing in the US were educated abroad, and that I’ve never heard of a graduating medical student who was unable to find a residency, and I’m pretty sure you’re just blowing smoke.

        1. This year, for instance, more than 29,000 applicants got placed in a first-year residency through the main matching process. But 8,640 did not — a number that includes international applicants and aspiring physicians who graduated from medical schools in recent years, as well as current fourth-year students. About 1100 of these are new MD grads; some are new DO grads and the rest foreign grads and previous grads. Some, but not all, will get a residency in a second application process. And there aren’t 100k new grads a year. More like 22,000. There may be 100k doctors in residency, but a residency takes 3-7 years, so only maybe 25,000 physicians graduate residency each year. It would take far longer to replace 1.1 M physicians.

      2. The AMA does not do anything like that. It has almost no power.

        1. Yeah, that would be the ACGME.

          1. It is.
            To the point of the boards.
            Medicine is a guild and anyone thinking government controls it is incorrect. It tries to and fails.

  6. Sanders does not have a plan. He has a series of slogans and expansive promises which poll well, because vaguely promising to solve all problems tends to be popular.

    1. This is why 14 year olds should get the vote.

    2. “”because vaguely promising to solve all problems tends to be popular.””

      Very popular. Politicians have been using it to get elected for a long, long time.

      1. Bread AND circuses!

  7. Indeed, the main trade-off that Sanders seems willing to discuss is the elimination of insurance companies, which he portrays as greedy middlemen driving up the cost of health care.

    Which is exactly wrong. If any group on the planet wants lower healthcare costs, it’s the insurance companies. The healthcare providers, however, want prices to remain as high as possible. Guess who’s winning?

    1. Depends on who you are calling a healthcare provider. Primary care providers are not going to get rich on that $85.00 for a 99213 visit.

      FQHC require a lot of additional grant funding and can’t keep their doors open on insurance reimbursements alone. The last FQHC I worked for was getting more than a million a year in grants and could barely stay in business.

      1. Right, but that’s why that provider really wants the same 99213 visit (yeah, I used to be in healthcare) to cost $925.00.

    2. Areas I’ve noticed where the money goes is technology, labs, and drugs.

      1. Yes, drug companies are a major problem in the cost of healthcare. I don’t have a clear solution, but they are a major pain point in high healthcare costs.

        1. I don’t have a clear solution

          Eliminate the FDA and reform patent law?

          1. Yeah, that sounds like a good start.

          2. that would get my vote.

        2. Pass a law that the US retail price of US-patented drugs can’t be more than 15% above the average price those drugs are sold to a selection of foreign health services — e.g. Canada, Britain, Germany, France and Japan. Penalty? Withdrawal of patent.

          That’ll bring the US price down while raising the foreign prices so they carry more of the development cost, which now falls on the American consumer.

          Yeah, Bernie suggested something like this, but I had the idea first.

    3. Insurance companies drive up the cost of health care for two reasons. First, they need to offer their clients a discount off the “list” price, so they need a higher list price for that. Second, they need to take their piece of the pie, which also drives up the price. The people who get stuck in all of this are the people who have to pay cash, as they pay the list price or something close to it. Health care providers might offer a 25-30% discount off the list price, but that often ends up much less than the amount the insurance companies raised the price in the first place. This is one of the reasons why the battle is over insurance rather than the availability of health care.

      1. “Second, they need to take their piece of the pie, which also drives up the price.”

        No, the piece of the pie is gained from the float and efficiencies inherent in risk pooling. This sort of logic was used all the time back in the 60s and 70s. “There is no way a commercial company can compete with a nationalized monopoly because the national monopoly does things at cost, while the private company has to pay for marketing and profit.”

        And yet time and again, when allowed to compete, private companies outdid nationalized ones regularly.

      2. so how come this dynamic does not also apply to auto or homeowners’ insurance? If only health coverage carriers could compete in an open market free of govt intrusion.

  8. Comrade Bernie:

    You will have to exclude me from your plan for all since I’ll refuse to comply.


  9. Seems every photo of Sanders has him in that pose. Will someone pull his finger already. I’d bet he’s fly around the room like a deflated balloon.

  10. As a Koch / Reason left-libertarian, I’m willing to tolerate the additional big government programs (like M4A) and increased spending that will accompany a Democratic Presidency, as long as that President is better on immigration than Orange Hitler.

    1. The Dems won’t even end drug prohibition to ruin the cartels whose violence destabilizes Central America.

      1. Of course, they think they are going to benefit with more votes as people flee those shitholes to come here.

    2. flagged

  11. The contradiction in thinking that you can give people more of something and somehow pay less for it is the contradiction at the heart of every socialist plan. Socialism is nothing but an ideology centered on the rejection of the fact that there is no such thing as a free lunch.

    1. To summarize one of the better lines from Atlas Shrugged, no one becomes a socialist thinking they’re the ones who are going to work harder and get less.

  12. What’s interesting is Vermont has already tried universal health care and abandoned it due to cost.

    1. He said on his Fox News Town Hall that the Vermont governor and legislature did not do it right. His plan will be better, somehow.

      1. That’s the thing about socialism. It’s never done right.

  13. It requires the government to initiate force what more needs to be said?

  14. Isn’t spending a lot of money to help the sick a good thing? Just what the hell else does that old bastard think we should be spending our money on?

    1. “Isn’t spending a lot of money to help the sick a good thing?”

      You’d think so, since progressives think spending a lot of money to educate the young is a good thing,

  15. The supply of medical facilities and health care workers needs to increase dramatically. Until that’s allowed to happen, prices will continue to be sky high and rising. The government needs to stop trying to figure out schemes to pay the inflated prices or to somehow cap them.

    1. Hold it Juice. Do you mean to tell me that the way to lower the price and increase the availability of something is to raise the supply of it? Who knew?

    2. The supply of medical facilities and health care workers needs to increase dramatically. Until that’s allowed to happen, prices will continue to be sky high and rising.

      ^ This. It really is that simple.

      1. It absolutely is. Yet, you never hear anyone from either side of the isle ever talk about increasing the supply of health care. They forever just want to divide up what is there in different ways. It is lunacy.

        1. I’ve even been told that increasing the supply would drive up costs because of unnecessary redundancy. Monopolies are the most economically efficient ways to organize markets, right? Although those very same people tell me that the main bad thing about free markets is the monopolies that inevitably result, at which point I get confused.

          1. “A monopoly is okay when it’s the government!” Fucking Bolsheviks.

          2. Nobody needs 23 kinds of deodorant.

    3. “The supply of medical facilities and health care workers needs to increase dramatically. Until that’s allowed to happen, prices will continue to be sky high and rising.”

      While that will help, it won’t solve everything. The biggest problem is that everyone consuming healthcare walks into the provider’s office with a blank check. They never have an incentive to choose the least effective option for treatment. 40 years ago, if you had heart problems, you’d get nitro pills. 20 years ago, you’d get an angioplasty. Now a days they are giving bypass surgery even to 75 year olds. Yes, heart pills are less effective than angioplasty- and with advances in surgery medicine have made bypasses in a lot of cases the best plan of action. But those heart pills are orders of magnitude cheaper. But with a blank check, the most effective treatment is always the best option- regardless of cost.

      Price competition is magical. It is what drove the cost of home electronics down to the point that everyone can afford a TV. It is what has kept elective medical care like lasik and plastic surgery from growing in cost as much as other health care. We need more price competition, and supply/demand will take care of itself.

    4. Allowed by whom?

      Who determines number of med school slots?

      Who determines who gets in?

      Who determines residency slots? You know about the match.

      Who determines criteria to take NBME?

      Who decides that after all of the above to get a license in South Dakota.

      Who decides that community hospital of South Dakota will grant you privileges

      Who decides that you will be given boards in pediatrics or urology without which none of the above means anything. Then you need to pass that exam and keep up with other requirements.

      So y’all can decide how to pay for it. Medicine is a guild and Trump nor Sanders do not get it.

  16. If Bernie Sanders gets elected as President, Congress’ first act should be to bestow upon him the honorary military rank of Colonel.

    1. That would be great.

      Reminds me of Dean Martin in Back To School and Dangerfield chuckling when he says it.

  17. Hey, don’t even worry about getting to a hospital under Berniecare, because you may not make it alive.

    Ambulance and paramedic services are already screwed over by low Medicare payouts and idiotic rules, and will no doubt be doubly screwed under Berniecare.

    Companies in a lot of urban and suburban locations will reduce crews and put them on call rather than have someone on duty 24/7. 911 truly will be a joke that you can contemplate while you bleed out waiting for an ambulance.

    1. The list of horrors this crazy bastard would inflict on the nation should he ever get the chance is endless.

      1. Which crazy bastard?

        EMS takes every call.

  18. You’re being too logical about this. Every Socialist knows these programs don’t work and they’re full of contradictions. They don’t care because like Sanders said, they’re punishing insurers for their “greed.” You need to focus the argument on emotional issues and emphatically explain how corporations are not greedy (and how greed is nothing more than a pejorative for free, voluntary exchange) just because you pay a lot.

  19. Nothing is impossible for the man who doesn’t have to do it himself. Sanders has a 90,000 foot high view of health care. He has absolutely no idea how to make this work in the trenches.

  20. Sanders just needs voters to believe the contradiction for one day – election day. After that, what voters believe really doesn’t matter to him.

  21. “… insurance companies, which he portrays as greedy middlemen driving up the cost of health care.”

    To be replaced by incompetent government bureaucrats driving up the cost of healthcare—while dramatically lowering quality. A twofer. I expect elected officials, and government employees will be exempt, of course.

  22. First they came for the greedy insurance companies and I said nothing. Then they came to destroy the greedy healthcare providers and I said nothing.

    Then I needed help, and the government operated health care system did nothing and I died.

  23. Speaking as someone whose wants are limitless, I am thrilled to see a candidate whose desire to give me stuff is also, apparently, limitless. I’m on the Bernie gravy train, and you’ll have to pry me off with a crowbar or a gun. Now get to work, people, there’s a whole lot of stuff I don’t have that I’m expecting you and Bernie to provide.

  24. If you want to reform/improve/streamline any industry, why would you turn to people for solutions who have, for the most part, never produced anything in their lives? Instead of the health care industry, why don’t we let these geniuses of organization and economics try their hands on something a little less important. Maybe the candy industry? The playing-card industry? Let ’em have their way, and in 5 years, if candy or playing cards are cheaper and more widely available, then they can have a go at the healthcare industry.

    1. Congress has a small number of individuals with backgrounds in health care. You rarely, if ever, hear from them on the subject. It’s almost like they’re kept quiet on purpose.

      1. They’re not “kept” quiet. When they speak up, the reporters shut
        their notebooks and scurry away.

  25. Here’s the Bern ducking a question by the simple expedient of calling it “democratic socialism”, since including that magic word means no thugs:

    “Student asks Bernie Sanders about ‘failures of socialism’
    During a CNN town hall, a student whose family fled Soviet Russia asked Democratic presidential candidate Bernie Sanders about the “failures of socialism” around the world.”


  26. dare i say: the ‘premium’ paid for the operations of private insurers is worth it for the compartmentalization/diversification. Maybe an insurer can go down for whatever reason, but the system goes on.

    No one ever has an answer for when i ask “What happens if the federal government ‘takes over’ healthcare and fails at it?

  27. Hospital costs are vastly inflated though. My father needed an ambulance ride from a nursing home to the hosptial. It was a mile away. The cost was $2,000.

    1. This is the biggest problem with tackling the healthcare issue–no one with any real authority, and I mean no one, ever addresses the actual cost of healthcare and how to get it back to the inflation-adjusted levels of the 1980s, much less the 1950s when it was dirt-cheap by any standard. And if we’re going to continue importing nearly all of fucking Central America to this country like Shika wants to do, we’re going to need an increase in supply on an Olympian scale, because it’s just going to get more expensive, not less. Combined Medicare/Medicaid services cost last year were over $1.4 trillion.

      Increasing the number of healthcare providers is the most obvious road, but it’s telling that none of our exceptional political leaders ever makes it a serious plank of healthcare policy.

      1. You are welcome to receive 1950s healthcare.

        1. So you’re claiming the current cost levels are justified? Here’s a clue, there was far less government interference in the market in the 1950s than there is now.

          Don’t cry about the cost of healthcare while denigrating the period when it was actually cheaper in real terms.

        2. Costs are ridiculous. But I do joke from time to time that if you want cheap health care, buy a bucket of leeches.

          1. you’re pretty much right thought.

            I heard recently about how many years ago, my great grandfather was diagnosed with cancer and his ‘treatment’ was the doctor dropping of some morphine once a week to keep him comfortable until he passed. Today they would probably spend 6 or 7 figures helping him cling to life. The real problem is much of modern medicine isn’t curing people, its just treating them indefinitely. I’m not saying its a big money making conspiracy, it just is what it is. Cheating death by whatever means necessary is not cheap.

          2. Echospinner’s implication that the quality of our healthcare was somehow at 3rd-world levels in the 1950s was probably the most exceptional aspect of his comment.

    2. “”The cost was $2,000.””

      Curious, was insurance involved or did they bill you directly?

  28. Meet the new DemocRat platform, same as the old one. Promise a world of free “stuff” to people who can’t do basic math. Never underestimate the attraction of free stuff to the lazy, dishonest, ignorant and just plain corrupt. Case in point: Venezuela.

    1. Maybe Trump should invade Venezuela and make Bernie the president. If Bernie can turn Venezuela around, we’ll let him back in the US.

  29. “What Sanders is proposing, in other words, is that the government finance a significant increase in government services while also radically reducing the amount it pays for those services. Even making generous assumptions, it’s almost impossible to see how his plan could work.”

    I can see how it would work. Rationing. You’ll have a ‘right’ to health care but you’ll have to wait for it. Right now I can usually see my general practitioner on a same day or next day basis. A specialist will be a few days to a week. With a government rationed system those wait times can increase to weeks or months. How many people will wait that long? I’ll wager that most, outside of the critically ill, will not do so. Demand drops and the ‘right’ to health care becomes affordable.

    Just don’t get sick. At least not critically sick.

    1. It’s amazing how many problems can be reduced to the (speed + quality = cost) algorithm. You can only set the value on two, reality dictates the third.

  30. Like it or not Medicare for All is being offered as a possible solution to providing better health care access. The alternative is a bigger, better plan which President Trump is keeping secret until after the election. Two old white men each offering fantasies. For what ever faults it has the Affordable Care Act (ACA) is a good frame work to build on to get more access and hopefully lower prices in the future. I say either support the ACA or pick your fantasy.

    1. For what ever faults it has the Affordable Care Act (ACA) is a good frame work to build on to get more access and hopefully lower prices in the future. I say either support the ACA or pick your fantasy

      No, going back to the pre-Medicare/Medicaid days would be far preferable, as healthcare costs were empirically cheaper.

  31. The community of medical professionals will be the first to understand the concept of “useful idiots” after they help the Dems win the election in 2020.

  32. “There is a huge contradiction at the heart of Bernie Sanders’ Medicare for All plan.”

    Not so much. Any honest person looking at our medical system would see a rent seeking mafia that spends most of it’s energy carving up the pound of flesh they extract from citizens among themselves. Care is secondary to that.

    The contest is not between free market and government planning, but between government planning plus mafia shake downs, or just government planning.

    We may end up with *more* health care freedom under BernieCare, as I often hear that foreigners and their socialized medicine can buy more medicine over the counter than we can.

    1. We may end up with *more* health care freedom under BernieCare, as I often hear that foreigners and their socialized medicine can buy more medicine over the counter than we can.

      That’s only assuming the FDA’s monopoly-encouraging modus operandi is eliminated, though. It’s not an accident that Plan B, for instance, costs $50 a pop when it could cost $10 or less with more competition.

  33. […] Bernie Sanders’ Medicare for All plan. Certainly, these trade-offs are not part of the way he advertises […]

  34. […] Bernie Sanders’ Medicare for All plan. Certainly, these trade-offs are not part of the way he advertises […]

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