Medicare for All

Bernie Sanders Thinks Medicare for All Would Solve America's Health Care Problems. It Would Make Them Worse.

The nation's largest health care program faces a shortfall in less than a decade.

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Bernie Sanders (I–Vt.) thinks there's a crisis in American health care, and only Medicare for All can solve it. He's half right.

There is a crisis in the nation's health care system. But that crisis is Medicare itself—the program as it exists today.

In an op-ed for USA Today, Sanders says the current status quo is an "economic and medical emergency for millions of Americans." The solution, he argues, is to expand Medicare, the health coverage program for seniors, into a national, government-run health care program, because Medicare "guarantees coverage."

But that guarantee only goes so far—and we may discover its limits sooner rather than later.

In 2026, Medicare's hospital insurance trust fund is expected to become depleted, according to a report last month from the program's actuaries. Initially, it will bring in enough money to pay for about 89 percent of its expenditures. Over the next 20 years, that figure will dip down as low as 78 percent.

Insolvency doesn't mean the program shuts down entirely. But what it does mean is that in less than a decade, the program won't be able to pay all of its bills. When that happens, the program's supposed guarantee won't mean much at all. Health care for millions will be in jeopardy because of the federal government's consistently poor fiscal management.

People who rely on the program may not be able to access the care they need or may face much longer wait times. Benefits might end up being scaled back, or practically unavailable even if they are theoretically guaranteed. Alternatively, Congress could raise taxes to finance the program's full costs. Higher taxes, reduced benefits, longer lines, or some combination of the above: When a shortfall hits, those are the primary options.

Sanders' call for Medicare for All, in other words, ignores the longstanding problems with Medicare itself. His advocacy for single payer is almost entirely unresponsive to the longstanding fiscal challenges of the federal government's largest health care program, which, despite their predictability and inevitability, have proven stubbornly difficult to solve. If anything, Medicare for All would increase the scale of those problems, and put care for millions more people on the line in the process.

Under Sanders' vision of Medicare for All, private health insurance as we know it today would be outlawed. That doesn't just mean no competition. It means no alternative and no escape. So if the program struggles to meet its obligations, and care suffers as a result, there's essentially nowhere else to turn. Sanders would trap every American in a system that would almost certainly struggle with financing from the outset.

That's because Sanders, it's clear, has no idea how to pay for the program he has in mind. His proposal is vastly more generous than comparable universal coverage programs run by other countries. Multiple estimates have found that it would add about $32 trillion to the federal tab over a decade, even under generous assumptions. Yet Sanders has never proposed a specific financing mechanism to offset the massive increase in government spending his single-payer plan would entail.

Nor has he answered numerous other practical, necessary questions that designing and implementing single payer would entail: How exactly would health care providers be paid? What would happen when the expansion of coverage increased demand for health care services—especially if provider payments are simultaneously cut?

American health care has real problems; it's expensive, bureaucratic, and inequitable. But decades of government intervention has, if anything, only made these problems worse—if not created them in the first place. The tax break for employer-sponsored insurance in the aftermath of World War II locked people into job-based coverage and encouraged the purchase of ever-more expensive plans, insulating individuals from the cost of their decisions. The creation of Medicare (and to a lesser extent Medicaid) rapidly funneled huge amounts of federal funding into the hospital system and coincided with decades of increased national spending on health care. Federal health care programs now represent what is arguably the nation's largest long-term fiscal challenge.

But now the long term is almost here. And instead of addressing the deep and difficult problems that persist in the current system, Sanders and his followers appear to have only one answer, which is to keep doing the same thing, but more of it. Sanders-style Medicare for All isn't the solution to our health care crisis—it's just a much bigger, much harder to solve version of the same crisis we already face.

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  1. “”because Medicare “guarantees coverage.” “”

    But it doesn’t guarantee services, nor payment in full.
    But outpatient is only covered at 80%. Preventives services not covered. Medicare is so great you need to purchase additional coverage just to get the bills paid.

    1. I was going to bring that up too. If Bernie’s plan outlaws private insurance then it isn’t really Medicare For All. It’s Single Payer For All.

      1. Medicare, as we know it today, is an 80/20 plan after deductibles [currently about $1300 for a hospital admission within a 60 day period]; if there is no private insurance you will not be able to cover that.

      2. “If Bernie’s plan outlaws private insurance then it isn’t really Medicare For All. It’s Single Payer For All.”

        Shhhh. That’s supposed to be a secret.

  2. Higher taxes, reduced benefits, longer lines, or some combination of the above: When a shortfall hits, those are the primary options.

    I imagine there will be much more ‘Hands off my Medicare’ screeching in the near future.

    1. You will also see all manner of medical specialists heading for retirement within the next five or so years.

      1. a) I doubt it unless they are already in/near retirement

        b)like it or not, a specialist supply-side driven system like we have actually increases costs, spending, and utilization. Cardiologists don’t get paid for telling patients you really didn’t need to come in to see me about your heart. You’re fine Nor do they since that’s exactly for whom they’ll order 25 extra diagnostic tests. The only real exception are generalists/gatekeepers and two oddball specialists (pediatricians and geriatricians) who don’t have much effect on increasing the number of their patients.

        And it ain’t just my dog and me saying this on the internet – Dartmouth Medical School

        1. What you’re quoting as “Dartmouth Medical School” is not actually the opinion of “Dartmouth Medical School,” or even an academic journal. It’s an op-ed in a community newsletter affiliated with the medical school reflecting the opinion of exactly one researcher.

          This one researcher’s opinion that costs are rising because there are too many doctors and that we can therefore reduce costs by further restricting the supply of doctors is not supported by any data and is counter to common sense and basic economics.

          Reducing the supply of doctors may reduce medical spending, but it won’t reduce the cost of healthcare.

          1. It is not counter to common sense or economics. It is the reason Mayo Clinic puts doctors on salary – to eliminate the incentive to ‘create’ income by overtreating and overdiagnosing. It is the major reason that gatekeepers and case managers intermediate in expensive medical conditions cuz specialists have a direct conflict of interest in controlling utilization and patients CAN’T have the knowledge (or objectivity) to do so.

            It is the reason ‘proton beam’ ends up clogging the top of google search results for prostate cancer. It is a technology that is medically useful for some brain and pediatric cancers. But once you’ve spent $150+ million for that machine/building – and realize there just aren’t enough brain/pedia cancers to keep it utilized – well then you damn well better create the demand for it. Who cares if it costs 2x more than regular photon therapy for more common cancers – insurance will pay!!! Supply sure as hell can create its own demand and that’s been known in economics since Say.

            And no it isn’t one researcher – though it is true that the handful of them at Dartmouth are a bit lonely in this country. Far noisier are the establishment pigs at the trough who want Medicare to pay for more and more residencies but have no interest in training the doctors that Medicare (or any govt-paid plan) actually needs like GP’s or geriatricians. So when did libertarians come to believe that cronyist capture is free market economics?

        2. Huge numbers of docs ARE near retirement age, so ThomasD is correct.

          And cardiologists DO get paid for telling patients that their heart is fine. It’s called preventative medicine, one of the things that promoters of government administered health care are always shouting that we need more of.

          But sure, having specialists does, indeed, increase the cost of health care, as do all more sophisticated products and services that Americans with insurance enjoy.

          But single payer is not a panacea for the problems that the US and all countries currently with single payer systems face- how to pay for the ever-increasing costs of health care for aging populations who demand the most sophisticated (and, therefore, most costly) treatments which exist. Canada, the UK, etc. are all facing budget deficits, forcing them to either cut services or raise taxes or both. That’s the whole point of this article. One of the world’s largest single payer health care systems, US Medicare, is on the verge of bankruptcy, even though it has systematically “stolen” $trillions from the private systems over the decades via cost shifting, the primary reason that the private health system is so expensive.

          The only real solution to the crisis is to institute explicit rationing and force the citizens to accept less. And, yes, the authoritative federal government is by far the best at such things. But no politician, especially not “more free stuff” politicians like Sanders, will ever admit this. They all remember what happened to Governor Lamb of Colorado years ago.

          1. I’m not saying single-payer is a solution to anything. Our govt is uniquely crappy in the world at managing the healthcare for even the peeps on their coverage. And mainly for the reason you cite – they can’t say no – not to patients, not to doctors, not to anyone. And we Americans seem to prefer it that way since we can’t even talk honestly about the issue and we are perfectly ok with corruption.

            But the major point in that article is that saying ‘we need more doctors and gummint should pay for that and not ask questions or demand/manage anything about that’ is simply the same damn problem that’s gotten us into the expensive mess we’re in. Govt can’t say no and we wouldn’t listen to that even if they did say no.

          2. Yes, the demographics alone are in my favor. But beyond that there is also the simple relationship between profit and performance. Right now many procedural specialties still make money from medicare. When that stops being the case many of the people currently performing those procedures will simply leave the business.

            They won’t be happy about it, but the ones who are already financially secure damn sure wont be giving it away either.

      1. Yes, with longer lines a significant number of patients either get better or die before they get to the front. It’s just another rationing tool. We need more rationing (except of course when it comes to my health care).

  3. Even if some of his economic ideas clash with my libertarian philosophy, Sanders is still better than any Republican because he supports legal access to abortion care throughout all 3 trimesters.

    1. Meh. I’ve come to expect better from you.

      1. I haven’t; OBL is tedious.

        1. I don’t get how people think it’s clever or interesting. All it does is relabel leftist bullshit as “libertarian”.

          1. It’s a hard task to parody progressives, given that they are silly and ignorant to begin with.

            1. “It’s a hard task to parody progressives, given that they are silly and ignorant to begin with.”

              You prefer backward, bigoted, belligerently ignorant, and superstitious?

              1. He says “silly and ignorant” — you pop up as if on cue.

          2. I thought it was an attempt to parody libertarians who emphasize liberal immigration policies or otherwise oppose parts of the GOP platform. It’s pretty boring, though.

            1. He mocks libertarians for being libertarian by trying to give the impression that libertarians should be conservatives.

            2. It’s either that or an attempt to parody some of the more right-leaning commenters’ image of a Reason writer. In either case it’s very tiresome.

          3. ” All it does is relabel leftist bullshit as “libertarian”

            Yeah, we get enough of that around here without his ‘help.’

    2. Let me know how much “legal access to abortion care throughout all 3 trimesters” helps when you need emergency surgery because of an injury or because one of your organs is going south or you get cancer or COPD or your kid or spouse gets sick, or even when you and your spouse get pregnant with a child you want.

      Bernie is promising “Medicare for All” to get elected POTUS, but you can bet that the “All” won’t include Congress or the President.

  4. Just for the record, his proposal is MediCAID for all. A lot of people were taxed to pay in advance for the Medicare they now receive (if they can find an in-network doctor accepting new patients). Medicaid recipients paid little to nothing for their coverage. So dumping the entire rest of the US population, regardless of citizenship, into a single government run program is not Medicare, it is medicaid.
    But either way, it can be paid for by taxing the millionaires in congress 300% on all income above their salary, and 200% of their net worth each year.

    1. You’ve got it backwards. A lot of people were taxed to pay for the Medicare their parents and grandparents were receiving. Now their children and grandchildren are being taxed for the Medicare they are receiving. One of the Big Lies is that your FICA taxes are for your own benefit. Medicare has been living hand-to-mouth for a long time.

  5. Bit of a stretch to say Bernie Sanders “thinks” anything at all. He’s a moron.

    1. I’m convinced that he’s really a die-hard capitalist who happens to be peddling ideological wares. He’s found a robust market for them.

      1. Well he did sell his book opposed to handing it out to his comrades for free.

        1. According to him it’s great to make a million selling a crappy book but bad to build a business that sells things people actually want and need.

          1. Profit is evil for the other guy.

          2. If you dig down in socialist logic, then the only things a person should pay for, as opposed to being provided, are things they do not need.

        2. I doubt that book was written democratically.

  6. Pay cash for all minor medical stuff and catastrophic health insurance for major medical stuff.

    This would eliminate the ‘need’ for Medicare, Medicaid, and ObamaCare and save Americans almost a trillion in federal taxes each year.

    1. cash for all minor medical stuff

      You might want to flesh that out a bit, as to the difference between “minor” and “catastrophic” and what amount of cost would be allocated to each.

      Hospitalizations, as in a joint replacement or for a condition like pneumonia or congestive heart failure, are not always catastrophic but they certainly do cost a lot. As do a lot of outpatient procedures.

      1. The insurance carrier and the customers gets to decide what is minor or major medical stuff.

        If an insurance company says that pneumonia is minor medical stuff and you think it is major, go with a different company.

  7. “Sanders would trap every American in a system* that would almost certainly struggle with financing from the outset.”

    *health care, economic, bureaucratic, regulatory, education…just fill in the blank

  8. “People who rely on the program may not be able to access the care they need or may face much longer wait times.”

    Wasn’t there something about Soviet bread lines being a good thing, because it meant people were getting food? Same idea.

  9. I’m calling bullshit. Under Medicare for all we collectively spend trillions less on healthcare then we would under the current system.

    1. I suppose if you say so, what choice do we have but to believe you? Suderman’s pesky facts and figures be damned!

      1. I didn’t make it up. You can look into the claim yourself.

          1. Or should that be…

            THAN cite it?

        1. Sure, source the claim.

    2. One problem with that statement is in the word “collectively.” We spend different amounts right now (not collectively), reflecting different conditions in life and different desires for levels of coverage. Under M4A, even if we “collectively” spent less, a lot of us would end up spending much more for services that are much worse and/or undesired. But that doesn’t really touch the other big problem with that statement, which is that it would require massive cuts to providers. Predictably, this would cause shortages in providers (that’s what price controls do), long wait times, and incentivize the best and the brightest to pursue other careers.

      1. Under M4A, even if we “collectively” spent less, a lot of us would end up spending much more for services that are much worse and/or undesired.

        That’s what the Affordable Obamacare Act was all about. And “we” still somehow managed to collectively spend even more.

        1. That’s what the Affordable Obamacare Act was all about. And “we” still somehow managed to collectively spend even more.

          Yeah, absolutely. I was just pointing out the problems with the statement even assuming that it would turn out true. It wouldn’t, of course, since the group that benefits from rent-seeking and taking taxpayer money is concentrated, while the one that pays (the rest of us) is dispersed.

    3. Under Medicare for all we collectively spend trillions less on healthcare than we would under the current system.
      You mean like Venezuela, where medical care can’t even prevent starvation?

    4. Under Medicare for all we collectively spend trillions less on healthcare then we would under the current system.

      We currently spend $1.4 trillion on Medicare and Medicaid Services alone, and these programs are notorious for supposedly underpaying doctors for the cost of services, compelling them to shift those costs to private insurance holders and thus increasing the cost of private plans.

      Please feel free to explain, using math, how adding more people onto Medicare rolls will lower the actual cost of healthcare or health insurance broadly.

      1. The only way Berniecare saves money is by denying services while preventing alternate coverage.

        1. The only way Berniecare saves money is by denying services while preventing alternate coverage.

          ^ This. If if costs less, it will be because you we get less.

      2. Even the creators for the ACA knew more money was needed to fund the system which is why they did the mandate and the compliance tax. The ACA ran into money issues in part due to people without insurance not paying the tax.

    5. Under Medicare for all we collectively spend trillions less on healthcare then we would under the current system.

      Dumbshit, that’s possible because the price for healthcare for everyone else is raised to cover the difference.

      In other words, you drooling simpleton, Medicare, which I pay my taxes to support, pays doctors less, so in turn I — through my deductibles, copays and whatnot, have to pay them more to make up the difference.

      Tell me — are you really this stupid, or are you just trolling?

      1. There’s the additional unstated option of paying health care providers a lot less money, which would become a reality under Berniecare. Like Big Pharma, Big Doc and Big Nurse have to come in for some price-control love to provide stuff at lower cost. Look up doctor and nurse salaries in some of the beloved single-payer countries. It’s not part of the platform, of course, but it would be a lot like “If you like your plan, you can keep your plan.”

        1. Yeah, that’s what I’m getting at. Eliminate private participation and either Medicare needs to pay a lot more (yeah, that’s not going to happen) or the entire healthcare industry will have to get by with a lot less money.

          But of course OP would retort that by eliminating “the middle man” (insurance companies) the cost savings would allow proper funding. *Cough* bullshit *cough*.

  10. I wouldn’t assume that Bernie drinks his own Koolaid.

  11. It’s easy to agree that Sanders’ plan is flawed, he doesn’t spell out how it will be financed, or how the transition away from ALL the employer based plans, current Medicare, Tri-care, and the individual plans will go. (I do wonder why he doesn’t propose something more like Medicare for All – like the current traditional Medicare, with co-pays and deductibles, allowing for supplemental insurance.) I’m glad this Reason article mentioned a few points about how lousy our current system is, and why – such as employer-provided health insurance and the creation of Medicare. (Reason has brought these up before, but not in a while.) What I would really like to see on Reason is a coherent, detailed proposal on how to reform out f**ked up system, including how the transition away from our current, multi-tiered, inefficient, system will go. If any of the full-time employees at Reason have employer provided insurance – with its tax breaks – then I’m going to assume your reform proposal will mean you’re going to give up that perk. If it doesn’t – then I will have a hard time taking you seriously.

    1. Of course he doesn’t provide details. He is the Trump con man of the left.

      Remember The Dotard said everyone would be covered with the greatest federal insurance in the world under his plan? He said it.

      Of course no one believes Trump. Problem is Bernie’s idiot followers do believe him.

  12. Medicare for all would be an acceleration to bankruptcy for America.

  13. The government can’t guarantee anything without also guaranteeing that it will use the full force of the military to compel you to act in the manner it has promised to someone else.

  14. In 2026, Medicare’s hospital insurance trust fund is expected to become depleted

    Maybe if you and I paid an even fairer share we could have the best health care that government can offer. Did anyone even think of that? I mean, come on.

  15. The one good thing Hillary has done for this country was keeping Bernie from getting the nomination in 2016.

    1. Bernie can’t win. Even vs the Con Man.

      Warren Buffett even said Bernie was toast this weekend at Woodstock for Capitalists.

    2. Will one of the up coming debates between Trump and Biden be sponsored by Gee, Your Hair Smells Terrific shampoo?

  16. I would have thought that the VA, a government health care program targeting veterans would come in for some criticism from Reason from time to time. Is there not a free market alternative? How about veterans paying for their own health care from their own pockets as god intended? Or is the system of government provided health care as it stands too popular so there is no groundswell to change the status quo.?

    1. How about veterans paying for their own health care from their own pockets as god intended?

      How about either the government make good on its promise to provide lifelong medical care for those who serve in the military or stop making that promise?

      Or is the system of government provided health care as it stands too popular so there is no groundswell to change the status quo.?

      If you know any veterans, you already know the answer to that question.

      1. “How about either the government make good on its promise to provide lifelong medical care for those who serve in the military or stop making that promise?”

        Frankly, I would have thought it would be easier for Libertarians to come up with an easier, more attractive market solution. I don’t think I’ve seen it.

    2. “”a government health care program targeting veterans would come in for some criticism from Reason from time to time.””

      It has. At the very least Peter Suderman did a piece on it.

      “”Or is the system of government provided health care as it stands too popular so there is no groundswell to change the status quo.?””

      Wait, you are referring to the VA? I’ve never met a vet, nor any of my vet friends that have had anything but disgust with the VA system.

      Why would we expect someone injured on the job would have to pay for their own opposed to the employer?

      1. “Wait, you are referring to the VA? I’ve never met a vet, nor any of my vet friends that have had anything but disgust with the VA system.”

        Expressing disgust is one thing. But do these veterans continue to avail themselves of the service or do they turn to private market solutions? In other words, what they do is more telling than what they say.

        “Why would we expect someone injured on the job would have to pay for their own opposed to the employer?”

        Does the VA treat only treat job related injuries? Wouldn’t corrective lenses, birth control etc also be covered under VA? Or is that only when in active service as opposed to physical and psychological injuries which I suppose are taken care of for the life of the patient.

        1. So what you’re saying is that people will take advantage of free shit, even if that free shit sucks.

          1. If the free market alternative is even shittier, what choice do people have?

  17. Comrade Sanders: Does Medicare for All cover penis and bosom enlargement?

    Asking for the newly weds next door.

    1. Oh! The Buttigiegs are your neighbors?

  18. TEXAS REPUBLICAN SAYS VACCINES ARE ‘SORCERY,’ CLAIMS ‘PARENTAL RIGHTS’ ARE MORE IMPORTANT THAN SCIENCE

    Stickland, whose Twitter profile says he is a “Christian Conservative Liberty Loving Republican,” engaged in arguments with several other Twitter users off the back of his debate with Hotez. In one, the representative asked a user, “Vaccines are dangerous,don’t you agree?” and in another attacked “another guy in a white coat who thinks he’s a better parent than everyone else!”

    “I will fight—with everything in me—against the big government you desire,” he wrote to another doctor. “One where you can force me to do things against my will. One where the state owns my children. Take a hike communist.”

    Newsweek.

    Sounds like one of the Peanuts.

    1. Pederast and bet-welcher shriek hopes you won’t recall that there are plenty of non-fundie libertarians that have pushed back on HnR against Ron Bailey’s argument that choosing to go unvaccinated is not a libertarian action.

  19. Bernie is a pernicious old coot. Evil.

    1. He smells like mothballs

  20. “It means no alternative and no escape.”? Actually there are a number of countries that offer better care at lower out of pocket cost. India is one that comes to mind.

    1. India ranks 145th among 195 countries in terms of quality and accessibility of healthcare, behind its neighbours like China, Bangladesh, Sri Lanka and Bhutan,

      Read more at:
      http://timesofindia.indiatimes.com/articleshow/64283179.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

    2. The World Health Organization ranks India as 112. The US is ranked at 37.

  21. Just because VA care sucks doesn’t mean that Medicare for all will suck, right? Right?

  22. Medicare already has more patients than any single payer system in the developed world. A single payer system in America would not be like Canada or the UK. It would be like if the entire EU had a single payer market. It just doesn’t work on that scale with so many different regional and state governments.

    1. I agree with this. Also Medicare hasn’t been capable of even basic and obvious reforms of medical care for the elderly – which is the biggest difference between our govt-run system and every other country’s govt-run system. Our inability to even talk about anything in public doesn’t give much confidence that just adding more people to it will work.

  23. People are so shortsighted. Add narcissism and you have a dysfunctional society.

    A nation is just like a business. Why shouldn’t it include health insurance.

    Businesses need healthy employees just as nations need healthy citizens.

    The money spent by the nation on healthcare just means businesses don’t have to.

    Try to see the big picture.

    1. I’m not sure you understand what “business” is. The government banning private insurance is not business. Allowing private healthcare insurance across State lines is business.

      1. I know that when healthcare is free privately funded health insurance will go out of business.

        1. In Canada and the UK, both with socialized health insurance, private health insurance is available and profitable. The public system doesn’t cover everything. Rolfing, for example. If you want to be covered for rolfing, you need to turn to the private companies.

          1. In those systems, the examples you state aren’t free. If they were, there wouldn’t be much opportunity for private business.

            There will always be an opportunity for “special and unnecessary ” services that some will pay a premium for. That is always going to be a business opportunity.

            1. There are private health insurance providers in the UK and Canada. I think they cater to the wealthy. For the rest, the public health insurance seems adequate. It’s not free, as nurses, doctors and administrators have to be paid. Medicine and equipment also cost money. But for the patient, it can be said to be free. A visitor with a broken arm will receive full medical attention and be presented with a bill for $2 when they leave. For parking.

    2. “A nation is just like a business. Why shouldn’t it include health insurance.

      Businesses need healthy employees just as nations need healthy citizens.”

      21. The State has the duty to help raise the standard of national health by providing maternity welfare centers, by prohibiting juvenile labor, by increasing physical fitness through the introduction of compulsory games and gymnastics, and by the greatest possible encouragement of associations concerned with the physical education of the young.

  24. Bernie, as did Trump, is promoting slogans where more of us need to understand how. As a senior on Medicare, I am concerned this broad brush forced solution will bankrupt Medicare. As a systems thinker, a few thoughts:
    1. Politicians act elitist to healthcare and Social Security so both suffer inattention. Why not put all politicians on the same plans so they are in the same boat as those they say they serve?
    2. Why not increase Medicare’s power to negotiate lower drug costs? Why not tear down the wall between reactive healthcare and preventative healthcare? Why not reallocate taxes, as other countries do to cover healthcare, infrastructure and education, maybe more as there is a lot of waste in government spending while we are forced to live frugal lives.
    3. It is time for both parties to serve the needs of the majority of Americans, our planet and be a citizen of a world in chaos. I think it is a time for accountability to all that look the other way, accept monies from manipulative sources or who obstruct progress for the greater good. We need to learn from this Dictator wanna be POTUS and strengthen our constitution and where objectivity and the rules of law should not be compromised as we have seen on a daily basis the last two years.

  25. The author and everyone else forgot the biggest problem of all – Unintended Consequences!
    Even if you come up with a solution to all the problems, come up with a great and wonderful plan there will be unintended consequences and they will be huge. Government programs don’t deal with unintended consequences very well if at all. Congress and government is to slow to react and congress is generally incapable of reacting.
    Obamacare is the perfect proof. Everyone admits it is broken but nothing can be done to even attempt to fix it. That is reality.
    Want to lower the cost of healthcare and improve the availability? Get the Federal Government out of it 100%. End any tax advantages for employer paid or self funded healthcare. End medicaid. End any Fed involvement. Medicare being the exception since we are stuck with it.
    Let the states decide if they want to provide charitable care for their citizens and let them tax themselves to pay for it. Return health care and insurance to the free market, to the consumers of the services. Get it out of the hands of the Federal Government and employers. That is how it got screwed up in the first place.

  26. 1900 !!! Healthcare costs; 1-point on consumer price index !!!
    1910 AMA will solve healthcare……..
    1910 Subsidizing doctors will solve healthcare…..
    1925 Gov research and development will solve healthcare…..
    1945 Healthcare standards will solve healthcare……
    1946 Federal subsidies to hospitals will solve healthcare…..
    1951 Employer insurance buyers will solve healthcare…..
    1965 Medicare will solve healthcare………..
    1965 Medicaid will solve healthcare………
    1972 Federal Hospital zoning will solve healthcare……
    1974 Federal Equal Coverage will solve healthcare….
    1984 Pharmaceutical patenting will solve healthcare….
    2003 Subsidies for Prescription drugs will solve healthcare…
    2014 Obamacare will solve healthcare….
    2015 !!! Healthcare cost; 38-points on consumer price index !!!

    STUPID – Continuing to REPEAT the same mistakes and expecting different results…..

  27. A better way:
    Phase Out Plan:
    Abolish the income tax, tax code and IRS.
    Enact the Fair Tax (sales tax).

    States, counties, cities and local municipalities should abolish property taxes, all fees including license fees and all other taxes, including income taxes. Replace with sales tax.

    Phase out all federal safety net programs. Make it illegal, by amendment, for government at any level to run or pay for any entitlement program of any kind.

    Update the safety net. Have a means tested financial safety net (cash/voucher) at the state level (they have financial restraints), not a safety net based on government run programs for everyone.

    No benefits for those who do not qualify for assistance. A true safety net. And people would be reminded of the cost of government every time they spent a dollar.

  28. US Medicare is one of the largest single-payer health care systems in the world with over 45 million subscribers (larger than the entire Canadian health care system).
    And, as the author correctly notes, Medicare is on the verge of bankruptcy, so it is obvious that the US is unable to run a single payer system successfully.
    But even more telling are these facts
    1. In order to meet payments, Medicare markedly reduces what it pays to providers (hospitals and doctors), sometimes to as little as 20 cents on the dollar.
    2. In order from going bankrupt themselves, hospitals and doctors have been forced to raise their prices to everyone else. This is called “cost-shifting”. So for decades Medicare has been “stealing” $trillions from the private health care system via cost-shifting.
    3. Even considering these startling economic factors, Medicare is still on the verge of bankruptcy!
    So if the US were to convert to “Medicare for all”, from where would it get the cost-shifted funds? There would be no private system from which to steal the $trillions.

  29. Why not just regulate medical care prices, the way grocery bag prices are regulated?

  30. Blah blah blah. If conservatives had any ideas to fix the problem it would’ve been done. They couldn’t even repeal Obamacare- the apparently much hated healthcare system.

    Face it- universal healthcare has been done the world over in many different ways and works so long as you’re not trying to actively sabotage it. Only the morons think the free market works with a product as inelastic as healthcare.

    1. Who cares what ideas conservatives have about fixing the problem?

      Libertarians know that the problem is government thinking they can fix it.

    2. You are literally the stupidest person posting here. You make that slack-jawed, 85-IQ hicklib Kirkland look like Isaac Newton.

  31. Want to know what Government run Socialized Medicine would look like? Ask a Veteran who has to use a VA hospital. What do you expect from someone who has lived their entire adult life at the largess of taxpayers. Comrade Sanders has never built anything, never produced anything… even in his given job, has never passed any profound or even noteworthy legislation… He’s a loser. Follow him at your peril.

  32. Meanwhile…This Biden snippet is NOT making the national news…his Jim Crow quotes and eliminatign Trump tax cuts, yes, but not this one…

    Joe Biden makes campaign stop in Columbia, SC. At the event, Biden promised the first thing he’ll do if elected is repeal President Donald Trump’s tax cut.

    “I don’t have to raise anybody’s taxes to improve education. I don’t have to raise anybody’s taxes to improve rural infrastructure. I don’t have to raise anybody’s taxes to make sure we have health care. All I got to do is take back from those folks who don’t deserve it,” Biden said.

  33. What scares me about all of this? How stupid the American public actually is and how afraid they are of health care costs. Talking with many different people, they are worry about the costs and how to pay if something bad happens. These are people with insurance. For example, my family deductible is $5500 a year, then it goes to 80/20.
    Bernie and others play on these fears and people eat it up. They want to believe the Gov. has a better way (they keep looking for the Gov to help in any other mess). So it is easy for them to believe.
    Their memories are also very short and since the media “forgets” and doesn’t report/discuss the bad outcomes, the public doesn’t get anywhere near facts.
    Sadly, I can see something like this passing and destroying our health care. It might not be the best now but it can get way worse.

  34. That doesn’t just mean no competition. It means no alternative and no escape.

    Of course you can. Back-alley prostate exams. Panamanian heart surgery. Statins and viagra from your local pusher at half the price and better quality than government drugs.

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