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Medicaid for All Would 'Bankrupt the Nation,' Warns Bernie Sanders—In 1987

Thirty years ago, the young Sanders thought the cost of universal coverage would be "astronomical."

credit: Phil Roeder via Foter.com / CC BYcredit: Phil Roeder via Foter.com / CC BYSen. Bernie Sanders (I-Vt.) introduced new legislation yesterday to expand Medicare to everyone in the United States. The bill, which came with 15 Democratic co-sponsors, envisions universal coverage, paid for by tax increases, that would be far more generous than what is offered by any other first-world government-run health care system offers.

Notably absent from Sanders' proposed single-payer system was a detailed plan to pay for it. The senator said he would lay out the tax hikes necessary to fund his new system in separate legislation.

That may be because enthusiasm for single payer tends to die down pretty quickly once people get a sense of what sort of tax increases would be necessary to fund it. An Urban Institute analysis of a previous version of Sanders' plan estimated that it would cost $32 trillion over a decade.

Back in 1987, a much younger Bernie Sanders apparently had that sense too. He warned that expanding Medicaid, the jointly run federal-state health care program for the poor and disabled, to everyone in the country would "bankrupt the nation."

"If we expanded Medicaid [to] everybody. Give everybody a Medicaid card—we would be spending such an astronomical sum of money that, you know, we would bankrupt the nation."

Watch the video, unearthed by NTK Network:

Medicaid, notably, is far less generous than Medicare, the health program for seniors that Sanders wants to expand.

Medicaid's provider networks are narrower, and its benefits are generally more limited. It pays doctors quite a bit less than Medicare, on average, and it costs substantially less per capita. Relative to Medicare, it's the bargain option.

This is a short clip, and the full version may reveal additional relevant context. But what Sanders is describing in the segment above is the comparatively high cost of health care services in the United States relative to countries like Canada. As the clip ends, Dr. Milton Terris begins to discuss the ways in which other countries limit extra charges and use the power of government monopoly to force down prices.

Forcing health care spending down to the levels seen in other countries would radically upset the system, pushing doctors out of business and likely leaving many hospitals with little choice but to close down or eliminate services. It would, at minimum, be incredibly difficult politically, since it would require decreasing funding to hospitals and other large medical facilities, which would in turn require eliminating jobs or drastically reducing compensation. At the end of every health care spending cut is an individual with a job and a paycheck.

In the clip, the young Sanders is at least making an attempt, however limited, to understand the economic and policy distinctions between the United States and other countries and why transitioning to single payer via America's existing government-run systems would be difficult.

The most striking thing about the legislation Sanders introduced yesterday, in contrast, is that it effectively wishes those questions away. It promises huge overall savings along with coverage that would be far more expansive, and far more expensive, than Medicaid for all, with no clear way to pay for it, and no specific strategy for driving costs or spending down.

In 30 years of political advocacy, Sanders has not solved any of the fundamental problems with single payer. He has merely opted to pretend they do not exist.

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  • BestUsedCarSales||

    We really need to stop bullying this old guy. What's he ever done?

  • Chipper Morning, Mean Girl||

    Someone should take that slide projector scene from the new IT movie and replace it with a progression of Bernie shots over the years.

  • MSimon||

    2001 - A Space Odyssey?

  • Mickey Rat||

    Been the country's crazy, old, good for nothing, freeloading uncle for three decades?

  • DEATFBIRSECIA||

    But that's BEFORE Doc went back in the Delorean and informed Young Doc that by going back in time he would inevitably... um... where was I going with this?

  • BestUsedCarSales||

    You were making sick references.

  • Chipper Morning, Mean Girl||

    You are in the wrong thread.

  • BestUsedCarSales||

    I'm constantly unaware and confused, mang.

  • Citizen X - #6||

    Yeah, you leave Bobby Clown out of your Sikh mind-games.

  • ||

    That's a pretty low pun-jab.

  • BYODB||

    Ultimately Sanders doesn't care about the costs or the effects of such a program, he merely wants to be President and promising Unicorns to everyone is the go-to plan for that.

  • MSimon||

    Sorry Bernie. I want a pixie. About 5' 8".

  • BYODB||

    *butch lesbian with a pixie-cut appears out of the nothingness*

  • ||

    Martina Navratilova-style 5'8", butch with a pixie cut or Rosie O' Donnell-style 5'8", butch with a pixie cut?

    I must know lest I be unable to accurately cast judgement on wish-Bernie.

  • Mark22||

    This is the problem with you genies: you act like typical government bureaucrats, with too much power, with cynicism and anger, and no interest in actually serving your customers.

  • Citizen X - #6||

    Senile dementia is a hell of an affliction.

  • Fist of Etiquette||

    So is socialism.

  • BYODB||

    You're saying there's a difference?

  • Zeb||

    Yeah, senile dementia only happens to old people and socialism is more common among the young.

  • Get To Da Chippah||

    Well duh, Peter! That was thirty years ago. Money is so much more valuable today that we could easily afford it by taxing the richest people just a little more! The rich haven't been paying their fair share anyhow, as far as I'm concerned.

    LRN 2 PROG!

  • Mickey Rat||

    Sanders has no time for bean counter concerns. He us a visionary!

  • sarcasmic||

    Citizens! In all times, two political systems have been in existence, and each may be maintained by good reasons. According to one of them, Government ought to do much, but then it ought to take much. According to the other, this two-fold activity ought to be little felt. We have to choose between these two systems. But as regards the third system, which partakes of both the others, and which consists in exacting everything from Government, without giving it anything, it is chimerical, absurd, childish, contradictory, and dangerous. Those who parade it, for the sake of the pleasure of accusing all governments of weakness, and thus exposing them to your attacks, are only flattering and deceiving you, while they are deceiving themselves.

    For ourselves, we consider that Government is and ought to be nothing whatever but the united power of the people, organized, not to be an instrument of oppression and mutual plunder among citizens; but, on the the contrary, to secure to every one his own, and to cause justice and security to reign.


    -Bastiat 1848ish

  • sarcasmic||

  • Chipper Morning, Mean Girl||

    And then read some Molinari.

  • DEATFBIRSECIA||

    "the truth, the truth...ack!"

  • Fuck You - Cut Spending||

    to secure to every one his own

    What about the poor??? Won't someone think of the layabouts?!

  • timbo||

    Do you mean to tell me that people have been pointing out the inevitable failure of massive nanny governments and keynesianism for hundreds of years?

    Next you'll tell me that someone pointed out the value of division of labor, the penal nature of licensing/regulation, and the value of free markets back then too.

    "That Which is Seen and Unseen" should be read by all americans by 12th grade. Very short and simple book to understand.

    Will never happen. The process of stupidity has been completed. This whole spectacle is but the process of inevitable failure which will take decades to finally stamp out the US economy as but a Roman relic.

  • ||

    Next you'll tell me that someone pointed out the value of division of labor, the penal nature of licensing/regulation, and the value of free markets back then too

    In fact, this fellow named Karl Marx pointed these things out repeatedly and passionately. Those parts don't tend to get excerpted in the "Marxism for Antifa College Students" editions, though.

  • timbo||

    Marx espoused the value of free markets and championed less government?

  • sarcasmic||

    Groucho

  • timbo||

    Richard?

  • sarcasmic||

    I looked that up knowing the name, and almost puked up by eighth grade lunch with like a rubber spoon and stuff.

  • ||

    If there's one Marx that should be hunted down and tortured before execution, it's Richard.

  • TrickyVic (old school)||

    We'll be right here waiting for that to happen.

  • ||

    Marx espoused the value of free markets and championed less government?

    Yes he did, oddly enough.

    I've posted this here before, but this is perhaps my favorite Marx quote:

    The sphere of circulation or commodity exchange, within whose boundaries the sale and purchase of labour-power goes on, is in face a very Eden of the innate rights of man. It is the exclusive realm of Freedom, Equality, Property and Bentham. Freedom, because both buyer and seller of a commodity, let us say of labour-power, are determined only by their own free will. They contract as free persons, who are equal before the law. Their contract is the final result in which their joint will finds a common legal expression. Equality, because each enters into relation with the other, as with a simple owner of commodities, and they exchange equivalent for equivalent. Property, because each disposes only of what is his own. And Bentham, because each looks only to his own advantage. The only forces bringing them together, and putting them into relation with each other, is the selfishness, and the gain and the private interest of each. Each pays heed to himself only , and no one worries about the others. And precisely for that reason, either in accordance with the preestablished
    harmony of things, or under the auspices of an omniscient providence, they all work together to their mutual advantage, for the common weal, and in the common interest.
  • ||

    Marx thought the most evil thing in the world was the socialist proposition that government control of the economy would free the proletariat, rather than perpetuate their slavery - he goes off on this in the Manifesto even.

    One of his main errors was thinking that the "Dictatorship of the Proletariat" would be a fundamentally different kind of government, that would willingly get out of the way and let the free market operate.

  • timbo||

    Interesting that Marx uses that verbiage. I did not take that as advocating free markets however. Free trade of a commodity in this sense reads as though a commodity is an almost found resource or something that is achieved via one's individual labor. Is that correct? I always read excerpts of his stuff as being vehemently opposed to using another one's labor for any sort of profit. Which of course is a mutual exchange of value for benefit between those two parties. It always reduced everything he ever said to the most base class warfare insanity in my eyes.

  • ||

    Free trade of a commodity in this sense reads as though a commodity is an almost found resource or something that is achieved via one's individual labor. Is that correct?

    Yes - it's a pretty romanticized view of free trade, but the essence is that in Marx's ideal world, each worker owns his own means of production (which includes natural resources, which in Marx-world are free).

    I always read excerpts of his stuff as being vehemently opposed to using another one's labor for any sort of profit.

    He argues extensively that surplus value is not a thing, so that all profit is theft any time an owner of a means of production employs someone else to do the work and takes a share of the money. At the same time, he's perfectly well aware that resources cost money, tools wear out, organization is an important function, etc., etc., so that his extensive arguments along these lines unwind themselves over the course of several hundred pages.

  • ||

    The practical upshot, though, is that in contrast to what we get from excerpts of Marx presented by "Marxist" statists, Marx saw the government as mainly an enemy that served the interests of the aristocracy and the bourgeois, labor exploitation as something primarily enabled and propped up by the government, and free markets where means-of-production-owning workers can sell their wares at their own prices on their own terms as the ultimate ideal to be striven-for.

    Marx is a particularly rich source of excerpts for anti-free-market people, however, because he often uses the term "free market" to satirically describe the views of factory-owners who were actually advocating government regulation and suppression of labor while calling that "free markets."

  • timbo||

    Good on you for actually reading that. As I grew up in the 80's and watched the iron curtain and ussr fail, I knew it was all bullshit at that time and never felt reading it mattered

    Thank you for the info.

  • Fuck you, Shikha (Nunya)||

    God I tried to read it. I couldn't. I found it so stupid it wasn't even fun to make fun of.

  • Mark22||

    inevitable failure of massive nanny governments and keynesianism for hundreds of years

    In Keynes' defense, he didn't advocate continuous massive government spending. His point was that sometimes economies get "stuck" in some state and need a brief government stimulus to get unstuck. That point is probably also wrong, but it is nowhere near as ridiculous as what people use his name for these days.

  • MisterZizzy||

    "unless we change the funding system and the control" is omitted from the beginning of Sanders' quote (along with the finish where he talks about Canada spending less than the U.S.).

    I expect Reason to exercise a little more integrity than butchering a quote to get a clickbait-y headline. Sad.

  • timbo||

    Sanders' does believe in fully socialized medicine correct?

    He does advocate for government control over everything to include controls over markets and production correct?

    Not sure where to insert these items.

  • timbo||

    There are two types of socialists:

    One is just a power hungry, would-be authoritarian who uses the "free everything" sales pitch and class warfare to achieve power

    and

    the other is actually stupid enough to think socialism can be successful in the face of myriad counter evidence and 100s of failed countries that prove otherwise. People who believe in marxist socialism are first and foremost very dumb.

    Which one is Sanders? And of course, the later simply becomes the former once in power.

  • sarcasmic||

    I disagree. I know several intelligent people who support socialism. My father for one. And he's no slouch.

    It's an emotional thing. It's all about fairness. And when emotion rules, reason sits on the sidelines.

    Intentions are a magical thing to some people. They feel that good intentions can create good results by virtue of being good. They've never heard that the road to hell is paved with good intentions. It's not stupidity. It's more an inability to be unemotional about certain things.

  • ||

    There's truth to what you say - I know a number of socialists whom I don't consider stupid. They are, however, to a person, profoundly ignorant of economics, and proud of it.

  • Fairbanks||

    It's not so much ignorance of economics as ignorance of human nature. Socialism doesn't work because it's human nature to want to put in as little effort as possible to achieve a given objective. Why is it so difficult for people to understand that baffles me.

  • Fuck you, Shikha (Nunya)||

    And smart people just make better arguments to back their emotional contrivances.

  • Mark22||

    Friedman:

    [You assume] somehow that government is a way in which you put unselfish and ungreedy men in charge of selfish and greedy men. But government is an institution whereby the people who have the greatest drive to get power over their fellow men, get in a position of controlling them. Look at the record of government. Where are these philosopher kings that Plato supposedly was trying to develop?
  • Griffin3||

    Drink!

  • Ham_Bone||

    "Human beings are born with different capacities. If they are free, they are not equal. And if they are equal, they are not free." Aleksandr Solzhenitsyn

  • ||

    People who believe in marxist socialism are first and foremost very dumb.

    Not least because, as I point out above, "Marxist Socialist" is actually an oxymoron. Marx would be the first to crawl up out of his grave and pop those people.

  • ||

    In 1987 Elizabeth Warren was a Republican who did consulting work for Wall Street.

    Warren voted as a Republican for many years, saying, "I was a Republican because I thought that those were the people who best supported markets".[21] According to Warren, she began to vote Democratic in 1995 because she no longer believed that to be true, but she states that she has voted for both parties because she believed that neither party should dominate.

    People change. Especially politicians.

    In the 1980s, when a policy proposal was discussed, "how are you going to pay for it" was a question that got asked. The standard Team Blue answer was "we'll just raise taxes on the very wealthiest Americans, just a little bit."

    What was striking about 2016 that a lot of us noticed is that this isn't even a question anymore. This is back to that topic that's come up here on and off for the last year, which is that the political establishment has collectively decided that debt and spending don't matter, that we can simply kick the can down the road forever and never worry about "how we're going to pay."

    In the 80s even Sanders knew we had to pay. Now, nobody does.

  • Fuck you, Shikha (Nunya)||

    And if someone makes an honest query into payment they are mocked and told inflation fixes all of that.

  • Joe_C||

    No, they're called heartless Nazis because they don't want to support something that would "help people" (by actually hurting them and everyone else too). We've gone from asking intelligent queries to calling people Hitler.

  • Mark22||

    People change. Especially politicians.

    Warren changed when she discovered that she was 1 millionth Native American, and realized the horrible level of discrimination that she received throughout her life because everybody was racist towards her.

    /s

  • mjerryfuerst||

    The small excerpt is presented out of context from a much longer video. Please provide a link to the whole discussion for an accurate perspective.

  • ||

    Is the "accurate perspective" that the cost doesn't matter, after all, and that Bernie knew that then as well as he does now, or that the cost does matter, and that Bernie understood that then as well as he does now?

  • jjjjj||

    Reason is being patently dishonest and not including the rest of the video, where Sanders explains how we can use rainbows and unicorn farts to solve the problem.

  • JeremyR||

    Oh sure. But on the flip side, every other 1st world country in the world has some sort of socialized medicine and pays half of what we do.

  • ||

    But changing the method of payment doesn't change the cost. We need to address the reasons why we spend so much, rather than just playing shell games with the money.

  • Michael S. Langston||

    Sorry, but any single data point without context is meaningless.

    IE - saying we pay much more begs the question - are we paying to much or others paying too little?

    Or more directly, if by paying 1/2 what we pay now, got us 75% less coverage for 50% fewer people, that isn't a net positive. It would be a failure as compared to the US.

  • Joe_C||

    Minor note of contention, that's not what "begging the question" means. You mean raises the question. :)

  • Michael Ejercito||

    So why has not California or Hawaii or Iowa enacted it?

  • Sevo||

    JeremyR|9.14.17 @ 5:25PM|#
    "Oh sure. But on the flip side, every other 1st world country in the world has some sort of socialized medicine and pays half of what we do."

    And Venezuela has socialized medicine and pays 1/4 of what we do!

  • TrickyVic (old school)||

    And now It's down to 1/8

  • Ron||

    The beauty of single payer is that when the smaller, rural, hospitals close the government will force people to move to the big cities if they want treatment. this will solve the environmental problem of people living outside of the mega cities. and cut down on transportation cost, carbon fuels. Win Win

  • Hunthjof||

    That is the progs goal. Why cause a population in heavy urban centers are far easier to control. The worst thing to happen to the progressive movement was the invention of the suburb. They were humming along until the people got tired of the political machines ruling the major cities and bolted. They have been trying to get us back into the cities for decades. Then the political machines will rule our lives again.

  • josh||

    Well, it was 1987, so I'm sure he'd say he has more information and experience. Problem is, this is sort of like politician changing their mind about term limits after they get elected. The basic facts of the issue don't change over time. It either works or it doesn't, although admittedly, the peripheral issues can change with time. Or, he was just a young politician trying to get elected and he didn't want to alienate moderates, so he pandered, which he's certainly not going to admit to, because Bernie is the good one, don't ya know.

  • Bob Meyer||

    I wish that Suderman and other writers at Reason would stop calling it "Single Payer". It's not single payer. If I pay for my health care that's single payer. If the government pays for health care it's Federal Health Care, or Tax Payer Health Care or even Eternal Waiting Line Health Care but it's not Single Payer Health Care.

  • ||

    "Three-hundred-and-fifty-million-payer" doesn't roll off the tongue quite as gracefully.

  • Episteme||

    I prefer the term "Voltron-payer."

  • Fuck you, Shikha (Nunya)||

    Do I at least get to pick which Voltron?

  • TrickyVic (old school)||

    Free market - yes.

    Socialism - you get whichever Voltron is on duty.

  • Joe_C||

    This has been used everywhere, and I fucking hate it.

  • Everything is awful||

    According to The Hill, the plan will be paid with 7.5% employer tax, 4% household income tax, and an undisclosed amount on "the top 0.1%". Obviously that pays for a extension of Medicare to those 55 and up. Not sure how they pay for the rest of you!!

  • Mark22||

    I suspect the majority of those 55-65 are happy with their employer-provided health care plans and don't want to have to deal with the crap that goes along with a government program. So this may be a political non-starter.

  • Presskh||

    Just one more means of gaining control of the economy by the left, as well as creating a huge permanent class of government-dependent Democrat voters.

  • Presskh||

    I think Bernie's got a wonderful idea! Why, just look at how Medicare and Medicaid have both succeeded in containing medical costs in this country!

  • IceTrey||

    Nothing about this question matters except the fact that single payer requires the initiatory use of force by the government. That's why it's bad and why it will always be bad.

  • Len Bias||

    "The bill, which came with 15 Democratic co-sponsors, envisions universal coverage, paid for by tax increases, that would be far more generous than what is offered by any other first-world government-run health care system offers."

    No, it doesn't, the quality and/or availability would plummet as soon as it's implemented.

  • TrickyVic (old school)||

    More people to see doctors, less doctors to see, equals longer waits and rationing. And death panels.

  • RabbitHead||

    It could just be that Bernie used to think that bankrupting the nation was an undesirable outcome and now no longer feels that way.

  • Len Bias||

    Unlike 30 years ago, he would likely not live to see the country bankrupted should single payer be implemented.

  • Presskh||

    Bingo, Rabbithead.

  • Memory Hole||

    Isn't there already a de facto universal medical care guarantee in place now? If so would it not make sense to cut out the costs that insurers place on the system? Could we mitigate the overall cost of this medical care guarantee by providing preventive care?

  • TrickyVic (old school)||

    Is being against it, before you were for it, still a thing?

  • Joe_C||

    So if every child, homeless person, and person living below the poverty line paid up their share of about $9K per year over the next decade, I'd only have to double my tax rate. Sounds like a great idea.

    I love this country, but it seems like it's getting time to move. Hong Kong seems pretty awesome.

  • Longtobefree||

    No worries, mate.
    Everybody gets free Medical care.
    OK, so maybe we will need a few more doctors and nurses. Reinstate the draft, and assign enough people to the medical fields to serve everybody. In addition, the cost is now part of the military budget and "health care" costs go down. So the system has paid for itself.
    TA-DA!

    Next step, that pesky wall needs paying for - - - -

  • Eman||

    Bernie is just staying true to the proud american stereotype of valuing quantity more than quality. It won't matter how shitty the healthcare is cuz there will be so much of it.

  • rageon||

    Because gods forbid any intelligent, thinking person CHANGES HIS MIND in 30 years, right?

  • rageon||

    End the drug war, and with it, federal grants to local PD's. Bam. I just saved us $100 billion a year, AND increased tax revenues. Stop supporting Israel's terrorism. There's $38 billion over the next 10 years. In fact cut the US military, across the board, by a third. There's a few more hundreds of billions a year, and we'd still have the biggest, most dangerous military on the planet. The money is there. Americans just have to decide whether to protect human life and liberty or continue to destroy it. Universal health care is not a matter of "can't." It's a matter of "won't."

  • XM||

    What would be your reaction if a politician said "I want the tech industry to be gone, and this bill will flush it out of the market". In a sane society most people would say "you're insane" and that man would never hold public office again.

    And yet, that's what Bernie and his fringe left wants to do. Bernie's plan not only repeals Obamacare, but it would essentially take out most insurance companies. Out goes all the jobs and revenues and a billion dollar business is taken out of the economy. Meanwhile the other titans of the industry have to fill the void left in the market AND pay for the nation's healthcare.

    To their credit, the MSM has raised some concerns about the cost. But notice the lack of derision and incredulous disbelief on a senile old man's reckless plan that would seriously jeopardize the nation's long term financial health. This is the kind of stuff that transforms an empire to modern day Greece. It's a sequel to the prohibition. Trump would have to outlaw trade of any kind to have a similarly disastrous effect on the economy.

    I've read estimates that project the cost of Bernie's plan will exceed the NATIONAL DEBT. Again, if his insane plane comes to fruition, it will be taken down just like prohibition.

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