How Medicare For All Will Work
With Medicare for All, every American will have a Universal Medicare card, and this would give them access to all necessary health care including hospital visits, doctors appointments and more. With the new legislation, premiums for private insurance, deductibles and co-pays will all be eliminated. Also, no private insurance companies will be allowed to be part of Medicare .
Once people have coverage from the Medicare for All plan, they will not have to pay any out-of-pocket costs, except for if they need prescription drugs. This means there will be no charge even for things like a visit to the emergency room.
While Medicare for All faces substantial opposition from Republicans in Congress and the Senate, it would be introduced slowly if it were to pass. During the first year, the eligibility age for Medicare would drop to 55, and the program would expand to include coverage for dental, vision and hearing aids. During the second year, the eligibility age would drop to 45, and then to 35 during the third. Finally, it would be available to everyone from year four onward.
Sanders Defends High Cost Of His Medicare For All Plan
Sen. Bernie Sanders defended his Medicare for All plan, which has faced criticism from some of his 2020 rivals for its staggering price tag.
In an interview with PBS NewsHours anchor and managing editor Judy Woodruff, Sanders criticized the current U.S. health care system as dysfunctional and said his plan would be less expensive than if we do nothing.
A report released by the Urban Institute last week found that his single-payer approach would cost $34 trillion dollars over 10 years, more than the total cost of social security, medicare and medicaid combined.
Look, I am not denying that were going to spend a lot of money, Sanders said in response. But they cannot deny that were saving people substantial sums of money by eliminating all premiums. I talked to a woman in New Hampshire $1,700 per month in premiums, huge prescription drug costs. Under our bill, no one pays more than $200 a year. The average American will pay less for health care under Medicare for All.
Sanders also strongly denounced President Donald Trumps decision to pull U.S. troops from Syria, saying the U.S. now needs to work with allies to bring stability to the region.
Sanders dismissed concerns about his health, only three weeks after a heart attack.
I took some time off. Im feeling great right now. We had a wonderful rally on Saturday, were going to Iowa in a few days. Were back and running.
Bernie Sanders Embraces New Study That Lowers Medicare For All Price Tag But Skepticism Abounds
If Your Time is short
- Many of the study’s assumptions are flawed, and experts uniformly told us it overestimates the potential savings.
- It cherry-picks data in calculating mortality effects.
UPDATE: This story was updated to include more information about recent studies the Sanders’ campaign referenced regarding the costs of single-payer. This update does not change the rating.
Defending his signature health plan a single-payer system known “Medicare for All” that would move all Americans to government-funded coverage Vermont Sen. Bernie Sanders argued that the massive health care expansion would actually save the system hundreds of billions of dollars.
Sanders figures come from a study published Feb. 15 in The Lancet, a British medical journal.
“It said Medicare for All will lower health care costs in this country by $450 billion a year and save the lives of 68,000 people who would otherwise have died,” Sanders said at the Feb. 25 Democratic presidential debate.
We reached out to one of the studys authors, but never heard back.
A spokesperson for the Sanders campaign said the paper is “similar to 22 other recent studies that have also shown that moving to a single-payer healthcare system will cost less than our current dysfunctional healthcare system.”
“The notion that were going to get rid of all these avoidable visits thats not been borne out,” she said.
The cost-sharing questionOur ruling
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Student Debt And Education Plans
The latest statistics show almost 45 million Americans owe around $1.6tn in student loan debt.
Sanders says if elected president he would cancel this debt and provide at least $48bn per year to eliminate tuition fees.
He plans to spend around $2.2tn in total on his education plans over the next decade.
Sanders says he would raise around $2.4tn from a tax on Wall Street over the next decade to pay for these plans. This would raise levies on the US financial markets for buying and selling stocks, bonds and derivatives.
Others point to Sweden’s implementation of a similar system in the 1980s, which resulted in a drop-off in trading and investors until the tax was abolished.
Lets Say Medicare For All Happens How Would The Transition Occur
That depends on how disruptive of a model is adopted, said Alan Weil, JD, MPP, editor-in-chief of Health Affairs, a journal of health policy thought and research.
If we literally eliminate all private insurance and give everyone a Medicare card, it would probably be implemented by age groups, Weil said.
People would have a few years to transition, and once its your turn, youd move from private coverage and into this plan, Weil said. Because the vast majority of providers take Medicare now, conceptually, its not that complicated.
Although the current Medicare program truly is. While it covers basic costs, many people still pay extra for Medicare Advantage, which is similar to a private health insurance plan.
If legislators decide to keep that around, open enrollment will be necessary.
Youre not just being mailed a card, but you could also have a choice of five plans, said Weil. Preserve that option and that offers a layer of complexity.
Architects of a single-payer health system will also have to tweak Medicare to make it suitable for people who arent only 65 or over.
Youd have to come up with billing codes and payment rates and enroll a bunch of pediatricians and providers who arent currently involved with Medicare, Weil noted. Theres a lot that would need to happen behind the scenes.
Katie Keith, JD, MPH
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Universal Childcare And More Social Security
This plan would guarantee free childcare to every family in America.
Sanders says this would cost $1.5tn over a decade, which would be paid for by the remaining revenue generated by his wealth tax.
As we’ve explained, critics believe these revenue projections are overly optimistic.
As for social security in the US, this includes several welfare programmes including retirement benefits and disability income. Sanders wants to increase these benefits at a cost of $275bn over a decade.
He proposes a tax on Americans earning more than $250,000 annually to pay for this.
The Committee for a Responsible Federal Budget says the plan would secure these benefits if passed – but may reduce the incentive to work, save and invest.
Dental Coverage In The Medicare For All Plan
If the Medicare for All bill passed, the government would beef up Medicare to include things like vision care, lab services, maternity care and, most importantly, dental benefits. This would mean that all Americans could enjoy dental health care coverage from their insurance plan. It would also mean that Americans health care coverage would be even more comprehensive than coverage available in other countries with single-payer systems. For example, Canadians have single-payer care, but their dental care is not covered. Dental benefits are also left out of single-payer plans in the Netherlands and Australia.
Today, many Americans cant afford dental care coverage, and more than 35 percent of all adults in the country dont have any dental benefits. This means that more than one-third of American adults dont regularly go to the dentist for teeth cleanings, checkups and more and they greatly increase their risk of developing oral diseases and conditions that can have a larger negative impact on health overall. In fact, poor oral health can lead to things like cardiovascular disease, dementia and diabetic complications.
If Sanders Medicare for All plan became law, many of the adults who currently dont have dental coverage would finally have access to dental insurance. This may increase the amount of times that they choose to visit the dentist boosting their oral health, and, in turn, their overall well-being.
The Original Discount Dental Plan
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How Will Medicare For All Be Financed
The specifics vary a bit plan to plan. In Jayapals bill, for instance, Medicare for All would be funded by the federal government, using money that otherwise would go to Medicare, Medicaid, and other federal programs that pay for health services.
But when you get right down to it, the funding for all the plans comes down to taxes.
That still might not be as awful as it sounds.
After all, you wont be paying premiums, Weil pointed out.
Although you may be able to say right now that your employer pays part of your health benefits, economists would say it comes out of your pocket, Weil said. Youre also paying office co-pays and deductibles.
With Medicare for All proposals, some portion of the money youre now paying toward health insurance would be shifted to taxes.
Would Sanderss Health Plan Lower American Health Spending Its Hard To Tell
One of Sanderss main arguments in favor of his health care bill is that American health spending is out of control and single-payer would rein it in.
There is broad consensus from conservative to progressive economists that the Senate Medicare for All bill, as written, would result in substantial savings to the American people, a paper released by his office argues.
There are certainly policies in the Sanders plan that would reduce American health care spending. For one, moving all Americans on to one health plan would reduce the administrative waste in our health care system in the long run.
American doctors spend lots of money dealing with insurers because there are thousands of them, each negotiating their own rate with every hospital and doctor. An appendectomy, for example, can cost anywhere from $1,529 to $186,955, depending on how good of a deal an insurer can get from a hospital.
That doesnt happen in a single-payer system like the one Sanders proposes. Instead of dealing with dozens of insurers that set hundreds of prices, doctors only need to send bills to the federal government.
One 2003 article in the New England Journal of Medicineestimates that the United States spends twice as much on administrative costs as Canada. A 2011 study in the journal Health Affairs estimates American doctors spend four times as much dealing with insurance companies compared with Canada.
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Will Quality Of Care Go Down
The rhetorical response to single-payer health insurance is that its government-controlled healthcare. Its then used to argue that the government would be making important decisions about the care you get and dont get, and who you see, Weil said.
But Medicare for All could actually give you more choice than private insurance.
With Medicare, you can go to any doctor, Weil said. I have private insurance and have a lot more restrictions as to who I see.
Bernie Sanders’ Plans May Be Expensive But Inaction Would Cost Much More
Facing existential challenges, we must spend heavily on a Green New Deal, Medicare for All and similar plans
In Wednesday nights Democratic debate, the former South Bend mayor Pete Buttigieg charged that the Vermont senator Bernie Sanders policy proposals would cost $50tn. Holy Indiana.
Larry Summers, formerly chief White House economic adviser for Barack Obama, puts the price tag at $60tn. We are in a kind of new era of radical proposal, he told CNN.
Maya MacGuineas, president of the bipartisan Committee for a Responsible Federal Budget, claims Sanders agenda would at least double federal spending.
Putting aside the accuracy of these cost estimates, they omit the other side of the equation: what, by comparison, is the cost of doing nothing?
A Green New Deal might be expensive but doing nothing about climate change will almost certainly cost far more. California is already burning, the midwest and south are flooding, New England is eroding, Florida is sinking. If we dont launch something as bold as a Green New Deal, well spend trillions coping with the consequences of our failure to be bold.
A related criticism of Sanders and Warren is that they havent come up with ways to pay for their proposals. Sanders only explained $25tn worth of revenue, which means the hole in there is bigger than the size of the entire economy of the United States, charged Buttigieg.
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Medicare For All Pros And Cons
Medicare for All can be a divisive subject.
Supporters claim its the best way to cover every American and hold down escalating health care costs.
Critics argue that the program would be expensive and question how the government can effectively manage such a massive system.
Arguments in Favor of Medicare for All
- Enrolling everyone under a single plan is a way to guarantee universal coverage, especially for economically vulnerable people.
- It would reduce out-of-pocket spending for individuals.
- Through regulation and negotiation, the government could control the price of drugs and medical services.
- Americans could switch jobs without losing their existing plan or health care coverage.
- Providers would spend less money and time on administrative activities because they would only deal with one government agency, instead of multiple private insurance companies.
- Hospitals and doctors would be required to provide the same level of service at a low cost, instead of targeting wealthy clients or pushing expensive services.
Increased cost is one of the most common arguments against Medicare for All.
A 2018 study by the RAND Corporation estimated that federal spending on health care could increase from $1.09 trillion per year to $3.5 trillion per year if a single-payer plan passed.
Arguments Against Medicare for AllDon’t Leave Your Health to Chance
How Likely Is It That Medicare For All Will Happen
Likely, but not any time soon, guesses Weil.
I think were divided politically in lots of ways as a country, he explained. I dont see our political process able to metabolize change on this scale.
Plus, healthcare providers, legislators, policy makers, and insurance providers are still trying to wrap their heads around what this change would mean.
On the other side of optimism, McDonough stresses that Medicare for All would have to accomplish what looks like a Herculean task in todays world pass a divided U.S. Congress.
From his perspective, McDonough said financially and administratively, Medicare for All could be achieved, recognizing some significant disruption and confusion as a certainty.
Looking at the current roadmap to healthcare reform of any kind, McDonough said unless the Democrats control the Senate with at least 60 votes, Medicare for All would not be achievable in 2021, even with a President Sanders.
Right now, according to nonpartisan polling, the odds of Democrats retaining a majority in the U.S. Senate is less than 50 percent, he added.
When citizens are polled on the subject, they agree that the concept of Medicare for All sounds good, said Weil. But when you start to talk about disruption in coverage and the potential of taxes to go up, peoples support starts to weaken, he said.
In other words, you may despise your health insurance, but at least you understand just how awful it is.
Additional reporting by Brian Mastroianni
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What Would This Mean For Doctors Hospitals And Drug Companies
Under Medicare for all, doctors and hospitals would remain in private hands. But because the government insurance would effectively be their only source of income, the government would have much more control over the medical system. Nearly every estimate of the cost of Medicare for all assumes that the public system would pay doctors and hospitals less than they currently earn from private insurers. That could mean substantial pay cuts for certain health care providers who see a lot of privately insured patients.
Drug companies would probably take the biggest cut. Estimates tend to assume that the government would pay them substantially lower prices for their products than they currently receive.
Medicare For All: What Is It And How Will It Work
Experts answer your most pressing questions and explain how Medicare for All could change healthcare in America.
Ask someone what they think about the idea of Medicare for All that is, one national health insurance plan for all Americans and youll likely hear one of two opinions: One, that it sounds great and could potentially fix the countrys broken healthcare system. Or two, that it would be the downfall of our countrys healthcare system.
What you likely wont hear? A succinct, fact-based explanation of what Medicare for All would actually entail and how it could affect you.
Its a topic that is especially relevant right now. In the midst of the 2020 U.S. presidential election, Medicare for All has become a key point of contention in the Democratic Party primary. From Senators Bernie Sanders and Elizabeth Warrens embrace of single-payer healthcare to former Vice President Joe Biden and Sen. Amy Klobuchars embrace of reforms to the Affordable Care Act , how to best improve healthcare in America is a divisive issue for voters.
It also can become confusing and difficult to parse out differences between different policies in order to assess how they might impact your day-to-day life if enacted. The other question in this divisive political climate: Will any of these plans be enacted in a Washington D.C. that has been defined more by its partisan divides and policy inaction?
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