Bernie Sanders Outlines Funding For His Plans But It May Not All Add Up
After months of resistance to discussing how he would pay for his plans like Medicare for all and canceling student debt, Mr. Sanders announced the explanation at a CNN event on Monday.
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By Maggie Astor
Senator Bernie Sanders of Vermont, under growing pressure to explain how he would pay for his very expensive policy agenda, released a checklist on Monday evening that he described as a full explanation of how he would finance all of his proposals.
The actual document is somewhat limited, and in some cases the revenue Mr. Sanders identifies doesnt match the costs of his plans.
For example, he estimated Sunday night on 60 Minutes that the price tag for his Medicare for all plan would be about $30 trillion over 10 years, but the revenue he identified for it in the outline totaled about $17.5 trillion. He later updated the outline to say that current federal, state and local government spending over the next 10 years would cover the rest.
The Urban Institute has estimated that Medicare for all would cost the federal government $34 trillion over 10 years after accounting for existing spending.
He made the announcement Monday evening during a town hall-style event on CNN, where he was also pressed over his recent comments on Fidel Castro and the behavior of some of his supporters online.
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.
The Basics Of Medicare For All
What to know about Bernie Sanderss health care plan.
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Its possible youve tuned out when the Democrats running for president have tussled over Medicare for all. But now that Bernie Sanders, who introduced the Medicare for All Act in the Senate, is ascending in the nominating contest, its a good time to take a closer look at what it would mean for the health system, your health insurance and finances, and the federal budget.
Heres our quick primer, with some suggestions for further reading.
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‘how Will You Pay For It’ Bernie Sanders Tackles Key Question On Medicare For All
Sen. Bernie Sanders is not ducking the key question constantly posed to Medicare for All supporters by journalists, fellow members of Congress, and critics: “How will you pay for it?”
“‘How are you going to pay for it?’ That is the question that bookends nearly every media conversation that takes place on Medicare for All. The straightforward answer is, we already are.” Sen. Bernie Sanders’ office
In a white paper released Wednesday alongside the 2020 contender’s , Sanders’ office outlined a number of possible funding mechanisms for the comprehensive bill and detailed the enormous savings the U.S. would reap by transitioning to single-payer.
“Every major industrialized nation on Earth has made healthcare a right, provided universal coverage to all, and achieved far better health outcomes in terms of life expectancy and infant mortality ratesall while spending far less per capita than we do,” the paper states. “Please do not tell us that the United States of America, the wealthiest nation in the history of the world, cannot do the same.”
The paper lists a number of policy changes that could help raise revenue for Medicare for All, including:
While acknowledging its list is not exhaustive, Sanders’ office said the U.S. has a large “variety of options available to support a Medicare for All, single-payer healthcare system.”
Medicare for All would also save the U.S. money by slashing prescription drug costs, Sanders’ office argued.
Medicare For All Basics: How It Works
The term Medicare for All is used by mostly progressive politicians to describe a single-payer, government-run health care program that covers all Americans.
It calls for a more robust version of Medicare the government health insurance program for the elderly and disabled to replace nearly all other public and private plans.
Medicare for All is essentially a single-payer system, in which the government pays for everyones health ca re instead of multiple groups such as employers and private insurers.
Many Americans would be required to contribute taxes to finance the system.
A Few Highlights of Medicare for All
- Private insurance, employer-provided insurance, Medicaid and the current Medicare program would be replaced by Medicare for All.
- All medically essential treatments would be covered with no premiums or deductibles.
- Private insurers would be barred from selling plans with similar coverage.
- Some out-of-pocket costs may still exist for prescription drugs and long-term care.
- Private insurers could still offer supplemental plans to cover items excluded from Medicare, such as cosmetic surgery.
- The government would set payment rates for drugs, services and medical equipment.
- The Veterans Health Administration and Indian Health Service would stay in place.
- Taxes would finance the new system.
Meanwhile, other Democrats have proposed more incremental approaches that offer a public plan option that would keep current sources of coverage in place.
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The Sanders Bill Includes An Exceptionally Generous Benefit Package
Sanderss single-payer proposal would create a universal Medicare program that covers all American residents in one government-run health plan.
It would bar employers from offering separate plans that compete with this new, government-run option. It would largely sunset Medicare and Medicaid, transitioning their enrollees into the new universal plan. It would, however, allow two existing health systems to continue to operate as they do now: the Veterans Affairs health system and the Indian Health Services.
Those who qualify for the new universal Medicare plan would get four years to transition into the new coverage. In the interim, they would have the option to buy into Medicare or another publicly run option that does not currently exist.
Eventually, though, they would all end up in the same plan, which includes an especially robust set of benefits. It would cover hospital visits, primary care, medical devices, lab services, maternity care, and prescription drugs as well as vision and dental benefits.
The biggest difference between this plan and the version Sanders introduced in 2017 is the addition of a long-term care benefit that would cover care for Americans with disability at home or in community settings. This benefit was also added into the House version of the Medicare-for-all bill earlier this year.
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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.
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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Would Bernie Sanderss Medicare
Lets just say, hypothetically, you are self-employed, and you have youve got a husband and two kids, okay? Family of four. You know how much that family is paying today for health care? $28,000 a year.
Sen. Bernie Sanders , remarks during a Fox News town hall, April 15, 2019
During a town hall on Fox News, 2020 presidential hopeful Bernie Sanders said his Medicare-for-all plan would save most Americans money by reducing the cost of health care. According to Sanders, any tax increase as a result of his plan would be less than what an average family currently pays in premiums, co-payments and deductibles for health insurance.
As an example, Sanders told the audience that the average self-employed family of four would pay less for health care under his plan than the $28,000 a year they currently pay. That estimate comes from the 2018 Milliman Medical Index. The index estimates the total cost of health care for an average family of four and includes fees usually covered by an employer. Leaving out this aspect, as well as referring to the family as self-employed, makes Sanderss claim misleading.
Sanderss campaign told the Fact Checker that he misspoke when he said self-employed, rather than making clear that the family gets insurance via an employer. Sanders has tweeted this $28,000 figure without the self-employed qualifier, but even so, hes leaving out important information.
The benefits package
Administrative cost savings
Would You Have To Change Your Current Health Insurance
Yes. People who get their coverage from Medicare would see the smallest change. They would keep getting insurance called Medicare from the government, only with new benefits and fewer fees. People with nearly any other type of insurance would have to switch to the government plan.
But, as Mr. Sanders often points out, people who lose their private insurance would, in almost all cases, get more generous government insurance instead. Nearly every doctor and hospital in the country would probably accept the new Medicare insurance, so changing your insurance would probably not mean changing doctors, as it often means now when you change your private insurer.
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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.
Bernie Sanders New Medicare For All Plan Includes Dental
Bernie Sanders has spent years trying to reform the American healthcare system. Last week, he introduced a new plan that would drastically shift the landscape of health insurance for all Americans, and he did it alongside several other Democratic senators, including Elizabeth Warren, Kirsten Gillibrand and Richard Blumenthal. Sanders new plan is entitled Medicare for All, and it is essentially a single-payer, government-run program.
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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 Sanderss Payroll Tax Proposal Explained
A payroll tax is just a tax on salaries, assessed either on the employer or the employee. Payroll taxes finance Social Security and the bulk of Medicare under the current American system, and are widely used as part of the revenue base for European welfare states.
Payroll taxes can assessed on employers or employees. In the case of Social Security, half the burden falls on employers and half on employees. Economists widely believe that it doesnt actually matter who formally pays the tax, the result in either case is to reduce workers take-home pay. Sanderss vision for financing Medicare-for-all includes raising employer-side payroll taxes by 7.5 percentage points in order to raise roughly $3.9 trillion over 10 years.
On average,this is less than what employers are currently spending on premium contributions for their employees, so workers and employers should generally come out ahead under this system. But those broad averages mask a wide range of impacts.
According to the Kaiser Family Foundation, the average employer contribution for a single persons health insurance in 2016 was $5,946. Sanderss employer-side payroll tax would be less than that for workers earning below $80,000 a year but higher for more affluent workers. For family coverage, the average employer contribution was $14,561 which would make the cutoff point about $194,000 in household income.
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