During the Democratic primary debates, Hillary Clinton disingenuously asked Senator Bernie Sanders how he would pay for this costly program, even though she had headed a commission appointed by her husband, President Bill Clinton, that failed to create a very similar program.
On Monday Senator Bernie Sanders (VT Independent) introduced a bill calling for single-payer healthcare insurance, which he has termed “Medicare for all.” It would extend the insurance that is now limited almost entirely to Americans 65 and older to people of all ages. It was quickly co-sponsored by Democratic Senators Cory Booker (NJ), Elizabeth Warren (MA), and Kamila Harris (CA) – each of whom may be opposing Senator Bernie Sanders for the Democratic Party’s presidential nomination in 2020.
Would Medicare for all be very costly. Yes – it would probably cost at least $2 trillion. But right now our nation’s healthcare bill comes to about $3.2 trillion. So, if we could cut our healthcare costs by as much as one third, we should not be asking how much this program will cost, but just be thankful for all the money we will be saving.
Most of the savings would be in administrative costs. Right now, healthcare providers employ armies of clerical workers to negotiate reimbursement payments with opposing armies of insurance company employees. One side is trying to get as much reimbursement as possible, while the other is trying to keep it as low as possible.
At the end of the day, their efforts cancel each other out, while not one of these three million workers provides one any medical care. But they do add hundreds of billions to our nation’s massive healthcare bill.
To get back to Hillary Clinton’s question: The main way we pay for extending the Medicare program to all Americans is to cut our administrative costs by no longer employing these three million folks to argue with each other over insurance reimbursement.
Back in the 1950s, it was easy to dismiss the views of anyone who wanted to increase the role of the federal government in our economy because that person must be a “communist.” Now, the person leading the charge for Medicare for all, Senator Bernie Sanders, calls himself a “socialist”. That provides some folks with a great excuse to dismiss his proposal.
Whether or not Senator Bernie Sanders is actually a socialist, we can ask if his proposal would be a step toward socialism, which can be defined as having the government own most of the means of production.
Under Medicare, a schedule of payments for thousands of medical procedures is provided to all healthcare providers. If they consider the payments too low, then they won’t accept Medicare patients.
What if they do? Does that make them government employees? Hardly.
Medicare is not a perfect system: there is likely tens of billions of dollars of waste. But it would be a vast improvement over the hodge-podge healthcare system we currently have. Americans pay almost twice as much per capita for medical care as do the citizens of most other wealthy nations. And interestingly, our health is not only no better, but by some measures it’s actually worse.
Medicare for all, just like Medicare, would continue to be a voluntary system. If you chose not to join – while you would still have to pay taxes to support that system – you would be free to pay your private medical insurance premiums, or even see doctors on a pay-as-you-go basis.
We currently have what is, by far, the most inefficient healthcare system in the world. Tens of millions of Americans are still uninsured. Medicare for all would provide first rate, lower cost, universal medical care. What’s not to like?
About the Author
Steve Slavin has a PhD in economics from NYU, and taught for over thirty years at Brooklyn College, New York Institute of Technology, and New Jersey’s Union County College. He has written sixteen math and economics books including a widely used introductory economics textbook now in its eleventh edition (McGraw-Hill) and The Great American Economy (Prometheus Books) which came out last month.