What you should know about the Sanders, Jayapal, Warren versions of Medicare for all

Surveys indicate about 70% of Americans favor Medicare for All. I’m guessing about 99% of those folks don’t understand what they support.

  1. No deductibles, or co-pays will increase demand for services – that’s one of the reasons insurance uses them, including today’s Medicare – not to mention higher spending
  2. Expansion of Medicare to include dental, vision and hearing care plus long-term care will increase demand and strain resources and cost more money
  3. Their version of Medicare – for – is estimated to cost up to $35 trillion in additional funding over ten years
  4. Any realized overall administrative savings from a single payer system do not accrue to the federal government and thus do not actually offset the cost of M4A
  5. Lowering all health care payments to providers to current Medicare levels has potential serious consequences in terms of available resources to provide health care
  6. Lowering prescription drug costs may create limitations on available drugs
  7. Paying for M4A will require substantially higher payroll taxes, income taxes, a new VAT or some combination thereof and will involve all Americans. It’s not free healthcare, it’s not government provided health insurance. In terms of net out-of-pocket spending for Americans, there will be winners and losers
  8. To manage costs on an ongoing basis will require more active involvement by Medicare is determining the medical necessity for healthcare, closer control of fees and available resources providing healthcare – the same things we criticize insurance companies for doing
  9. The elimination of tax-free employer payments for employee health benefits may create additional taxes for many workers
  10. How Americans receive healthcare will change significantly

The – unrealistic- promises being made by Americas most progressive/liberal politicians are misleading Americans while failing to explain all the implications and consequences. Yes, we need universal coverage, yes, costs are high, but there are more responsible alternatives using the Medicare model.

We just need to deal in facts, not fantasy and we need to tell Americans the truth.


  1. Right now, with the country as divided as it is over various issues, I don’t think any plan would pass muster with the public. The far left is off the chart and the center and right politically don’t seem to have enough in the tank to put out a comprehensive healthcare plan.
    The idea of a comprehensive system for the whole nation doesn’t seem workable to me even in the best of times. The cost will be more than projected (it always is with large government programs) and the delivery of services will be stretched thin. In short, I think after the Covid pandemic no one will agree to it.


  2. In Southern New Jersey, the counties owned at least one county run nursing home. During the late 1980s and early 1990s, every county closed or sold them off. Why? Because they couldn’t afford them, manage them, or maintain them. Long term care is so expensive. I didn’t realize that was part of M4A.
    Just any one of the additional services (dental, hearing, vision) is a big expense, but all of them without co-payments is an insane cost to the taxpayers. The taxpayers can either pay for this out of their pocket or out of their paycheck, but it will get paid.


    1. Hi, I am interested in what the “responsible alternatives” you refer to might be. Currently hospitals are required by EMTALA to stabilize and treat uninsured patients that show up at the emergency room. This is a costly alternative to providing preventative healthcare for medical conditions before they reach the acute stage. We all share the burden of providing this emergency care for uninsured patients. Putting aside any expansion of services would including a medicare buy-in in the ACA marketplace be one possible solution to providing the most basic medical care?


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s