Bernie Sanders talks big, but the record shows that in his 25 years in Congress he has failed to deliver on any of his ideological proposals.
Expect the same from the independent Vermont senator’s ambitious Medicare for all plan. It’s impossible to take his single-payer plan seriously because it fails to address the single biggest issue: how to pay for it.
As even our president now knows, it’s complicated. And of the 16 Democrats who have piled onto Sanders’ proposal, none so far has added a plan to fund it.
President Obama’s Affordable Care Act was far from perfect, but it still represents a significant step, removing more than 17.7 million from the ranks of the uninsured and driving down the health care system’s costs. It could do far better with a few improvements Republicans for years have refused to make.
They should make those improvements now and call the result their own. The idea seemed to have some momentum over the summer. But now Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., are gaining support for another attempt to repeal Obamacare that is even more mean-spirited than previous ones.
Sanders’ proposal may someday offer a roadmap to health care for all, but it’s is a nonstarter in this Congress. Polls also show that while a majority of Americans like the idea of expanding Medicare, support plummets when they learn they’d have to pay higher taxes for it. If Medicare for all is going to be a centerpiece of the Democrats’ strategy to capture control of the House in 2018 and the White House in 2020, they’d better get real about the costs.
Sanders did provide a list of revenue-raising ideas, including increasing income-based payroll taxes and taxes on the wealthiest Americans. But an Urban Institute analysis of the single-payer plan he proposed as a presidential candidate didn’t come close to covering the total cost.
The plan also whiffs on two additional issues:
The history of Western nations implementing single-payer plans demonstrates that it takes a significant number of years before cost savings are realized.
Any move toward Medicare for all would ignite a nuclear-scale battle with the powerful health insurance industry that employs 460,000 workers and collected $713 billion in premiums last year.
The United States has the most expensive health care system in the world, eating up 17.6 percent of GDP. Americans spend nearly $10,000 per person per year — double that of most Western nations — but generate similar or, in some cases, worse life expectancy and health outcomes.
Sanders and Democrats are right that all people in this rich nation should have access to health care, and if other nations can do this at lower cost than we spend now for an inferior system, the United States has got to change. But Medicare for all won’t be a serious proposal without a detailed financial plan that Americans can see will accomplish the goal.