Sanders Unveils “Medicare for All” Universal Healthcare Bill

On Thursday, Vermont Senator Bernie Sanders unveiled his long awaited “Medicare-for-All” universal healthcare bill. He recognizes that it will be an uphill battle, acknowledging that the opposition to the bill will be “extraordinary,” coming from what he calls the “most powerful and greedy forces in American society”: the pharmaceutical industry, insurance companies, Wall Street and the Republican party.

Sanders sought to buttress the support of party constituents, warning them that the opposition “will spend an enormous amount of money fighting us. They will lie about what is in the program. They will frighten the American people.”

While many have called Sanders “idealistic” and “unrealistic,” Sanders seems to have no illusions about the opposition this bill faces. But the fate of the bill will revolve around the answer to a crucial question: is healthcare a right or a privilege in America? Sanders and other Democrats have recently been making the case that healthcare is a fundamental right, now it is time for the public to make that decision for themselves.

A recent Pew poll published in January showed that 60 percent of Americans said the government had a responsibility to provide health-care coverage for all, up from 51 percent the year before. The poll showed just 33 percent overall favored single-payer specifically — versus a “mix of government and private programs” — but among Democrats and Democratic-leaning voters, 52 percent wanted single-payer. And among self-described liberals, it was 64 percent.

The shift in public opinion, particularly amongst liberals, may explain the recent wave of Democrats joining to support single-payer and Sanders’ “Medicare-for-All” bill in particular. Sanders’ bill already has the backing of nearly a third of the Democratic caucus in the Senate – a record level of support for a single-payer bill. Four years ago he introduced the bill with just one signature, his own.

Sanders’ plan would be a dramatic overhaul of the entire American healthcare system, transitioning it over the course of four years to a federally administer national insurance program. The bill is functionally a gradual expansion of Medicare – the federal health insurance program for people who are 65 years or older – to all Americans.

During the first year of the plan, eligibility age for Medicare would drop to 55, and all Americans under 18 would be added to the program. The eligibility age would gradually decrease until the fourth year, when everyone would receive a “universal Medicare card.” The new program would be paid for by an increase in federal taxes.

The single-payer bill would provide comprehensive healthcare coverage for everything from the cost of hospital services, prescription drugs, mental health, maternity and newborn care and dental health. Sanders clarified that with the plan, “You’re going to the same private doctor that you went to. You’re going to go to the same hospital that you went to. The only difference is instead of having a Blue Cross Blue Shield [insurance] card – and having to argue with your insurance company – you’re going to have a Medicare for All card. That’s it.”

This contrasts with a nationally administered healthcare program like the U.K.’s N.H.S., in which end to end care including things like hospital services are owned and provided for by the government.

Single-payer systems have been voted on or attempted at the state level, like the recent attempt in California or the abandoned attempt in Sanders’ home state of Vermont. State single-payer plans are often considered too expensive and cost ineffective as states must raise taxes to pay for the new program without receiving large enough of a pool of people on who’s behalf to negotiate down prices. However, advocates of single-payer often point to the need for uniformity in the market which only a nationally run system can offer.

Nationally administered single-payer systems are often far more cost effective than private insurance systems for several reasons. One of which is the lower overhead of a program like Medicare which spends only 2% of its budget on administrative costs, far less than the average 12 percent to 14 percent of private health insurance companies.

Beyond administrative costs, single-payer systems benefit from national public awareness and as a result spend almost nothing on competitive advertising, shaving off around another 15% of costs. Finally, with a larger negotiation pool single-payer systems can often successfully negotiate costs down, particularly on prescription drugs whose business profit margins are among the highest at an average of 18.4 percent.

As a result, despite an increase in taxes, a single-payer healthcare system is often more cost efficient to run. The U.S. already spends more per capita on healthcare than countries that guarantee healthcare, such as Canada, France and Germany, despite which, some 28 million Americans remain uninsured and infant mortality rates remain higher and life expectancy, shorter.

One thing is for sure, despite acknowledged the uphill battle in front of him, Sanders’ is hopeful, stating “there is growing support among the American people and we will win this struggle.”

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