Medicare for All's Time Has Come

By Bernie Sanders, CNN

16 August 18

et's be clear. The American people are increasingly tired of a health care system that works for Wall Street investors, insurance companies and the pharmaceutical industry -- but ignores their needs. They want real change, and poll after poll shows that they want to move toward a Medicare-for-all, single-payer system. And for good reason.

Today, the United States has the most expensive, inefficient, and bureaucratic health care system in the world. Despite the fact that we are the only major country on earth not to guarantee health care for all -- and have 30 million uninsured and even more who are underinsured -- we now spend more than twice as much per capita on health care as the average developed country.

According to a recent Organisation for Economic Co-operation and Development analysis, we spend more than $10,300 per capita on health care. Meanwhile, Canada spends just $4,826, France spends $4,902, Germany spends $5,728, and the United Kingdom spends $4,264.

Further, despite this huge expenditure, which now constitutes almost 18% of our GDP, our health care outcomes are worse than most of these other countries. For example, our life expectancy is 2.5 years lower than Germany's and our mortality rate for children under the age of 19 is at the top of the list compared to other developed countries.

The ongoing failure of our health care system is directly attributable to the fact that -- unique among major nations -- it is primarily designed not to provide quality care to all in a cost-effective way. Instead, the system makes maximum profits for health insurance companies, the pharmaceutical industry and medical equipment suppliers.

The Medicare-for-all legislation that I wrote, which now has 16 co-sponsors in the Senate, would provide comprehensive health care to every man, woman and child in our country -- without out-of-pocket expenses. No more insurance premiums, deductibles or co-payments. Further, it would expand Medicare coverage to include dental and vision care. In other words, this plan would do exactly what should be done in a civilized and democratic society. It would allow all Americans, regardless of their income, to get the health care they need when they need it.

Under the current system, while thousands of Americans die each year because they lack access to the health care they desperately need, the top five health insurance companies last year made $21 billion in profits, led by the UnitedHealth Group, which made $10.56 billion.

As tens of thousands of American families face bankruptcy and financial ruin because of the outrageously high cost of health care, the CEOs of major insurance companies receive disgustingly high levels of compensation. According to Axios, in 2017, the CEO of UnitedHealth Group, Dave Wichmann, received $83.2 million; the CEO of Aetna, Mark Bertolini, received $58.7 million, and the CEO of Cigna, David Cordani, received $43.9 million.

Today, as an indication of how dysfunctional our current system is, about one out of every five Americans cannot afford to fill the prescriptions given to them by their doctors because we pay, by far, the highest price in the world for prescription drugs. A 2013 study showed that in 2010, the United States paid, on average, about double what was paid in the United Kingdom, Australia, and Switzerland for prescription drugs. Since 2014, the cost of 60 drugs commonly taken has more than doubled, and 20 of them have at least quadrupled in price.

While millions of Americans are unable to afford the medicine they desperately need, or are forced to cut their pills in half in order to save money, five top drug companies made over $50 billion in profits last year and, in 2015, 10 prescription drug CEOs made a combined $327 million in total compensation.

Would a Medicare-for-all health care system be expensive? Yes. But, while providing comprehensive health care for all, it would be significantly less costly than our current dysfunctional system because it would eliminate an enormous amount of the bureaucracy, administrative costs and misplaced priorities inherent in our current for-profit system.

Instead of doctors and nurses spending a significant part of their day filling out forms and arguing with insurance companies, they could be using their time to provide care to their patients. We'd be able to save up to $500 billion annually in billing and administrative costs. That money could be used to greatly expand primary care in this country and make certain that all Americans got the health care they needed when they needed it -- saving billions on expensive emergency room care and hospital visits. Instead of paying the highest prices in the world for prescription drugs, we could save hundreds of billions over a 10 year period through tough negotiations with the drug companies.

The benefits of a Medicare-for-all, single-payer system are so obvious that even a recent study done by the right-wing Mercatus Center estimated that it would save Americans more than $2 trillion over a decade, reducing the projected cost of health care between 2022 and 2031 from $59.7 trillion to $57.6 trillion. Needless to say, that wasn't the point the study attempted to emphasize. Rather, the author of the study was hoping the headline -- "Medicare for All costs the federal government $32.6 trillion" -- would frighten the American people and get them to oppose it.

While opponents of Medicare for all focus their criticism on the increased taxes the American people will have to pay, they conveniently ignore the fact that ordinary people and businesses will no longer have to pay sky-high premiums, co-payments and deductibles for private health insurance.

At a time when health care in 2018 for a typical family of four with an employer-sponsored PPO plan now costs more than $28,000, according to the Milliman Medical Index, the reality is that a Medicare-for-all system would save the average family significant sums of money.

A recent study by RAND found that moving to a Medicare-for-all system in New York would save a family with an income of $185,000 or less about $3,000 a year, on average. Even the projections from the Mercatus Center suggest that the average American could save about $6,000 under Medicare for all over a 10-year period.

A Medicare-for-all system not only benefits individuals and families, it would benefit the business community. Small- and medium-sized businesses would be free to focus on their core business goals instead of wasting precious energy and resources navigating an incredibly complex system to provide health insurance to their employees.

Needless to say, there is huge opposition to this legislation from the powerful special interests that profit from the current wasteful system. The insurance companies, the drug companies, Wall Street and the Koch brothers will undoubtedly spend billions on lobbying, campaign contributions and television ads to defeat Medicare for all. But they are on the wrong side of history.

Here is the bottom line: If every major country on earth can guarantee health care to all and achieve better health outcomes, while spending substantially less per capita than we do, it is absurd for anyone to suggest that the United States of America cannot do the same.