The race to put a man on the moon seemed like the perfect analogy [Medicare for all as] a challenge that we took on as a nation, despite the prohibitive cost. But … we’re not talking about a moonshot. We’re talking about a shot to Jupiter.
Medicare for All
The phrase Medicare for all is like the phrases carbon footprint and deep fried—you probably have a visceral response to the phrase even before you know what we are talking about. In fact, a survey from the Kaiser Family Foundation found that 62% of Americans have a positive reaction to the phrase Medicare for all. Interestingly, when you swap in the phrase single-payer health insurance system, support drops to 48%.6
The difference in support for these two concepts exists because Medicare for all means different things to different people. To wit, the 116th Congress is considering eight separate proposals, all of which fall under the rubric of Medicare for all.
The proposals basically fall into two categories:
- Medicare expansion: 47% of Americans receive insurance through their employers, through one of 858 private healthcare insurers. Also known as single payer, Medicare expansion would eventually guarantee that all Americans would receive healthcare.
- Medicare buy-in: These so-called public option plans would not guarantee healthcare to all Americans, but they would allow some fraction of the 47% to purchase Medicare coverage.
The former is a frontal assault; the latter is a sneak attack. The idea behind the Medicare Buy-In (and with the public option proposed by proponents of the Affordable Care Act [ACA]), is that as soon as some Americans are allowed to purchase Medicare coverage for themselves, others will clamor for the same right. The battle over the ACA has breathed new life into both proposal categories.
No wonder. It’s late in the game, and the stakes are high: 23 million Americans receive health insurance because of changes mandated by the ACA, either through the health insurance marketplace or the expansion of Medicaid. Despite this, approximately half of the people in the U.S. report spending less on food, clothing and other necessities to pay their medical bills.7 Worse still, last year, Americans borrowed $88 billion to pay for healthcare.8 Medical costs are an enormous burden for many Americans, and making Medicare accessible to a larger cross-section of the country would go a long way toward making that burden more bearable.
The problem, of course, is cost.
Charles Blahous, former deputy director of President Bush’s National Economic Council and now a senior research strategist at George Mason University’s Mercatus Center, believes Sen. Bernie Sanders’ Medicare for All Act would cost $32.6 trillion for the first 10 years after full implementation. At least.9
