What Would 'Medicare for All' Really Mean?

Some liberal U.S. politicians are promoting concepts of 'Medicare for All'. Learn how these proposals are different than the current American health care system (and how they compare to other countries' systems) in this episode of BrainStuff.

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Episode Transcript

Speaker 1 (00:02):
Welcome to brain Stuff from how Stuff Works, Hey, brain Stuff,
Lauren vogelbam here. In the American presidential race, Senator Bernie
Sanders was the first candidate to float the idea of
Medicare for All, a massive expansion of the popular government
funded health program to cover all Americans, not just those
sixty five years of age and older. While hailed by

(00:25):
Sanders progressive supporters, the proposal failed to gain traction with
mainstream Democratic voters and was ridiculed as a wildly expensive
and even socialist idea by Republican critics. The crowded field
of Democratic presidential hopefuls has now swelled to twelve official candidates,
including Sanders, and Medicare for All is now being embraced
by a larger swath of politicians and voters alike. According

(00:49):
to recent polls, fifty percent of Americans, including of Republicans,
now support the creation of some kind of national health plan,
and Sanders is no longer the only congress person trying
to pass comprehensive Medicare for all legislation. In February of
twenty nineteen, Representative Promelagia Paul, a Democrat in Washington State,
and progressive colleagues in the U. S. House of Representatives

(01:10):
released their own Medicare for All Act of twenty nineteen,
which goes even farther than Sanders original seventeen bill. Not
only would the Giapaul proposal do away entirely with private
health insurance and require absolutely no premiums or co pays
of any kind, it would significantly extend Medicare to cover
comprehensive dental, vision and long term care. Giapaul wrote in

(01:32):
a statement, our bill will cover everyone, not just those
who are fortunate enough to have employer sponsored insurance, not
just children, not just seniors, not just those who are healthy.
It's time to ensure that healthcare is a right and
not a privilege, guaranteed to every single person in our country.
It is time for Medicare for All. Let's break down

(01:53):
what that might entail. First, some history. Medicare was created
in nineteen sixty five as a safety net health insurance
program for older Americans. All Americans over sixty five years
of age qualify for Medicare health coverage regardless of pre
existing conditions, and Medicare covers a significant portion of the
costs of doctor's office visits. Treatments and surgeries, plus prescription medications.

(02:15):
Although Medicare recipients also pay annual premiums and out of
pocket costs, Medicare for All proposals, like gypaulse would make
three monumental changes to the current Medicare system. First, there
would be absolutely no age limit. Every American from newborns
to centenarians would be covered by the same government funded
health insurance. Second, private health insurance carriers would be barred

(02:39):
from offering plans to compete with Medicare for All. Third,
patients would pay absolutely nothing, no premiums, deductibles, co pays,
or coinsurance for all covered health care services, which under
the Jipol bill include just about everything under the sun,
including expensive long term care insurance to cover nursing homestays.
All of this potential lee spells doom for the one

(03:01):
point to twillion dollar private health insurance industry. We spoke
with one Care and Politz, who studies healthcare reform and
private health insurance for the Henry J. Kaiser Family Foundation,
a nonpartisan nonprofit group that analyzes major health care issues
fasic America and beyond. She jokes that Medicare for All
would even put her out of business. Pault said, the

(03:23):
Medicare for All proposals that have been discussed are very comprehensive.
Would cover everything you're used to having covered in private
health insurance today, plus dental, vision, hearing, long term care, nursing,
home care. You would get this red, white and blue
Medicare for All card show that when you go to
the doctor and you'd get taken care of. Simple. Okay.
So that's the basics of what Medicare for All could be.

(03:46):
What wouldn't it be. Medicare for All is not socialized
medicine like the United Kingdom's National Health Service. Under that system,
the government is not only the soul insurer, but it
also runs most of the medical clinics and hospitals. That's
not the case under any of the proposed Medicare for
All plans, which more closely resemble Canada's healthcare system, also

(04:07):
called Medicare. Doctors and hospitals would remain private businesses, but
all insurance coverage and therefore all reimbursements paid to doctors
and hospitals would be provided through Medicare A. Canada's healthcare system,
by the way, doesn't cover vision, dental, prescription, drugs or
long term care. Those are covered by private insurance, which

(04:29):
brings us to an important question. The important question who
would be paying for all this? Medicare for All is
also what's known as a single payer healthcare system. Technically,
the single payer will be the federal government. But where
will the government get its money? New taxes, of course,
not only income taxes, but also payroll taxes, corporate taxes,

(04:50):
excise taxes, et cetera. In Medicare alone cost American taxpayers
five and nineties seven billion dollars, or nearly five teen
percent of the entire four trillion dollar federal budget. The
projected cost of Sanders seventeen Medicare for All bill, which
did not include expensive add ons like long term care,

(05:10):
is thirty two trillion dollars over ten years. So, although
it's important to note the costs could even out over
the long term, in the short term that's about six
times what Medicare currently costs US per year. As Paul
It said, quote, that's a lot of money. Right now,
the federal government and states together are paying almost half

(05:30):
of the nation's healthcare bill. But if we stop paying
premiums and deductibles and co pays, there would have to
be a new way to raise revenue. When Americans learned
that the switch to Medicare for all would almost certainly
mean higher income taxes, support for the national healthcare concept
drops by. But while the exorbitant cost of Medicare for
all is a favorite talking point of its critics, the

(05:52):
numbers are deceiving. Americans will certainly pay more in taxes
under such a plan, but they will pay absolutely nothing
in premiums and other out of pocket healthcare costs. Paul said,
American households and the government combined are currently spending three
point five trillion dollars a year on healthcare, more than
any other country on the planet. When you multiply that

(06:13):
out by ten years, it's thirty five trillion dollars greater
than the cost of Sanders Medicare for all proposal by
a full three trillion. So a switch to a single
payer system could actually save money overall, but money aside.
Would Medicare for all mean worse healthcare. There's no doubt
that a massive overhaul of the U S healthcare system

(06:35):
like Medicare for all would be hugely disruptive. Most private
insurers would go out of business, pharmaceutical companies would lose
profits as drug prices were capped, and since Medicare typically
reimburses doctors and hospitals at lower rates than private insurers,
there would be wins and losses for private medical practices.
That said, there's no indication that switching to a Medicare

(06:57):
for All system would result in fewer covered treat mints.
Jiapaul's proposal promises the opposite, and neither should the new
insurance concept result in long ways for life saving procedures
and medications. Paul It said, we don't currently have that
in Medicare. You don't see senior citizens queuing up for
doctor's appointments and prescriptions. It's all quick and easy. The

(07:18):
key question is what will those payment rates be for
doctors and hospitals. The Giapaul bill doesn't really say. That's
still a key question to be addressed and debated. Currently,
a growing number of doctors don't accept Medicare patients because
of the low reimbursement rates and large amount of paperwork
required for reimbursement. The Medicare for All Act of twenty

(07:38):
nineteen does allow doctors and patients to opt out of
the single payer system and simply pay in cash for
medical services, and giapaulse Plan is only one type of
universal health coverage being proposed in Congress. Other versions include
keeping the current system but adding a public option based
on Medicare, as well as allowing older people not yet
eligible for Medicare to buy into the system. All of

(08:01):
that is a primer for now. We will keep you
updated as developments occur. Today's episode was written by Day
Bruise and produced by Tyler Clang for iHeartMedia and How
Stuff Works. For more on this and lots of other
expansive topics, visit our home planet, how stuff Works dot com.