New Analysis Shows 'Medicare for All' Can Cover Everyone While Cutting Costs

In addition to a new poll showing it would be extraordinarily popular, California’s single-payer bill—the Healthy California Act—would also cut costs while providing coverage for all.

That is the conclusion of a new analysis (PDF) published on Wednesday by the Political Economy Research Institute (PERI).

“We estimate that, through implementation of Healthy California, overall costs of providing full health care coverage to all Californians could fall by about 18 percent relative to spending levels under the existing system,” the authors of the report note.

They conclude:

The analysis, which was commissioned by the California Nurses Association/National Nurses Association, adds fuel to an ongoing debate over the costs of insuring all Californians—a debate sure to reverberate nationally.

As the extremely unpopular American Health Care Act lingers in the Senate, polls increasingly show that most Americans view single-payer healthcare favorably. Last year, Gallup found that a majority of Americans would support replacing the Affordable Care Act with a Medicare-for-all style program. PERI’s analysis attempts to show that such a program, if implemented correctly, is no utopian fantasy but rather fiscally sound public policy.

“What this new study proves is that we can finally achieve the dream of guaranteeing health care for all Californians, without the punishment of crippling out of pocket costs, at far less than what was predicted by those who make enormous profits off the pain and suffering of everyday Californians,” said RoseAnn DeMoro, the executive director of National Nurses United.

According to a new survey published by Tulchin Research firm, Californians are strongly behind each of these objectives.

  • 94 percent of respondents favor lower healthcare costs
  • 82 percent “favor eliminating premiums, co-pays, deductibles, and all out of pocket expenses for covered services”
  • 81 percent “support ensuring every Californian has healthcare”
  • “70 percent of Californians favor establishing a public, Medicare for all type system”

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Previous reporting suggested, contrary to PERI’s findings, that the Healthy California Act would impose exorbitant and unsustainable costs on the state.

“Democrats’ single-payer health-care dream just became a nightmare,” CNBC ominously declared following the publication of a study conducted by the California State Senate, which found that the Healthy California Act would cost $400 billion annually.

Many, however, have questioned the extent to which the panic-stricken tones of major headlines align with the numbers. Matt Bruenig, writing for Jacobin, pointed out that, if the State Senate numbers are correct, California would ultimately spend “15 percent of the state’s GDP” on healthcare—”three percentage points lower than the share of GDP the United States overall spends.”

In conclusion, Bruenig noted that “if the plan would work like this report says it does and at the cost this report says it does, it is a no-brainer.”

Some commentators have attempted to bolster the economic case for single-payer with a moral argument, as Sarah Jones did recently in The New Republic.

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“It’s a matter of policy, yes, but of morality too, and there is an unassailable moral logic for single-payer,” Jones argued. “Opponents of single-payer must reckon with it, just as they ask advocates to reckon with political practicalities. Advocates must repeatedly ask: Is the status quo tolerable?”

Increasingly, judging by surveys of public opinion and town-hall confrontations, Americans are answering Jones’s question with a resounding ‘no.’ In California, the goal for single-payer backers now is turning popular sentiment into political reality.

“Healthcare costs Californians billions and one-third of people with healthcare still don’t have enough coverage,” said California State Senator Ricardo Lara in a statement. “The good news is that California can get a lot more for our money and reduce the costs of healthcare for middle class families and businesses.”

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