San­ders’ health care bill draws Democrats with eye on 2020.

An­a­lysts say cost for sin­gle-payer sys­tem will be in the tens of tril­lions


Democrats eye­ing a 2020 pres­i­den­tial bid signed onto Sen. Bernard San­ders’ new “Medi­care-for-all” bill Wed­nes­day, in­sist­ing it won’t blow a hole in the fed­eral bud­get.

An­a­lysts have put the price tag for a na­tional sin­gle-payer health sys­tem in the tens of tril­lions of dol­lars, and Cal­i­for­nia scrapped its own plans this year say­ing it would dou­ble the state’s bud­get.

But top Democrats said they can defy the pro­jec­tions, be­liev­ing that a govern­ment-run sys­tem will be able to find enough sav­ings to pay for it­self.

Sen. Kirsten Gil­li­brand of New York said a sin­gle-payer ap­proach is “dif­fer­ent way of look­ing at the prob­lem,” and not only wouldn’t add to the debt, but would ac­tu­ally save the govern­ment in the end.

“In­stead of giv­ing money to in­sur­ance com­pa­nies that are for-profit, that pay mil­lions of dol­lars in CEO salaries … you are al­low­ing money to go di­rectly to the care­givers and the doc­tors,” Mrs. Gil­li­brand told The Wash­ing­ton Times. “So it is much less money over­all.”

Mr. San­ders re­leased his long-awaited pro­posal Wed­nes­day on Capi­tol Hill, and drew im­me­di­ate sup­port from pro­gres­sive ac­tivists who said it’s the be­gin­ning of the next ma­jor health-care con­ver­sa­tion in the U.S.

Join­ing Mr. San­ders, Ver­mont in­de­pen­dent and a self-iden­ti­fied so­cial­ist, were a group of Democrats whom news re­ports have placed in the pos­si­ble run­ning for a 2020 pres­i­den­tial bid, in­clud­ing Mrs. Gil­li­brand and Sens. Corey A. Booker of New Jersey, Eliz­a­beth Warren of Mas­sachusetts, Ka­mala D. Har­ris of Cal­i­for­nia, and Jeff Merkley of Ore­gon.

The plan would give Amer­i­cans an in­sur­ance card en­ti­tling them to pub­licly funded care, al­low­ing them to see the doc­tor with­out pay­ing any­thing out-of-pocket, or shelling out pre­mi­ums to pri­vate com­pa­nies.

His new plan hasn’t been run through bud­get pro­jec­tions yet, but the sim­i­lar plan he out­lined dur­ing the 2016 pres­i­den­tial cam­paign was scored by the Cen­ter for a Re­spon­si­ble Fed­eral Bud­get, a non­par­ti­san watch­dog, that es­ti­mated it would cost $25 tril­lion and add $16 tril­lion to the debt with­out ad­di­tional off­sets.

Pa­trick New­ton, a spokesman for the group, said the costs of Mr. San­ders’ lat­est plan are likely to be sim­i­lar.

“That is the most cyn­i­cal anal­y­sis,” coun­tered Mr. Booker.

He said health care costs now eat up 17 per­cent of the an­nual gross do­mes­tic prod­uct un­der the cur­rent sys­tem, which he said is far more than “com­peti­tor na­tions” and is hurt­ing busi­nesses in the U.S.

“So how can you tell me that what we are propos­ing is more ex­pen­sive, when the com­peti­tor na­tions that have uni­ver­sal ac­cess have much lower cost in much bet­ter out­comes?” he said. “Any­body can ac­tu­ally step back and say that this is ac­tu­ally a cheaper way to go about it, a less ex­pen­sive way, ex­cuse me, to go about it, and that we could ac­tu­ally drive up out­comes much bet­ter than we are do­ing now.”

Re­cent polls sug­gest a slim ma­jor­ity of Amer­i­cans like the idea of a sin­gle, govern­ment-run plan, though Repub­li­cans ap­peared to rel­ish the bill’s ad­vent, say­ing it gives them a chance to prod vul­ner­a­ble red-state Democrats over “govern­ment-run” health care ahead of the 2018 midterms.

“Bernie San­ders’ $32 tril­lion so­cial­ist health care plan will force Se­nate Democrats to choose be­tween lib­eral ac­tivists and com­mon sense,” said Katie Martin, a spokes­woman for Na­tional Repub­li­can Sen­a­to­rial Com­mit­tee. “Democrats must come clean on whether they back San­ders’ plan for govern­ment-run health care, or if they will stand with tax­pay­ers against this un­re­al­is­tic boon­dog­gle.”

Mr. San­ders of­fered few de­tails Wed­nes­day on how he plans to pay for his plan, though he pledged that higher taxes would be off­set by zero­ing out what Amer­i­cans pay pri­vate in­sur­ers to­day.

His of­fice also rolled out a menu of pos­si­ble fund­ing op­tions that in­cluded a 7.5 per­cent pay­roll tax on em­ploy­ers, a des­ig­nated 4 per­cent tax on in­come, and mak­ing the in­come tax code more pro­gres­sive by rais­ing mar­ginal tax rates on the rich.

“To­day, we be­gin the long and dif­fi­cult strug­gle to end the na­tional dis­grace of the United States — our great na­tion — be­ing the only ma­jor coun­try on Earth not to guar­an­tee health care to all of our peo­ple,” Mr. San­ders said.

Mrs. Har­ris, mean­while, passed on the chance to weigh in on the cost ques­tions — at least for now.

“There hasn’t been an as­sess­ment yet,” she said of the San­ders plan. “Then we can have a talk about it.”


Sen. Bernard San­ders, Ver­mont in­de­pen­dent (cen­ter) un­veiled his “Medi­care-for-all” bill Wed­nes­day. Democrats who have pres­i­den­tial as­pi­ra­tions have en­thu­si­as­ti­cally signed on to Mr. San­ders’ bill and are in­sist­ing that this pro­posed sin­gle-payer health­care sys­tem won’t blow a hole in the fed­eral bud­get.

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