Only hours before the NBC Democratic primary debate, Sen. Bernie Sanders released his single-payer healthcare plan. The Sanders campaign named the plan “Medicare for all,” and the name is almost as deceptive as the plan itself.
Sanders promises that, if he were elected president, all Americans would have full health insurance without limits: no deductibles, no copays. Sanders claimed in the debate that his administration would pay for this program through tax reform (read: increase). Sanders claims that single-payer healthcare systems guarantee lower costs.
One of the most striking of Sanders’ arguments for the program is that all “other industrialized nations” have a similar program, so the United States should, too. But do all other “industrialized nations” have the healthcare Sanders envisions? And is single-payer healthcare truly that much cheaper?
Everyone’s Not Doing It
To answer the first question, we must first discuss the term “industrialized nations.” Sanders has used this term intermittently with “advanced nations,” and occasionally “every country in the (developed) world.” This complicates his argument somewhat, because it is difficult to fact-check an inconsistent (and very vague) claim.
But even if we take Sanders’ most accurate and narrow claim of advanced nations (“industrialized” is kind of 1870s, Bernie), the argument still does not hold. Many “advanced” nations do not have a single-payer healthcare system (although most of them are universal, but, thanks to Obamacare, so is the United States).
In Western Europe, for example, numerous countries such as the Netherlands, Germany, and France have a multi-payer healthcare system with deductibles and even copays. Private insurance companies and the government both contribute to the healthcare system. Sanders even mentions some of these countries by name in his “Medicare for all” program.
There are, of course, advanced nations, such as the United Kingdom and Sanders’ beloved Denmark, that do have single-payer healthcare systems. But that in and of itself is not an argument. There are tons of less advanced nations with single-payer healthcare systems: Russia, Venezuela, and North Korea are just a few from a long list. These countries do not really have a reputation for providing amazing healthcare.
Socializing Healthcare Doesn’t Cut Costs
Having debunked that myth, let us move on to the costs. Sanders himself claims that his plan “has been estimated to cost” a whopping $1.38 trillion a year. That is a very expensive program even in Sanders’ modest calculations. But Sanders claims that single-payer healthcare programs are simply always cheaper, essentially because no private companies are involved in the process.
A simple fact check with the World Bank shows that this is a ridiculous claim. Norway, which has a single-payer healthcare system, spent a little over $9,700 per person on healthcare in 2013, which is $600 more than the average American citizen in the same year. A comparable country with a multi-payer system, such as Germany, spent about $5,000 per capita in 2013, almost half as much as a person in Norway did. In contrast to Sanders’ plan, Norwegians still pay a deductible every year.
There are also disparities between countries that have a similar system. The Dutch, with a system somewhat comparable to that of the Germans, spent about $6,150 per capita in 2013 (compared to Germany’s $5,000 per capita). British subjects, with a single-payer system comparable to Norway’s, spent about $3,600 in 2013 in healthcare, almost a third of Norway’s. In short, the amount of money spent on healthcare has very little to do with a single-payer or multi-payer healthcare system.
Let the People Choose
Most people in America would agree the American healthcare system is broken. It delivers inadequate quality of healthcare for the amount of money the people of the United States spend on it. Health insurance premiums are high, particularly felt by those without employment (benefits), and the system is incomprehensibly over-regulated and complicated, even for the people who designed it.
Sanders’ plan, however, is no fix for the system. It is almost impossible to comprehend how the federal government would even manage and handle the largest insurance company in the world, with over 318 million customers, given their history managing far smaller health issues (“Department of Veterans Affairs” and “healthcare.gov” come to mind).
The Sanders campaign would argue: what is the alternative, then? There is a very obvious American solution. A group of very smart men thought of it in the late 1780s. What if we do not make this a presidential issue at all? Why not just let the people in their individual states decide? After all, “the powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”