What would Sanders' government health-insurance plan

cost? - Columbus Dispatch

WASHINGTON President Franklin Roosevelt wanted national health insurance to cap off his
NewDeal. President Harry Truman, his successor, made it part of his Fair Deal.
More than half a century after Roosevelt and Truman could not persuade Congress to adopt
anational health-insurance system, Democratic presidential candidate Bernie Sanders has
resurrectedthe idea with his call to scrap the current U.S. private health-insurance system and
replace itwith one operated by the federal government.
Declaring that Roosevelt and Truman believed that health care should be available to all of
ourpeople, Sanders proposes a plan that would sweep away monthly premiums charged by health
insurersand instead finance government health insurance through higher taxes imposed on virtually
everytaxpayer.
Every major country on earth, whether its the U.K., whether its France, whether its Canada,has
managed to provide health care to all people as a right, and they are spending significantlyless per
capita on health care than we are, Sanders said during last weeks Democratic debate inNew
Hampshire. So I do not accept the belief that the United States of America cant do that.
Yet critics, including Kenneth Thorpe, a professor of health policy and management at
EmoryUniversity in Atlanta, contend that Sanders has woefully understated the cost of his plan by
asmuch as $1 trillion a year. Sanders home state of Vermont in 2014 abandoned a plan to adopt
astate insurance plan because of the exorbitant taxes it required.
And critics maintain that Sanders idea is politically impractical, pointing out how difficultit was in
2010 for President Barack Obama to persuade a Democratic-controlled Congress to approvethe
Affordable Care Act, which guaranteed private insurance or government coverage to millions
ofpeople without insurance.
What is beyond dispute is that Sanders bold proposal has electrified progressives who haveyearned
for the United States to emulate Canada, Britain and many other industrialized nations byadopting a
system in which the government is the only insurance provider.
They argue that since Canada instituted its national insurance system in 1971, health carespending
there has increased at a slower rate than in the United States, while life expectancy isabout two
years longer than it is here.
They have gained in quality of health care, but they are spending less, said Gerald Friedman,a
professor of economics at the University of Massachusetts-Amherst who has advised Sanders on
hisplan.
Sanders plan would cover a broad range of health care, including inpatient and outpatient
care,emergency-room visits, primary care and preventive care. A patient would go to the doctor,
presentan insurance card and not worry about co-payments or deductibles.
In the absence of monthly premiums, Sanders would finance the government system with a
2.2percent income tax on all households, a 6.2 percent tax paid by companies, dramatically

higherincome taxes on those earning more than $250,000 a year, and projected savings of $300
billion ayear through a more efficient system.
A lot of the premiums are going to profits of the drug companies and insurance industry,Friedman
said. When businesses are not paying premiums, those wages will increase, and those wageswill be
spent, providing a boost to the economy.
Critics skewer such claims. Thorpe produced a study contending that the plan would cost
astaggering $2.5 trillion a year, as opposed to Sanders estimate of $1.38 trillion annually.
Thenonpartisan Committee for a Responsible Federal Budget calculates that the funding of Sanders
planwould fall at least $3 trillion short over 10 years.
In addition, Sanders would tinker with a health system that is widely regarded as the mostadvanced
in the world. More than 90 percent of Americans have coverage, either through theiremployers,
Medicare which pays for care primarily for the elderly or Medicaid, which providescoverage to lowincome people.
Americans receive care swiftly, without the long waits for elective surgery associated with carein
Canada and Britain. A 2007 study by the National Bureau of Economic Research showed that
86percent of American women between ages 40 and 69 had mammograms, compared with 73.6
percent inCanada, and 29 percent of Americans had colonoscopies, compared with 4.6 percent of
Canadians.
Its true we overpay (to avoid) short-term inconvenience, said Thomas Miller, resident fellowat the
American Enterprise Institute in Washington. But he said the alternative is a system inwhich you are
told what you are going to get, and told you will have to wait for it.
To Friedman, any waiting periods are because governments dont put enough money into
theirsystem. He said the English spend well under half of what we spend per capita, and it shows.
Ifthey wanted to spend more, they would have shorter wait times.
jtorry@dispatch.com
@jacktorry1