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Examining Sanders' Medicare-For-All Proposal


Bernie Sanders has introduced a new version of his "Medicare for All" bill that was a cornerstone of his 2016 presidential campaign. He's one of several Democratic candidates for president who support some form of national single-payer coverage. But is that easier said than done? Julie Rovner, chief Washington correspondent for Kaiser Health News joins us. Julie, thanks for being with us.

JULIE ROVNER: Thanks for having me.

SIMON: And what's Senator Sanders proposing this year?

ROVNER: Well, he's proposing similar to what he's been proposing since the 1990s, which is basically to make Medicare, the program that now serves 50-some million elderly and disabled Americans, available to everyone and basically get rid of private health insurance at the same time. So everyone would be on Medicare - might not be the same Medicare that we know now, but they would be on a federal government-run program called Medicare that would provide much more robust benefits than most people have now either on Medicare or on their private insurance.

SIMON: More robust benefits, but would that also mean more robust taxes?

ROVNER: Yes, it almost certainly would because there would be no more private health insurance premiums, according to the - at least the proposal that we have. People wouldn't have to pay copays or coinsurance or deductibles or, you know, the money that now gets paid out of pocket. So taxes would presumably go up to make up for that.

SIMON: A lot of Democratic candidates are running on a policy of Medicare for All. What are some of the features of the plans that we might find worth knowing about?

ROVNER: Well, the Medicare for All plans would basically get rid of private insurance, and this is of some concern for those who are worried about the political prospects. There's 150 million people who get their insurance from a family member's employer. That would basically go away. The entire private insurance industry would go away.

There are some other proposals that would either maintain a role for private insurance - maybe they could cover some things. That's how some countries do it. And then there are others that make the whole thing optional. The people who wanted to go into a public plan could go into a public plan, but those who wanted to keep their private coverage could do that. That's one of the big debates that's going to have to happen before anybody settles on any particular plan.

SIMON: And everybody seems to want to bring down health care costs, but there's a big but, isn't there?

ROVNER: There is a big but. You know, we are still a free country. If they bring them down too much, you might have providers who wouldn't want to participate, or you might have hospitals closing their doors.

I mean, at some point, yes, health care is expensive. It doesn't have to be as expensive as it is in the United States. We pay way more for things than other countries do, but there is going to be some kind of a limit on how low you can push those prices. But remember, however much you pay for the health care, that's how much is going to have to be then raised in federal taxes to pay for this.

SIMON: Any chance of Republican support for any of these plans?

ROVNER: It seems highly unlikely, at least at this point. This is mostly a Democratic debate about, what do Democrats think the nation's health care should look like in the coming years and probably decades? Republicans are still kind of figuring out exactly what they would like to propose. Everybody seems to support more coverage, and they know that the status quo isn't working. People are paying too much, and even middle-class people often can't afford their health care. But Republicans are - seem, at the moment, happy to call this socialism and leave it at that.

SIMON: If there is an overhaul of health care, but it's not bipartisan, does that just mean that American health care is going to go back and forth, depending on which party's in power?

ROVNER: Well, that is the big concern. And there are a lot of Republicans who are saying, you know, we really should work together. And there is some bipartisanship going on now on issues like prescription drug prices and surprise medical bills - that people get unexpected out-of-network bills. But even those are proving difficult to find bipartisan consensus on - at least enough consensus to pass a law. So I think both sides know it would be better if they got together. They just haven't figured out how yet.

SIMON: Julie Rovner, chief Washington correspondent for Kaiser Health News. Thanks so much.

ROVNER: Thank you. Transcript provided by NPR, Copyright NPR.