Bernie Sanders’s new favorite Medicare-for-all study, explained

Sen. Bernie Sanders and his Medicare-for-all proposal were again the targets of attacks at Tuesday’s Democratic debate in South Carolina, but the senator had a retort for opponents who doubt his single-payer plan would work: a brand-new study published in The Lancet.

The study, authored by a group of Yale researchers, came to two conclusions that Sanders touted during the debate. Under Medicare-for-all, the researchers found, the United States would spend $3 trillion on health care annually, or about $460 billion less than the country spent in 2017 under the current system, and universal coverage would save almost 69,000 lives in America every year.

As his opponents painted his plan as too expensive and unrealistic, Sanders turned to the Lancet article to defend himself at Tuesday’s debate:

I’m sure you’re familiar with the new study that just came out of Yale University, published in Lancet magazine, one of the prestigious medical journals in the world. You know what it said? Medicare-for-all will lower health care costs in this country by $450 billion a year, and save 68,000 lives of people who otherwise would have died.

What we need to do is to do what every other major country on Earth does: guarantee health care to all people. Not have thousands of separate insurance plans, which are costing us some $500 billion a year to administer.

It was the perfect evidence for Sanders’s message: Single-payer health care would save money and save lives. But if you dig into the numbers, it gets a little more complicated.

The Yale study’s authors assume bigger savings and bigger health benefits than the other researchers who have looked at the same question. It’s certainly possible Medicare-for-all would result in lower spending and better health. But there are a ton of unknowns in how such a program would work in practice. That’s why we sometimes see wide differences in estimating what single-payer would cost.