Bernie Sanders' New Favorite Medicare for All Study Has Major Problems

Has any question taken up more airtime at the Democratic debates than how to pay for Medicare for All? The question keeps being asked partly because multiple estimates have found that the single-payer plan, which would eliminate virtually all private health insurance, would require more than $30 trillion in additional government spending over a decade, a historically unprecedented sum. But it has also been a fixture because of the way it has caused candidates to stumble in revealing ways.

No primary candidate is more closely associated with Medicare for All than the current front-runner and likely nominee Sen. Bernie Sanders (I–Vt.). At last night's debate, Sanders was once again asked how he would pay for the plan. He responded by citing a study "that just came out of Yale University, published in Lancet magazine, one of the prestigious medical journals in the world." The study, co-written by a former unpaid Sanders adviser, purports to show that Sanders' Medicare for All plan would save $450 billion a year, and 68,000 lives.

A detailed article produced by Kaiser Health News and Politifact, however, rates Sanders' claim "mostly false." The true part is that such a study exists. The false rating comes from the story's conclusion that the Lancet study's major findings are wildly disingenuous because they ignore or discount much of the evidence about what effects such a program would have on the health care system.

The Lancet study assumes, for example, that the Sanders plan could pay Medicare rates across the board. Medicare rates are far lower than private insurance rates, and the hospital lobby is a powerful political force that has successfully fought off payment reductions in multiple venues. When Washington state set up a government-run health insurance plan, state lawmakers ended up boosting rates to about 170 percent of what Medicare pays.