Policy 105 What Isn’t Medicare for All

Medicare For All Basics

What Isn’t Medicare For All?

The Short Answer

Medicare for All would eliminate the role of private insurance in the healthcare system, and finance health care completely through a progressive tax system. No other plan is as universal, affordable, or sustainable. 

The Details

There are a lot of plans that have adopted the “Medicare for All” language around universal healthcare. They’re called things like “Medicare Extra” or “Choose Medicare”, but, upon further inspection, they turn out to be plans that leave the private insurance industry as a major player.

Most of these plans center around a “public option” or “Medicare buy-in”. Essentially, they give people the ability to pay some amount of premiums or out of pocket costs, but opt-in to a public insurance program instead of a private one.

Some of these plans are better than others. They might expand Medicare benefits significantly, automatically enroll people below certain income levels into public plans, or have other methods of expanding health insurance, but none are a true Medicare for All plan.


So What’s the Problem? 

Most of these plans would be an improvement on our current health care system, but they just don’t have the same advantages that a true Medicare for All system would.

  • By not streamlining into a single insurer with no profit incentive, we leave a huge amount of savings on the table.
    • It would not eliminate the administrative costs of private insurance
    • Providers would still have large administrative costs to manage billing and claims in a multi-payer system
    • The public programs would become more expensive, because the people most likely to join them will be those who are facing serious or chronic conditions, and the elderly, who are more expensive to insure on the private market, and the healthy and young people would be a smaller part of the risk pool.
  • It doesn’t distribute costs well.
    • Instead of financing healthcare through the tax system, these plans leave in place a mixture of private health insurance, public programs, and out of pocket costs
    • By relying largely on personal spending, we wouldn’t eliminate the financial burden, and even bankruptcy, that to often falls on those facing serious illnesses.
  • It isn’t truly universal
    • We still wouldn’t be ensuring health care for every man woman and child, which is the central failure of our health care system.

Lastly, these plans require that insurance companies will play fair. What the ACA taught us is that insurance companies will always try and find ways to skirt regulations, sell “junk plans”, try to avoid paying claims, and do anything they can to grow their profits, while adding nothing of value to the healthcare system.


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