1 00:00:02,040 --> 00:00:07,200 Speaker 1: Welcome to brain Stuff from how Stuff Works, Hey, brain Stuff, 2 00:00:07,240 --> 00:00:12,080 Speaker 1: Lauren vogelbam here. In the American presidential race, Senator Bernie 3 00:00:12,160 --> 00:00:14,400 Speaker 1: Sanders was the first candidate to float the idea of 4 00:00:14,480 --> 00:00:18,079 Speaker 1: Medicare for All, a massive expansion of the popular government 5 00:00:18,079 --> 00:00:21,640 Speaker 1: funded health program to cover all Americans, not just those 6 00:00:21,680 --> 00:00:25,120 Speaker 1: sixty five years of age and older. While hailed by 7 00:00:25,160 --> 00:00:28,400 Speaker 1: Sanders progressive supporters, the proposal failed to gain traction with 8 00:00:28,440 --> 00:00:32,440 Speaker 1: mainstream Democratic voters and was ridiculed as a wildly expensive 9 00:00:32,440 --> 00:00:36,600 Speaker 1: and even socialist idea by Republican critics. The crowded field 10 00:00:36,600 --> 00:00:41,239 Speaker 1: of Democratic presidential hopefuls has now swelled to twelve official candidates, 11 00:00:41,280 --> 00:00:44,840 Speaker 1: including Sanders, and Medicare for All is now being embraced 12 00:00:44,840 --> 00:00:49,040 Speaker 1: by a larger swath of politicians and voters alike. According 13 00:00:49,040 --> 00:00:53,160 Speaker 1: to recent polls, fifty percent of Americans, including of Republicans, 14 00:00:53,360 --> 00:00:56,240 Speaker 1: now support the creation of some kind of national health plan, 15 00:00:56,600 --> 00:00:59,360 Speaker 1: and Sanders is no longer the only congress person trying 16 00:00:59,440 --> 00:01:04,160 Speaker 1: to pass comprehensive Medicare for all legislation. In February of 17 00:01:04,160 --> 00:01:08,039 Speaker 1: twenty nineteen, Representative Promelagia Paul, a Democrat in Washington State, 18 00:01:08,240 --> 00:01:10,800 Speaker 1: and progressive colleagues in the U. S. House of Representatives 19 00:01:10,840 --> 00:01:13,840 Speaker 1: released their own Medicare for All Act of twenty nineteen, 20 00:01:14,160 --> 00:01:18,440 Speaker 1: which goes even farther than Sanders original seventeen bill. Not 21 00:01:18,560 --> 00:01:21,800 Speaker 1: only would the Giapaul proposal do away entirely with private 22 00:01:21,800 --> 00:01:24,880 Speaker 1: health insurance and require absolutely no premiums or co pays 23 00:01:24,920 --> 00:01:27,880 Speaker 1: of any kind, it would significantly extend Medicare to cover 24 00:01:27,959 --> 00:01:32,920 Speaker 1: comprehensive dental, vision and long term care. Giapaul wrote in 25 00:01:32,959 --> 00:01:36,119 Speaker 1: a statement, our bill will cover everyone, not just those 26 00:01:36,160 --> 00:01:39,360 Speaker 1: who are fortunate enough to have employer sponsored insurance, not 27 00:01:39,440 --> 00:01:42,959 Speaker 1: just children, not just seniors, not just those who are healthy. 28 00:01:43,120 --> 00:01:45,640 Speaker 1: It's time to ensure that healthcare is a right and 29 00:01:45,720 --> 00:01:48,880 Speaker 1: not a privilege, guaranteed to every single person in our country. 30 00:01:49,120 --> 00:01:53,520 Speaker 1: It is time for Medicare for All. Let's break down 31 00:01:53,520 --> 00:01:57,440 Speaker 1: what that might entail. First, some history. Medicare was created 32 00:01:57,440 --> 00:02:00,000 Speaker 1: in nineteen sixty five as a safety net health insurance 33 00:02:00,080 --> 00:02:04,040 Speaker 1: program for older Americans. All Americans over sixty five years 34 00:02:04,080 --> 00:02:07,440 Speaker 1: of age qualify for Medicare health coverage regardless of pre 35 00:02:07,480 --> 00:02:10,760 Speaker 1: existing conditions, and Medicare covers a significant portion of the 36 00:02:10,800 --> 00:02:15,400 Speaker 1: costs of doctor's office visits. Treatments and surgeries, plus prescription medications. 37 00:02:15,440 --> 00:02:18,640 Speaker 1: Although Medicare recipients also pay annual premiums and out of 38 00:02:18,639 --> 00:02:23,480 Speaker 1: pocket costs, Medicare for All proposals, like gypaulse would make 39 00:02:23,560 --> 00:02:27,920 Speaker 1: three monumental changes to the current Medicare system. First, there 40 00:02:27,919 --> 00:02:31,920 Speaker 1: would be absolutely no age limit. Every American from newborns 41 00:02:31,919 --> 00:02:34,960 Speaker 1: to centenarians would be covered by the same government funded 42 00:02:34,960 --> 00:02:39,240 Speaker 1: health insurance. Second, private health insurance carriers would be barred 43 00:02:39,240 --> 00:02:42,919 Speaker 1: from offering plans to compete with Medicare for All. Third, 44 00:02:43,120 --> 00:02:46,800 Speaker 1: patients would pay absolutely nothing, no premiums, deductibles, co pays, 45 00:02:46,919 --> 00:02:50,679 Speaker 1: or coinsurance for all covered health care services, which under 46 00:02:50,720 --> 00:02:53,320 Speaker 1: the Jipol bill include just about everything under the sun, 47 00:02:53,600 --> 00:02:57,600 Speaker 1: including expensive long term care insurance to cover nursing homestays. 48 00:02:59,120 --> 00:03:01,600 Speaker 1: All of this potential lee spells doom for the one 49 00:03:01,639 --> 00:03:06,400 Speaker 1: point to twillion dollar private health insurance industry. We spoke 50 00:03:06,440 --> 00:03:09,400 Speaker 1: with one Care and Politz, who studies healthcare reform and 51 00:03:09,440 --> 00:03:12,560 Speaker 1: private health insurance for the Henry J. Kaiser Family Foundation, 52 00:03:12,880 --> 00:03:16,280 Speaker 1: a nonpartisan nonprofit group that analyzes major health care issues 53 00:03:16,280 --> 00:03:19,960 Speaker 1: fasic America and beyond. She jokes that Medicare for All 54 00:03:20,000 --> 00:03:23,680 Speaker 1: would even put her out of business. Pault said, the 55 00:03:23,720 --> 00:03:26,920 Speaker 1: Medicare for All proposals that have been discussed are very comprehensive. 56 00:03:27,000 --> 00:03:29,360 Speaker 1: Would cover everything you're used to having covered in private 57 00:03:29,360 --> 00:03:33,600 Speaker 1: health insurance today, plus dental, vision, hearing, long term care, nursing, 58 00:03:33,600 --> 00:03:36,000 Speaker 1: home care. You would get this red, white and blue 59 00:03:36,040 --> 00:03:38,320 Speaker 1: Medicare for All card show that when you go to 60 00:03:38,360 --> 00:03:42,760 Speaker 1: the doctor and you'd get taken care of. Simple. Okay. 61 00:03:42,880 --> 00:03:45,600 Speaker 1: So that's the basics of what Medicare for All could be. 62 00:03:46,360 --> 00:03:51,080 Speaker 1: What wouldn't it be. Medicare for All is not socialized 63 00:03:51,160 --> 00:03:55,200 Speaker 1: medicine like the United Kingdom's National Health Service. Under that system, 64 00:03:55,360 --> 00:03:57,720 Speaker 1: the government is not only the soul insurer, but it 65 00:03:57,800 --> 00:04:01,280 Speaker 1: also runs most of the medical clinics and hospitals. That's 66 00:04:01,320 --> 00:04:03,640 Speaker 1: not the case under any of the proposed Medicare for 67 00:04:03,680 --> 00:04:07,680 Speaker 1: All plans, which more closely resemble Canada's healthcare system, also 68 00:04:07,760 --> 00:04:12,360 Speaker 1: called Medicare. Doctors and hospitals would remain private businesses, but 69 00:04:12,440 --> 00:04:15,920 Speaker 1: all insurance coverage and therefore all reimbursements paid to doctors 70 00:04:15,920 --> 00:04:21,080 Speaker 1: and hospitals would be provided through Medicare A. Canada's healthcare system, 71 00:04:21,160 --> 00:04:24,159 Speaker 1: by the way, doesn't cover vision, dental, prescription, drugs or 72 00:04:24,240 --> 00:04:28,920 Speaker 1: long term care. Those are covered by private insurance, which 73 00:04:29,000 --> 00:04:32,720 Speaker 1: brings us to an important question. The important question who 74 00:04:32,760 --> 00:04:36,680 Speaker 1: would be paying for all this? Medicare for All is 75 00:04:36,720 --> 00:04:40,440 Speaker 1: also what's known as a single payer healthcare system. Technically, 76 00:04:40,480 --> 00:04:43,320 Speaker 1: the single payer will be the federal government. But where 77 00:04:43,360 --> 00:04:46,920 Speaker 1: will the government get its money? New taxes, of course, 78 00:04:47,200 --> 00:04:50,520 Speaker 1: not only income taxes, but also payroll taxes, corporate taxes, 79 00:04:50,560 --> 00:04:56,880 Speaker 1: excise taxes, et cetera. In Medicare alone cost American taxpayers 80 00:04:56,920 --> 00:05:00,240 Speaker 1: five and nineties seven billion dollars, or nearly five teen 81 00:05:00,240 --> 00:05:04,040 Speaker 1: percent of the entire four trillion dollar federal budget. The 82 00:05:04,040 --> 00:05:07,559 Speaker 1: projected cost of Sanders seventeen Medicare for All bill, which 83 00:05:07,600 --> 00:05:10,200 Speaker 1: did not include expensive add ons like long term care, 84 00:05:10,640 --> 00:05:15,080 Speaker 1: is thirty two trillion dollars over ten years. So, although 85 00:05:15,080 --> 00:05:17,400 Speaker 1: it's important to note the costs could even out over 86 00:05:17,440 --> 00:05:20,160 Speaker 1: the long term, in the short term that's about six 87 00:05:20,240 --> 00:05:24,680 Speaker 1: times what Medicare currently costs US per year. As Paul 88 00:05:24,680 --> 00:05:27,800 Speaker 1: It said, quote, that's a lot of money. Right now, 89 00:05:27,960 --> 00:05:30,720 Speaker 1: the federal government and states together are paying almost half 90 00:05:30,720 --> 00:05:33,559 Speaker 1: of the nation's healthcare bill. But if we stop paying 91 00:05:33,600 --> 00:05:36,159 Speaker 1: premiums and deductibles and co pays, there would have to 92 00:05:36,160 --> 00:05:39,480 Speaker 1: be a new way to raise revenue. When Americans learned 93 00:05:39,520 --> 00:05:41,600 Speaker 1: that the switch to Medicare for all would almost certainly 94 00:05:41,600 --> 00:05:44,839 Speaker 1: mean higher income taxes, support for the national healthcare concept 95 00:05:44,960 --> 00:05:49,599 Speaker 1: drops by. But while the exorbitant cost of Medicare for 96 00:05:49,640 --> 00:05:52,279 Speaker 1: all is a favorite talking point of its critics, the 97 00:05:52,360 --> 00:05:56,320 Speaker 1: numbers are deceiving. Americans will certainly pay more in taxes 98 00:05:56,360 --> 00:05:58,919 Speaker 1: under such a plan, but they will pay absolutely nothing 99 00:05:58,920 --> 00:06:03,520 Speaker 1: in premiums and other out of pocket healthcare costs. Paul said, 100 00:06:03,760 --> 00:06:07,080 Speaker 1: American households and the government combined are currently spending three 101 00:06:07,120 --> 00:06:10,160 Speaker 1: point five trillion dollars a year on healthcare, more than 102 00:06:10,160 --> 00:06:13,520 Speaker 1: any other country on the planet. When you multiply that 103 00:06:13,560 --> 00:06:17,119 Speaker 1: out by ten years, it's thirty five trillion dollars greater 104 00:06:17,160 --> 00:06:19,600 Speaker 1: than the cost of Sanders Medicare for all proposal by 105 00:06:19,600 --> 00:06:22,479 Speaker 1: a full three trillion. So a switch to a single 106 00:06:22,520 --> 00:06:27,640 Speaker 1: payer system could actually save money overall, but money aside. 107 00:06:27,880 --> 00:06:32,880 Speaker 1: Would Medicare for all mean worse healthcare. There's no doubt 108 00:06:32,880 --> 00:06:35,200 Speaker 1: that a massive overhaul of the U S healthcare system 109 00:06:35,279 --> 00:06:39,040 Speaker 1: like Medicare for all would be hugely disruptive. Most private 110 00:06:39,040 --> 00:06:42,600 Speaker 1: insurers would go out of business, pharmaceutical companies would lose 111 00:06:42,640 --> 00:06:46,480 Speaker 1: profits as drug prices were capped, and since Medicare typically 112 00:06:46,520 --> 00:06:50,160 Speaker 1: reimburses doctors and hospitals at lower rates than private insurers, 113 00:06:50,200 --> 00:06:53,320 Speaker 1: there would be wins and losses for private medical practices. 114 00:06:54,640 --> 00:06:57,479 Speaker 1: That said, there's no indication that switching to a Medicare 115 00:06:57,480 --> 00:07:00,320 Speaker 1: for All system would result in fewer covered treat mints. 116 00:07:00,680 --> 00:07:04,680 Speaker 1: Jiapaul's proposal promises the opposite, and neither should the new 117 00:07:04,720 --> 00:07:08,040 Speaker 1: insurance concept result in long ways for life saving procedures 118 00:07:08,040 --> 00:07:12,480 Speaker 1: and medications. Paul It said, we don't currently have that 119 00:07:12,560 --> 00:07:15,360 Speaker 1: in Medicare. You don't see senior citizens queuing up for 120 00:07:15,360 --> 00:07:18,720 Speaker 1: doctor's appointments and prescriptions. It's all quick and easy. The 121 00:07:18,800 --> 00:07:21,360 Speaker 1: key question is what will those payment rates be for 122 00:07:21,520 --> 00:07:25,280 Speaker 1: doctors and hospitals. The Giapaul bill doesn't really say. That's 123 00:07:25,280 --> 00:07:29,480 Speaker 1: still a key question to be addressed and debated. Currently, 124 00:07:29,600 --> 00:07:32,680 Speaker 1: a growing number of doctors don't accept Medicare patients because 125 00:07:32,720 --> 00:07:35,240 Speaker 1: of the low reimbursement rates and large amount of paperwork 126 00:07:35,280 --> 00:07:38,800 Speaker 1: required for reimbursement. The Medicare for All Act of twenty 127 00:07:38,880 --> 00:07:41,720 Speaker 1: nineteen does allow doctors and patients to opt out of 128 00:07:41,720 --> 00:07:44,360 Speaker 1: the single payer system and simply pay in cash for 129 00:07:44,480 --> 00:07:48,120 Speaker 1: medical services, and giapaulse Plan is only one type of 130 00:07:48,200 --> 00:07:52,040 Speaker 1: universal health coverage being proposed in Congress. Other versions include 131 00:07:52,080 --> 00:07:54,640 Speaker 1: keeping the current system but adding a public option based 132 00:07:54,640 --> 00:07:57,280 Speaker 1: on Medicare, as well as allowing older people not yet 133 00:07:57,280 --> 00:08:01,040 Speaker 1: eligible for Medicare to buy into the system. All of 134 00:08:01,080 --> 00:08:02,960 Speaker 1: that is a primer for now. We will keep you 135 00:08:03,080 --> 00:08:11,080 Speaker 1: updated as developments occur. Today's episode was written by Day 136 00:08:11,080 --> 00:08:13,520 Speaker 1: Bruise and produced by Tyler Clang for iHeartMedia and How 137 00:08:13,560 --> 00:08:15,880 Speaker 1: Stuff Works. For more on this and lots of other 138 00:08:15,920 --> 00:08:30,520 Speaker 1: expansive topics, visit our home planet, how stuff Works dot com.