Speaker 1: Welcome to brain Stuff from how Stuff Works, Hey, brain Stuff,
Speaker 1: Lauren vogelbam here. In the American presidential race, Senator Bernie
Speaker 1: Sanders was the first candidate to float the idea of
Speaker 1: Medicare for All, a massive expansion of the popular government
Speaker 1: funded health program to cover all Americans, not just those
Speaker 1: sixty five years of age and older. While hailed by
Speaker 1: Sanders progressive supporters, the proposal failed to gain traction with
Speaker 1: mainstream Democratic voters and was ridiculed as a wildly expensive
Speaker 1: and even socialist idea by Republican critics. The crowded field
Speaker 1: of Democratic presidential hopefuls has now swelled to twelve official candidates,
Speaker 1: including Sanders, and Medicare for All is now being embraced
Speaker 1: by a larger swath of politicians and voters alike. According
Speaker 1: to recent polls, fifty percent of Americans, including of Republicans,
Speaker 1: now support the creation of some kind of national health plan,
Speaker 1: and Sanders is no longer the only congress person trying
Speaker 1: to pass comprehensive Medicare for all legislation. In February of
Speaker 1: twenty nineteen, Representative Promelagia Paul, a Democrat in Washington State,
Speaker 1: and progressive colleagues in the U. S. House of Representatives
Speaker 1: released their own Medicare for All Act of twenty nineteen,
Speaker 1: which goes even farther than Sanders original seventeen bill. Not
Speaker 1: only would the Giapaul proposal do away entirely with private
Speaker 1: health insurance and require absolutely no premiums or co pays
Speaker 1: of any kind, it would significantly extend Medicare to cover
Speaker 1: comprehensive dental, vision and long term care. Giapaul wrote in
Speaker 1: a statement, our bill will cover everyone, not just those
Speaker 1: who are fortunate enough to have employer sponsored insurance, not
Speaker 1: just children, not just seniors, not just those who are healthy.
Speaker 1: It's time to ensure that healthcare is a right and
Speaker 1: not a privilege, guaranteed to every single person in our country.
Speaker 1: It is time for Medicare for All. Let's break down
Speaker 1: what that might entail. First, some history. Medicare was created
Speaker 1: in nineteen sixty five as a safety net health insurance
Speaker 1: program for older Americans. All Americans over sixty five years
Speaker 1: of age qualify for Medicare health coverage regardless of pre
Speaker 1: existing conditions, and Medicare covers a significant portion of the
Speaker 1: costs of doctor's office visits. Treatments and surgeries, plus prescription medications.
Speaker 1: Although Medicare recipients also pay annual premiums and out of
Speaker 1: pocket costs, Medicare for All proposals, like gypaulse would make
Speaker 1: three monumental changes to the current Medicare system. First, there
Speaker 1: would be absolutely no age limit. Every American from newborns
Speaker 1: to centenarians would be covered by the same government funded
Speaker 1: health insurance. Second, private health insurance carriers would be barred
Speaker 1: from offering plans to compete with Medicare for All. Third,
Speaker 1: patients would pay absolutely nothing, no premiums, deductibles, co pays,
Speaker 1: or coinsurance for all covered health care services, which under
Speaker 1: the Jipol bill include just about everything under the sun,
Speaker 1: including expensive long term care insurance to cover nursing homestays.
Speaker 1: All of this potential lee spells doom for the one
Speaker 1: point to twillion dollar private health insurance industry. We spoke
Speaker 1: with one Care and Politz, who studies healthcare reform and
Speaker 1: private health insurance for the Henry J. Kaiser Family Foundation,
Speaker 1: a nonpartisan nonprofit group that analyzes major health care issues
Speaker 1: fasic America and beyond. She jokes that Medicare for All
Speaker 1: would even put her out of business. Pault said, the
Speaker 1: Medicare for All proposals that have been discussed are very comprehensive.
Speaker 1: Would cover everything you're used to having covered in private
Speaker 1: health insurance today, plus dental, vision, hearing, long term care, nursing,
Speaker 1: home care. You would get this red, white and blue
Speaker 1: Medicare for All card show that when you go to
Speaker 1: the doctor and you'd get taken care of. Simple. Okay.
Speaker 1: So that's the basics of what Medicare for All could be.
Speaker 1: What wouldn't it be. Medicare for All is not socialized
Speaker 1: medicine like the United Kingdom's National Health Service. Under that system,
Speaker 1: the government is not only the soul insurer, but it
Speaker 1: also runs most of the medical clinics and hospitals. That's
Speaker 1: not the case under any of the proposed Medicare for
Speaker 1: All plans, which more closely resemble Canada's healthcare system, also
Speaker 1: called Medicare. Doctors and hospitals would remain private businesses, but
Speaker 1: all insurance coverage and therefore all reimbursements paid to doctors
Speaker 1: and hospitals would be provided through Medicare A. Canada's healthcare system,
Speaker 1: by the way, doesn't cover vision, dental, prescription, drugs or
Speaker 1: long term care. Those are covered by private insurance, which
Speaker 1: brings us to an important question. The important question who
Speaker 1: would be paying for all this? Medicare for All is
Speaker 1: also what's known as a single payer healthcare system. Technically,
Speaker 1: the single payer will be the federal government. But where
Speaker 1: will the government get its money? New taxes, of course,
Speaker 1: not only income taxes, but also payroll taxes, corporate taxes,
Speaker 1: excise taxes, et cetera. In Medicare alone cost American taxpayers
Speaker 1: five and nineties seven billion dollars, or nearly five teen
Speaker 1: percent of the entire four trillion dollar federal budget. The
Speaker 1: projected cost of Sanders seventeen Medicare for All bill, which
Speaker 1: did not include expensive add ons like long term care,
Speaker 1: is thirty two trillion dollars over ten years. So, although
Speaker 1: it's important to note the costs could even out over
Speaker 1: the long term, in the short term that's about six
Speaker 1: times what Medicare currently costs US per year. As Paul
Speaker 1: It said, quote, that's a lot of money. Right now,
Speaker 1: the federal government and states together are paying almost half
Speaker 1: of the nation's healthcare bill. But if we stop paying
Speaker 1: premiums and deductibles and co pays, there would have to
Speaker 1: be a new way to raise revenue. When Americans learned
Speaker 1: that the switch to Medicare for all would almost certainly
Speaker 1: mean higher income taxes, support for the national healthcare concept
Speaker 1: drops by. But while the exorbitant cost of Medicare for
Speaker 1: all is a favorite talking point of its critics, the
Speaker 1: numbers are deceiving. Americans will certainly pay more in taxes
Speaker 1: under such a plan, but they will pay absolutely nothing
Speaker 1: in premiums and other out of pocket healthcare costs. Paul said,
Speaker 1: American households and the government combined are currently spending three
Speaker 1: point five trillion dollars a year on healthcare, more than
Speaker 1: any other country on the planet. When you multiply that
Speaker 1: out by ten years, it's thirty five trillion dollars greater
Speaker 1: than the cost of Sanders Medicare for all proposal by
Speaker 1: a full three trillion. So a switch to a single
Speaker 1: payer system could actually save money overall, but money aside.
Speaker 1: Would Medicare for all mean worse healthcare. There's no doubt
Speaker 1: that a massive overhaul of the U S healthcare system
Speaker 1: like Medicare for all would be hugely disruptive. Most private
Speaker 1: insurers would go out of business, pharmaceutical companies would lose
Speaker 1: profits as drug prices were capped, and since Medicare typically
Speaker 1: reimburses doctors and hospitals at lower rates than private insurers,
Speaker 1: there would be wins and losses for private medical practices.
Speaker 1: That said, there's no indication that switching to a Medicare
Speaker 1: for All system would result in fewer covered treat mints.
Speaker 1: Jiapaul's proposal promises the opposite, and neither should the new
Speaker 1: insurance concept result in long ways for life saving procedures
Speaker 1: and medications. Paul It said, we don't currently have that
Speaker 1: in Medicare. You don't see senior citizens queuing up for
Speaker 1: doctor's appointments and prescriptions. It's all quick and easy. The
Speaker 1: key question is what will those payment rates be for
Speaker 1: doctors and hospitals. The Giapaul bill doesn't really say. That's
Speaker 1: still a key question to be addressed and debated. Currently,
Speaker 1: a growing number of doctors don't accept Medicare patients because
Speaker 1: of the low reimbursement rates and large amount of paperwork
Speaker 1: required for reimbursement. The Medicare for All Act of twenty
Speaker 1: nineteen does allow doctors and patients to opt out of
Speaker 1: the single payer system and simply pay in cash for
Speaker 1: medical services, and giapaulse Plan is only one type of
Speaker 1: universal health coverage being proposed in Congress. Other versions include
Speaker 1: keeping the current system but adding a public option based
Speaker 1: on Medicare, as well as allowing older people not yet
Speaker 1: eligible for Medicare to buy into the system. All of
Speaker 1: that is a primer for now. We will keep you
Speaker 1: updated as developments occur. Today's episode was written by Day
Speaker 1: Bruise and produced by Tyler Clang for iHeartMedia and How
Speaker 1: Stuff Works. For more on this and lots of other
Speaker 1: expansive topics, visit our home planet, how stuff Works dot com.