Sanders Health Plan Would Be More Generous Than Medicare

Democratic presidential candidate Bernie Sanders says his plan for a government-run health care system from cradle to grave is like Medicare for all
Sanders Health Plan Would Be More Generous Than Medicare
Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) outlines his plan to reform the U.S. financial sector in New York City on Jan. 5, 2016. Andrew Burton/Getty Images
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WASHINGTON—Democratic presidential candidate Bernie Sanders says his plan for a government-run health care system from cradle to grave is like Medicare for all.

But with full coverage for long-term care, most dental care included, no deductibles and zero copays, the Sanders plan is considerably more generous. Think of it as Medicare on growth hormones.

The scope of Sanders’ plan and its lack of detail have raised questions about its seriousness. Some health care experts see it mainly as a political document to distinguish Sanders’ ideas from Hillary Clinton’s approach.

Sanders runs the risk of looking “like he is living in a fantasy land, for putting forward an idea he can’t possibly deliver during his term in office,” said Drew Altman, president of the nonpartisan Kaiser Family Foundation.

Last Sunday, the Vermont senator released an 8-page outline of his “Medicare For All” plan, an idea he’s long advocated. The campaign estimates it would cost $1.38 trillion a year, paid for with new taxes that would take the place of private health insurance premiums. Here’s a look at some things Sanders left out of the outline:

Not Like Medicare

Medicare doesn’t cover long-term care, not to mention dentures, and seniors face deductibles and cost-sharing when they go to the doctor. Many buy an additional private insurance policy to cover Medicare gaps. “BernieCare,” as it is being called, would be above and beyond.

“It’s not Medicare for all,” said Republican economist Gail Wilensky, who ran Medicare under former President George H.W. Bush. “It’s nonsense to talk about it as if it were. You’re just giving people a comfort level that’s inappropriate.”

Even if there are important differences with Medicare, supporters of Sanders’ plan say it’s similar in the sense that virtually all seniors are covered under that program. Sanders’ approach is also called ’single-payer,' because the government would take over the health care system, currently about one-sixth of the economy.

Path to Savings Unclear

Sanders says his plan will cost $6 trillion less over 10 years than the current health care system. But his path to savings is unclear.

For starters, a government takeover of health care financing would eliminate all signals about value that private payers generate. A few years ago, it became obvious Medicare had a problem paying for home medical equipment when government officials could find the same items on the Internet for much less.

“How do you learn about the value of things if you don’t have an accompanying private sector?” asked economist Paul Hughes-Cromwick of the Altarum Institute, a Michigan-based nonprofit that does research and consulting. “All of a sudden you wouldn’t have an empirical basis on which to build.”

Altman, the Kaiser foundation president, said it’s possible a single-payer system could produce substantial savings, for example by eliminating administrative duplication among insurers.