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A reminder to B-list Democratic candidates: The US has a bad health care system

AP Photo/Paul Sancya
Three men unfamiliar with Canada.
  • Tim Fernholz
By Tim Fernholz

Senior reporter

Published Last updated This article is more than 2 years old.

Radical, unworkable, fantastic, irresponsible: That’s how a handful of Democratic candidates assailed the Medicare for All plan proposed by the front-runners at last night’s debate.

Former congressman John Delaney, former Colorado governor John Hickenlooper and Montana governor Steve Bullock all sought to establish themselves as moderate alternatives to Vermont senator Bernie Sanders and Massachusetts senator Elizabeth Warren.

These critics cast Medicare for All as unworkable compared to the private insurance business. But analysis after analysis shows that citizens of similarly wealthy countries with single-payer systems pay less, and also get better outcomes. In other words, even with the Obamacare reforms that expanded access and slowed rising costs, the US system remains a bad deal.

Here’s a recent international comparison of health care spending (pdf) by the Commonwealth Fund:

Commonwealth Fund

Compare that to the raft of public health measures where the US system has worse outcomes: In comparable countries, alternative health systems have reduced mortality consistently, even as the US has actually seen worsening outcomes in recent years.

Peterson-Kaiser Health System Tracker

Delaney repeated his talking point that Sanders’ plan to reimburse health care providers at current Medicare levels would put hospitals out of business. A careful look at the issue suggests the claim is false: Hospitals that serve more uninsured people are likely to gain revenues, while those that rely on private insurance may see losses.

The Medicare for All naysayers also focused on the political perils candidates might face if they propose “taking away” employer-sponsored health care. Proponents of single-payer say that the benefits of public health insurance will be as good as existing plans, and that rising taxes will be negated by falling premiums.

But whether or not politicians can sell this change to Americans is a different question from whether it is possible. Sanders’ recent trip to Canada with insulin-buying patients was a campaign stunt, sure, but American politicians literally can’t afford to pretend the rest of the world’s approach to health care doesn’t exist.

📬 A periodic dispatch from the annual session of the United Nations General Assembly in NYC.

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