The cost of Medicare for all

By CHARLES DUNAGIN,

A Virginia public policy center estimated Monday that the “Medicaid for all” health-care plan proposed by U.S. Sen. Bernie Sanders would add $32 trillion to government spending over a decade.

That’s a massive amount of money, which the study’s author said would require huge tax increases to pay for, as the proposal would replace private insurance coverage and out-of-pocket medical expenses that patients pay.

However, that $32 trillion figure, which is an estimate for 2022-31, is not a deal-breaker. Over a decade, the average increase in government spending would be $3.2 trillion. In 2016, the federal government spent $1.24 trillion in the Medicare and Medicaid programs alone. Adding those two figures implies total government health care spending of at least $4.4 trillion a year, although both Sanders and the author of the study say significant savings in areas like prescription drugs  and medical administration will reduce Medicare for all costs.

Total medical spending was $3.3 trillion in 2016. That figure has risen 4 to 5 percent annually for two decades. If that rate continues, you get to $4.4 trillion in just seven years.

Yet Sanders seemed offended. He criticized the report’s producer, the Mercatus Center at George Mason University, saying it’s biased because it receives funding from the Koch brothers, a pair of influential conservatives.

Sanders added that if the government of every other developed country can guarantee health care for all, and achieve better health outcomes while spending less per person than the United States currently does, there is no reason such a program wouldn’t work here.

It’s hard to argue with that, although it would be interesting to see statistics on health outcomes in other countries to verify that they’re better than in the U.S. It may be that Americans are willing to pay more for medical care, whether through private coverage or government assistance, to avoid long waits to see doctors and to get the best treatments available.

It would help if Sanders, who shot to prominence on this issue in his 2016 presidential campaign, had his own analysis of what Medicare for all would cost taxpayers. Surprisingly, he does not — which means either he doesn’t think the extra government expense is important or he doesn’t think his idea stands a chance of becoming law.

In the short term, advocacy of Medicare for all is likely to increase. It is well documented that Americans like free stuff, and government medical care may turn out to be the biggest goody of them all.

If anyone is listening, though, it is worth noting that many government programs exceed their original cost estimates. This means that $32 trillion projection may be low.

Further, the government already has a track record on medical care, and it does not give cause for optimism. The Veterans Administration has struggled for years, for example. How would nationwide Medicare do any better?