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senate Bill S. 1804

Medicare for All: Should the U.S. Adopt a Single-Payer Healthcare System?

Argument in favor

A single-payer healthcare system is the best way to ensure that all Americans have access to the healthcare they need without having to worry about paying for health insurance. It would be more efficient than the status quo at controlling costs and produce better outcomes while bringing the U.S. in line with other developed nations with single-payer systems.

Nathan's Opinion
···
09/15/2017
I urge all American lawmakers to SUPPORT this bill. I am an Ohio voter and attorney who resides abroad in Taiwan. I'd like to share my experience with the wonderfully efficient nationalized health insurance system here. About a year ago I needed a hernia surgery. They scheduled the operation for the day following my first walk-in visit to the hospital, which required only a 45-minute wait. All the staff were friendly and professional, spoke good English, and explained the operation and recovery treatment very well. The hospital even employs a liaison for foreigner patients requiring translation or other personalized assistance. In total the procedure cost me around USD $30 out-of-pocket, plus USD $200 for 2 nights of recovery in a more private hospital bed (I opted not to stay in the free, larger shared hospital room). Premiums for foreign residents are about USD $25 per month, which are generally paid by employers. Copays for normal doctor's visits are usually nominal, between $2 and $6 US . There is no justifiable reason to oppose implementing this kind of system in the US. With deepest respect, Nathan Snyder, esq.
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Richard's Opinion
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11/02/2018
To everyone making comments about the VA, can you even imagine how amazing those places would be for our veterans if Republican governments would actually fund them instead of running them into the ground! Think of all the people we could save!
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Cindy's Opinion
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11/02/2018
It becomes increasingly clear every single day that For Profit healthcare is a disaster. Even with insurance I am one health crisis away from catastrophe. It is far past time to try something new.
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Argument opposed

A single-payer healthcare system would concentrate too much power in the federal government, creating inefficiencies in the healthcare market. It would reduce physicians’ pay and consequently the quality of care they provide, and lead to long wait lists for patients to see their doctor — all while imposing a massive tax increase on middle-class Americans.

Dawn's Opinion
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11/02/2018
I've seen too many problems when you don't have choices. The VA is a prime example. The VA makes people wait too long for things like mental health care which in turn creates more suicide and more death overall. It's not worth the death toll
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SneakyPete's Opinion
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11/02/2018
👎🏻👎🏻 NO WAY DO WE NEED A SINGLE PAYER SYSTEM 👎🏻👎🏻 A single-payer healthcare system would concentrate too much power in the federal government, creating inefficiencies in the healthcare market. It would reduce physicians’ pay and consequently the quality of care they provide, and lead to long wait lists for patients to see their doctor — all while imposing a massive tax increase on middle-class Americans. 11*2*18 ..... SneakyPete .....
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John's Opinion
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11/02/2018
I’m a NO until I see the details of the new system and especially how it would be paid for. Allot to consider. There are allot of unintended consequences of making big changes and one may be the overall quality of care and another the development of new and important drugs. Without profit incentives there will be far less focus on developing new procedures, equipment, etc. We need to be careful how we deal with these mega changes as things can easily get worse rather than better.
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The house has not voted
  • The senate has not voted
      senate Committees
      Committee on Finance
    IntroducedSeptember 13th, 2017

What is Senate Bill S. 1804?

This bill — the Medicare for All Act — would provide individuals residing in the U.S. with healthcare for all “medically necessary care” under a single-payer healthcare system. Medically necessary care would include primary care, prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care. Patients would be able to choose to receive care from any qualified institution, agency, or individual.

Only public or nonprofit institutions would be allowed to participate. Health insurers would be prohibited from selling insurance that duplicates the benefits provided under this bill, but could sell benefits that aren’t medically necessary such as cosmetic surgery.

People currently enrolled in federal healthcare programs through the Dept. of Veterans Affairs (VA) or the Indian Health Service would maintain their current medical benefits and services.

While this bill’s sponsor intends to raise taxes to cover the cost of this program, those provisions aren’t included within this legislation. Information about their proposed taxes can be found below.

Impact

American healthcare consumers and taxpayers; healthcare providers; insurers; and the federal government.

Cost of Senate Bill S. 1804

A CBO cost estimate is unavailable.

More Information

In-Depth: Sen. Bernie Sanders (I-VT) introduced this bill to create a single-payer healthcare system:

“Today, we begin the long and difficult struggle to end the international embarrassment of the Untied States being the only major country on earth not to guarantee health care to all its people. At a time when millions of Americans do not have access to affordable health care, the Republicans, funded by the Koch brothers, are trying to take away health care from up to 32 million more. We have a better idea: guarantee health care to all people as a right, not a privilege, through a Medicare for All, single-payer health care program.”

Sanders’ bill itself doesn’t contain any tax increases, though he intends to impose new taxes and raise existing taxes to cover the cost of Medicare for All (which he projects will cost $1.38 trillion per year), including:

  • A 6.2% income-based healthcare premium paid by employers.

  • A 2.2% income-based premium paid by households.

  • Raising income tax brackets back to pre-Tax Cuts and Jobs Act levels and adding new brackets (37% between $250k-$500k, 43% between $500k-$2m, 48% between $2m-$10m, and 52% above $10m).

  • Taxing capital gains and dividends at the same rates as regular income.

  • Reducing tax deductions for households earning more than $250k.

  • Increasing the estate tax (aka the death tax) and reducing the exemption threshold.

  • An estimated $310 billion would come from funding that otherwise would’ve been spent on other government healthcare programs, such as the original Medicare.

Detractors argue that a single-payer healthcare system would cost taxpayers far more than Sanders projects and have a detrimental impact on the economy. An analysis by the Mercatus Center found that Sanders’ Medicare for All would cost at least $32.6 trillion over 10 years — or roughly $3.26 trillion per year — while the government’s spending on healthcare would near 13% in 2031 and continue to grow thereafter. 

Additionally, the study’s author said those “estimates are conservative because they assume the legislation achieves its sponsors’ goals of dramatically reducing payments to health providers, in addition to substantially reducing drug prices and administrative costs.” They add:

“A doubling of all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan… M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent relative to private insurance rates, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availability of existing health services, the quality of such services, or both.”

This legislation has the support of 16 Democratic cosponsors.


Media:

Summary by Eric Revell

(Photo Credit: iStock.com / zimmytws)

AKA

Medicare for All Act of 2017

Official Title

A bill to establish a Medicare-for-all health insurance program.

    I urge all American lawmakers to SUPPORT this bill. I am an Ohio voter and attorney who resides abroad in Taiwan. I'd like to share my experience with the wonderfully efficient nationalized health insurance system here. About a year ago I needed a hernia surgery. They scheduled the operation for the day following my first walk-in visit to the hospital, which required only a 45-minute wait. All the staff were friendly and professional, spoke good English, and explained the operation and recovery treatment very well. The hospital even employs a liaison for foreigner patients requiring translation or other personalized assistance. In total the procedure cost me around USD $30 out-of-pocket, plus USD $200 for 2 nights of recovery in a more private hospital bed (I opted not to stay in the free, larger shared hospital room). Premiums for foreign residents are about USD $25 per month, which are generally paid by employers. Copays for normal doctor's visits are usually nominal, between $2 and $6 US . There is no justifiable reason to oppose implementing this kind of system in the US. With deepest respect, Nathan Snyder, esq.
    Like (405)
    Follow
    Share
    I've seen too many problems when you don't have choices. The VA is a prime example. The VA makes people wait too long for things like mental health care which in turn creates more suicide and more death overall. It's not worth the death toll
    Like (53)
    Follow
    Share
    To everyone making comments about the VA, can you even imagine how amazing those places would be for our veterans if Republican governments would actually fund them instead of running them into the ground! Think of all the people we could save!
    Like (229)
    Follow
    Share
    It becomes increasingly clear every single day that For Profit healthcare is a disaster. Even with insurance I am one health crisis away from catastrophe. It is far past time to try something new.
    Like (215)
    Follow
    Share
    Lets join other enlightened democratic nations who have determined to help their citizens to live in good health. And thereby, as a healthy citizen, contribute to the ongoing prosperity of their freedom loving country. Just think how easily we pay for and support our Defense, no questions asked. And then witness uncomely Waste-again No Questions asked. We CAN afford support for Single Payer Health Insurance. A healthy nation can work and contribute our due share in support of our own Country. What do you think?
    Like (129)
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    Health care is a basic right and need of all individuals. I believe a single payer system is the only equitable path to take.
    Like (105)
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    A single-payer healthcare system would improve quality of care for millions of Americans, while also saving the entire country money in terms of healthcare costs. It's a more efficient system that has had wonderful outcomes for other developed countries and it is past time the US joined them.
    Like (86)
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    YES YES YES!!! The for-profit model is a ABJECT failure. Makings money of of the sick is immoral and denying care to the sick is too! The “heath” insurers really just want all your money and then to avoid helping you when your sick. All for GREED!!! Universal single payer healthcare system NOW!!!! I have experienced universal healthcare in two different countries (Japan and Australia) and when you come back to the USA you realize THIS FOR PROFIT SYSTEM IS SHITTY! It’s no wonder the rest of the civilized world looks at us sideways and wonder how we can bear to let people go bankrupt and die!!!
    Like (75)
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    Absolutely necessary. It should be a right for all citizens. We’re not in the Middle Ages any more.
    Like (64)
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    I understand that this bill could increase taxes. But that will be offset by the reduction in healthcare costs paid by individuals and businesses. Businesses will be able to create more jobs with the extra money. Individuals will no longer be shackled to abusive employers because they can't afford to lose health care coverage. I think the benefits far outweigh the risks.
    Like (63)
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    Make this happen, and do it yesterday.
    Like (48)
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    Please adopt single payer! I haven’t seen a doctor since my kid was born, we both need a dentist, and I know an older lady that just found out she has stage 3 cancer. She can’t afford treatment so she just resigned her self to death... this is madness that only more privileged people can get the health care they need and the rest of work ourselves to the bone or die without it.
    Like (48)
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    👎🏻👎🏻 NO WAY DO WE NEED A SINGLE PAYER SYSTEM 👎🏻👎🏻 A single-payer healthcare system would concentrate too much power in the federal government, creating inefficiencies in the healthcare market. It would reduce physicians’ pay and consequently the quality of care they provide, and lead to long wait lists for patients to see their doctor — all while imposing a massive tax increase on middle-class Americans. 11*2*18 ..... SneakyPete .....
    Like (46)
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    Healthcare should not bankrupt people
    Like (44)
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    Q: Why is the average lifespan declining in the USA? A: Our healthcare industry is guided by profit motive rather than providing care and treatment.
    Like (42)
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    It’s about fucking time. Privatized healthcare with no public option is the crime of the century.
    Like (41)
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    Relying on insurance through employment, forced to change plans when changing jobs, or having to spend a fortune for direct coverage is inhumane. The for-profit system is killing people and must be eliminated.
    Like (38)
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    Judging by published assessments of the happiness of first world countries around the world, the ones who rate highest are those with high taxes that fund universal health care and education at all levels. Could it be that they experience less stress and anxiety over these basics for a healthy, productive life?
    Like (36)
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    Hell yeah! It’s a no brained and peace of mind not to worry about paying those insane costs. If everyone pays into a system based on what you can afford then the overall rates should be lower. health care should be equitable for all period!
    Like (32)
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    It’s the only thing that makes any sense ! Unless the GOP plan is for Americans to be able to afford healthcare & nothing else ?
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