Bernie Sanders Single-Payer Healthcare plan

wanna go out for ice cream? (inside a warm store, of course)

Obama in 2008 believed Republicans could be reasoned out of their irrationality. Sanders today believes they can be swept aside when the people rise up and depose their corporate paymasters. Clinton, then as now, promises to grind away at them in a trench war that has gone on for decades and for which there is no end in sight.

the Democratic congress as a closing window

Make no mistake, the Trump budget is hardly senior-friendly. He’d freeze or reduce spending for many federal senior service programs—continuing a trend that has gone on for more than a decade. And his proposed cuts to Medicaid could hurt family caregivers of parents or younger relatives with disabilities. But the Medicare cuts? There is much less there than meets the eye.

The Committee for a Responsible Federal Budget does a nice job walking through the math, and concludes that the net reduction in Medicare spending would be between $515 billion and $575 billion, not $845 billion. The White House projects that total Medicare spending over the next decade will top $10 trillion.

The company — which along with Eli Lilly and Novo Nordisk control nearly the entire U.S. insulin market — has further prevented insulin competition in America by pursuing litigation against two companies that want to offer cheaper biosimilars. (Biosimilars are the generic-like equivalents for complex molecules such as insulin and other biologic drugs.) Like overpatenting, this tactic works against the millions of Americans who must take insulin.

Saying he wants to end the “international embarrassment” of the U.S. being the only wealthy country that doesn’t provide universal health coverage, Sen. Bernie Sanders (I-VT) released a new version of his Medicare for All plan Wednesday. The bill’s 14 co-sponsors include Sanders’ fellow presidential candidates Elizabeth Warren (D-MA), Cory Booker (D-NJ), Kamala Harris (D-CA) and Kirsten Gillibrand (D-NY).

The revamped health care proposal is similar to the plan Sanders released in 2017, though it adds a long-term care benefit for Americans with disabilities. Overall, the bill would transform the $3.5 trillion health U.S. care system by replacing private health insurance with a single-payer system that covers primary and preventive care, hospital stays, mental health, dental and vision services, and prescription drugs for all Americans.

“It is not a radical idea to say that in the United States, every American who goes to a doctor should be able to afford the prescription drug he or she needs,” Sanders said. “If every major country on earth can guarantee health care to all and achieve better health outcomes, while spending substantially less per capita than we do, it is absurd for anyone to suggest that the United States of America cannot do the same.”

Vox’s Sarah Kliff said Sanders’ plan “includes an exceptionally generous benefit package” compared the country’s peers, including Canada, which does not cover vision, dental or prescription drugs.

Here are some key features of Sanders’ plan:

Medicare for All would be phased in over four years, with the qualifying age falling by a decade each year.

In the interim, Americans would be given the option to buy into a publicly run health care program.

The Indian Health Service and the Department of Veterans Affairs would remain independent for at least 10 years.

There would be no premiums, deductibles or co-pays for health services, excluding prescriptions drugs.

Enrollees would face a $200 maximum co-pay for prescription drugs annually.

Medicare would be required to negotiate drug prices and create a drug formulary listing the medications that may be prescribed.

Providers would be paid under the existing Medicare fee schedule.

The program would be part of a new Universal Medicare Agency within the Health and Human Services Department.

Private insurers could provide only benefits not covered by the government, such as elective surgery.

Sanders left the big question – how to pay for his proposal – largely unanswered, although he did provide a list of suggestions, including a 4% tax on employees (exempting the first $29,000 in income for a family of four), a 7.5% tax on employers (exempting the first $2 million in payroll) and a new tax on “extreme wealth.”

The Trump campaign criticized the plan as a “government takeover of health care” and said that “free market policies” would be a better alternative. “So-called ‘Medicare for All’ means private insurance for none, kicking 180 million Americans off of their current plans,” said Kayleigh McEnany, spokeswoman for Trump’s re-election campaign. “‘Medicare for all’ is a euphemism for government takeover of healthcare, and it would increase wait times, eliminate choice, and raise taxes.”

The bottom line: The 2020 presidential election could turn on the question of health care, and with another iteration of his Medicare-for-All plan, Sanders has underscored his position as the leading progressive in the race for the Democratic nomination. The details of the plan may matter less than the simple fact that the two main U.S. political parties will likely offer voters a clear alternative on this defining issue.