All along, Sanders has been right and his critics wrong

One repeatedly finds the complaint among establishment media analysts that Bernie Sanders keeps saying the same things over and over, whether it be at debates, rallies, in interviews, or whatever. It seems like they want a candidate to be like a stand-up comedian, coming up with fresh material every so often and get bored by the same material, however important it might be.

It is true that Sanders stays relentlessly on message that health care is a basic human right and that the current levels of wealth inequality are obscene and about his proposals such as Medicare For All, free college, higher minimum wages, massive tax increases on the wealthy and corporations, and so on. Whenever he is asked about things that he thinks are distractions from his core message, he perfunctorily responds to it before immediately pivoting to the issues that he thinks are important. We saw that intense focus again last night which is why the consensus seems to be that he emerged from the debate unscathed by the attacks launched against him by everyone, while Michael Bloomberg seemed to be taken completely off-guard by a similar blitz.

But we are beginning to see the payoff for that relentless focus because the ideas that he has been promoting, once viewed as hopelessly unrealistic, are now part of the mainstream discussion. A major sign of this is an article today in the Washington Post that points to a new paper in the prestigious British medical journal The Lancet that supports what Sanders has been saying all along, that there would be huge savings from his Medicare For All proposal, exactly as he describes it, and which his rivals simply refuse to acknowledge because it undercuts the reasons for their opposition to it.

In his full article, Christopher Ingraham summarizes what The Lancet paper says.

If you watched last night’s Democratic debate in Nevada you might have heard Sen. Bernie Sanders (I-Vt.) cite “a major study [that] came out from Yale epidemiologist[s] in Lancet, one of the leading medical publications in the world” in support of his Medicare-for-all plan. He was talking about this study, which was just published last week.

All told, the study concludes, a single-payer system akin to Sanders’s plan would slash the nation’s health-care expenditures by 13 percent, or more than $450 billion, each year. Not only that, “ensuring health-care access for all Americans would save more than 68,000 lives.”

In their breakdown of the numbers, researchers applied the existing Medicare fee structure across the entire health-care system and found it would save about $100 billion annually. Keep in mind that this basically represents less money going to doctors and hospitals, a major sticking point for medical groups that oppose Medicare-for-all. But those declines would be more than offset by several hundred billions in savings from reduced administrative and billing costs, Galvani and her colleagues estimate. The lack of patient billing under a Medicare-for-all system would also eliminate the roughly $35 billion a year that hospitals now pay to chase down unpaid bills.

The authors estimate an additional $219 billion in savings from reduced “administrative overhead” that the current decentralized system creates, including “the elimination of redundant corporate functions and the truncation of the top-heavy salary architecture of health insurance corporations.” For instance, the plan would replace dozens of health insurance executives, many of whom make well over $20 million a year, with one administrator paid the same salary as the current Secretary of Health and Human Services.

Finally, letting the national Medicare system negotiate pharmaceutical prices would save about $180 billion, according to the analysis.

Add it all up and here’s what you get: a new system that would cost about $3 trillion a year, instead of the $3.5 trillion that is being spent now.

Galvani and her colleagues estimate that to fully fund Medicare-for-all, the federal government would have to bring in an additional $773 billion a year relative to current revenue levels. They estimate this could be paid for, in part, by a 10 percent payroll tax that would bring in $436 billion annually. Given that current employer contributions to health care work out to about 12 percent of payrolls, this would still be about $100 billion less than what employers currently pay.
The remaining funding could be paid via a 5 percent tax on household income, yielding $375 billion a year. Again, with the elimination of employee contributions to existing health insurance premiums, the average household could expect to save well over $2,000 a year — and have no co-pays or deductibles to worry about.

Lack of a universal health-care system means that regular medical care is unaffordable for many Americans: fully one quarter of us have put off needed care because of cost. More than 8 million Americans have started a crowdfunding campaign to pay for medical care, with approximately 1 in 5 Americans contributing to somebody else’s medical crowdfunding campaign. Ninety percent of those campaigns will fail to raise the necessary funds.

By addressing these and other problems, Galvani and her colleagues estimate that regardless of cost, Medicare-for-all would save about 69,000 lives each year. They end their paper by calling on the medical community to answer “the moral imperative to provide health care as a human right, not dependent on employment or affluence.”

It is very significant that an establishment paper like the Washington Post, no friend of Sanders, published this piece because the political and media establishment tends to ignore any inconvenient truths that they themselves do not generate, even if they appear in reputable journals. Being able to point to this article makes it harder for the critics of his plan, which includes pretty much all his rivals for the nomination, plus the Democratic party, plus the entire political-media establishment and the health care industry, to ignore these facts.

Sanders has been saying the same things for nearly 30 years and they are finally beginning to sink into the public consciousness. That demonstrates the power of consistency, persistence, and the refusal to be distracted.


  1. Dunc says

    Then there’s the savings that would be generated by allowing people timely access to minor, routine, and preventative care, rather than waiting until things get so bad they have to go to the ER…

  2. Matt G says

    Will no one think of the poor bureaucrats working for the health insurance companies?? An article just came out claiming that Americans pay four times as much for healthcare overhead than Canadians do.

  3. jrkrideau says

    @2 Matt G.
    Clearly we are doing something wrong if we are spending that much. I blame Premier Ford. Those healthcare “reforms” look pretty dodgy.

  4. Canadian Steve says

    But if you just give Medicare to anyone then a whole bunch of people that didn’t deserve care (especially those brown people) might get medicare too! /sacasm. damn that is disgusting but unfotunately it seems many people really do think it

  5. lorn says

    Bernies conflicts are not mainly about programs and wider goals. His issues center on his long history and habit of vehement, often self defeating, reflexive opposition to any outside organizational structure and forming a personality cult around himself.

    He spent a long time as an Independent who caucused with the Democrats. As far as I know he is still technically an Independent, not a registered Democrat. He was invited in. The Democrats wanted the votes and he could use the wider organization and ability to attend the groups and gather information from the inside. He figured he needed them less than they needed him. And he never let them forget it. He refused to cooperate on many issues and although sweetly asked to he refused to go along and vote for issues important to the wider Democratic party, including gun control. His influence was sometimes malign and often disruptive. He cut his teeth and polished his outsider image at the expense of the Democratic party. He has not been a considerate house guest within the Democratic caucus. He has never been easy to get along with and has gone out of his way to step on potential friendships when he thought it more politic to assert his independence, even when the point was meaningless. He is not well liked personally, largely because he is never ‘off’, and is largely only tolerated in committee. He is not a team player.

    He is very much a political animal who bases his reputation on being the moralizing outsider speaking from the ethical high ground politically while claiming to be apolitical. It is so much a habit of thought that he is hard pressed when he needs to switch gears when his own righteousness is questioned. Even when those answers should come easily.

    It is also very much about him. Hillary and Warren both have plans, in depth and on nearly every conceivable subject. Usually spelled out so that pretty much anyone could, with only minor adjustments, pick them up and use them to advance toward the goal. Bernie’s plans are harder to translate. The goal is good but the methods are not functional without Bernie. He is very much the magic ingredient in his own plans. So, to a point, the plans are always about Bernie and the entire organization has the same prickly feel and curmudgeonly demeanor. This is how organizations that have aspects of a personality cult work.

    This is why I much prefer Warren over Bernie. Bernie has good points, and he has ‘evolved’ on some important issues which, now that they are sadly no longer actionable, does put him more in line with the rest of the Democratic party so he isn’t unacceptable. I want Warren, but will settle for Bernie.

    As far as him being right. Lots of people have been right. All of them had flaws. FDR had a New Deal that largely excluded black Americans. It didn’t mean that The New Deal wasn’t progress. The differences between mostly right and more wrong are not telling. The question is: can you form a coalition that will push through legislation that positively changes the individuals relationship with government and society. To do that you have to work as a team, in coalition with many others. Trust and friendship may be the only way to fill in the gaps. Prickly saints don’t typically get as much accomplished as tough but affable team builders.

  6. says

    As an Albertan, I hope you get universal healthcare but want to warn you that Republicans, when they’re in power, will do exactly what conservative governments here do -- starve the system, make massive cuts, then do their damnedest to convince people how broken it is.

    If M4A even gets past the loaded Supreme Court.

  7. Sam N says

    lorn, considering the shit sandwich I ended up eating with Obama at the helm, maybe I want someone who is difficult and unliked. Have you considered that? I want someone who will not compromise and talk so damn much about reasonable policies that they become considered reasonable by the population. I am tired of ‘centrist’ democrats, downright right-wingers anywhere else on earth called centrists.

  8. Porivil Sorrens says

    So just as a preface, I’m going to flat out ignore any arguments about Sanders “harming” the Democratic party, because as far as I’m considered, that’s a plus, not a downside.

    Hillary and Warren both have plans, in depth and on nearly every conceivable subject.

    And those plans are generally watered down versions of progressive policies from almost a century ago, except with dozens of concessions to republicans that will never accept them at any point. “Having plans” means jack if they are bad plans.

    He is very much the magic ingredient in his own plans.

    I mean, yes, when you are a socialist trying to push social democratic policies to a party that would consider FDR a dangerous radical, you are kind of the linchpin.

    Bernie has good points, and he has ‘evolved’ on some important issues which, now that they are sadly no longer actionable, does put him more in line with the rest of the Democratic party so he isn’t unacceptable.

    Those being? Bernie has had a consistently progressive platform longer than most of us have been alive, and back when a significant chunk of the current democratic elite were republicans.

    The question is: can you form a coalition that will push through legislation that positively changes the individuals relationship with government and society.
    Nah. He could unilaterally and radically change the shape of US politics with executive orders literal hours after inauguration. Even if he didn’t get a single piece of legislation through, he could end all US military aggression, cut funding to wasteful products, force the FDA to relax drug criminality, and functionally neuter ICE. That makes him better than any means-tested “we’ll cancel 10k of your student loans, and shut down 5% of the detention centers!” plan Warren could cook up and try to slip by congressional republicans, who will still shoot it down.

    Also, seconding Sam. I want someone who will fight for progressive policies that are wildly popular among the actual population of the US, not someone who will bend over backwards to try and slip means-tested Republican-light legislation through congress.

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