May 1, 2019 | Updates

State-Level Single-Payer Failure “Offers Sobering Lessons” For Supporters Of Medicare For All

WASHINGTON – As some Members of Congress and 2020 presidential hopefuls continue to ignore the powerful case against Medicare for all, Amy Goldstein of The Washington Post reports that the failed effort to implement single-payer health care on the state level in Vermont “offers sobering lessons for the current crop of Democrats running for president, including Vermont’s own Sen. Bernie Sanders (I), most of whom embrace Medicare-for-all…”

Then as now, many of the advocates shared “a belief that borders on the theological” that such a system would save money, as one analyst put it – even though no one knew what it would cost when it passed in Vermont.  That belief would prove naive.  The choices [then-Gov. Peter] Shumlin favored would essentially have doubled Vermont’s budget, raising state income taxes by up to 9.5 percent and placing an 11.5 percent payroll tax on all employers – a burden Shumlin said would pose “a risk of economic shock” – even though Vermonters would no longer pay for private health plans.

So, would “Medicare for all” be any different?

Those building a national single-payer model would confront many of those same dilemmas.  But as the 2020 campaigns get underway, few Democrats show signs of acknowledging, let alone wrestling with, the gritty complexities.  Even Sanders, eager as he was for Vermont to become the first single-payer state, seldom mentions that it did not come to pass.  “I see no evidence from the Medicare-for-all advocacy community of a serious effort to understand and learn from the lessons from Vermont’s failure,” said John McDonough, a was a senior aide to Sen. Edward M. Kennedy (D-Mass.) and is now a professor at the Harvard T.H. Chan School of Public Health.  “Those who ignore history are cursed to repeat it.”

Yet, proponents of Medicare for all seem determined to replicate this failure on a national level, as “a single-payer health care system in the United States would cost between $54.6 and $60.7 trillion over the first 10 years,” while “the initial federal obligations would be in the ballpark of $10,000 annually per person”and “would require enormous tax increases,” a new report finds.

Here’s the bottom line:

  • “There’s no possible way to finance [Medicare for all] without big middle class tax increases,” as Marc Goldwein, CRFB’s senior vice president, explained to The Washington Post.
  • National polling by the Kaiser Family Foundation indicates that six in 10 Americans oppose Medicare for all once they learn it forces families to pay more in taxes.



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