Examining Conflicting Claims About ‘Medicare for All’

Since Senator Bernie Sanders of Vermont drove the idea of “Medicare for all,” or a single-payer health system, to the center of the political debate, few other issues have so divided the Democratic presidential candidates and voters. The result has been a cascade of competing assertions, estimates and statistics about the costs and effects of what would amount to a fundamental overhaul of the size and role of the government and the way Americans receive care.

Here’s a fact check of some of these claims.

what the facts are

Studies diverge on the cost of Medicare for all because of different assumptions.

What Was Said

“She’s making it up. Look, nobody thinks it’s $20 trillion. It’s between $30 trillion and $40 trillion, every major independent study that’s gone out there that’s taken a look at this”
— Joseph R. Biden Jr., in a November interview on PBS

“Bernie has said that it will cost $31 trillion, he’s come up with 16 of that $31 trillion, and that’s half.”
— Senator Michael Bennet of Colorado, in an October interview on CNN

The Medicare for all proposal released by Senator Elizabeth Warren of Massachusetts last week would cost the federal government an additional $20.5 trillion over a decade, and she would fund it in large part through new taxes on business and the wealthy. Unlike Ms. Warren, Mr. Sanders has not committed to funding proposals, but he has released several “options to finance Medicare for all” — characterized as discussion starters — that would generate about $16.2 trillion over 10 years.

Mr. Biden and Mr. Bennet have a point that several major studies have found higher additional federal expenditures than Ms. Warren’s estimate or Mr. Sanders’ revenue options: $34 trillion over a decade, according to the liberal Urban Institute; $32.6 trillion, according to the conservative Mercatus Center; and $24.7 trillion, according to an estimate by Kenneth E. Thorpe, a health care economist at Emory University. And the RAND Corporation, a research group, projected an increase of $2.4 trillion in 2019 alone.

But lower estimates exist as well. A University of Massachusetts at Amherst study suggested the number was $13.5 trillion while Gerald Friedman, a health economist at the same university who did not contribute to that study, said that a single-payer system would need to come up with about $9.6 trillion more.

Apart from examining different time frames, such diverging estimates result from the unpredictable nature of projecting how Medicare for all would work in practice. How much fees paid to doctors and hospitals, prescription drugs prices and administrative costs could be reduced — and how many more people would become insured and use health care services — will all affect a single-payer system’s bottom line.