Prospect Debate: The Cost of Sanders’s Single-Payer Health Plan

In “The False Lure of the Sanders Single-Payer Plan,” Paul Starr criticized the Sanders plan on a number of grounds, including its cost in new taxes. While arguing that even the cost estimates by the Sanders campaign would make the plan impossible to pass, Starr also cited the much higher estimates of the cost by Kenneth Thorpe.

The cost of the Sanders plan has now become a national issue. Here Gerald Friedman, who made the cost estimates for Sanders, defends those numbers, while Thorpe provides the most detailed account he has yet provided of why the Sanders plan would cost almost twice as much as Friedman’s estimates. Starr elaborates on three additional reasons to be skeptical about the single-payer proposal. 

Gerald Friedman is professor of economics at the University of Massachusetts. Kenneth E. Thorpe is the Robert W. Woodruff Professor and Chair of the Department of Health Policy and Management, in the Rollins School of Public Health of Emory University. Paul Starr is co-editor of the Prospect and professor of sociology and public affairs at Princeton University. 

—The Editors



The Critics of Sanders’s Health Plan Understate Benefits and Overstate Costs

In his article “The False Lure of the Sanders Single-Payer Plan,” Paul Starr is wrong about Senator Bernie Sanders’s improved “Medicare for All” plan, and wrong about single-payer health care, because he relies on a flawed analysis by Kenneth Thorpe.

While Thorpe does not provide enough documentation to make an explicit comparison between his estimates and those provided in detail by the Sanders campaign, we can extract enough to conclude that his analysis relies on fundamentally flawed assumptions. To conclude that the Sanders health plan will cost $1.1 trillion more per year than estimated, Thorpe is assuming that national health expenditures over the next decade will total $51 trillion, or 21 percent of GDP. Read More.



Why Sanders’s Single-Payer Plan Would Cost More Than His Campaign Says

Based on Gerald Friedman’s work, Bernie Sanders’s campaign has published implausibly low estimates of the additional federal expenditures needed to fund the senator’s single-payer health plan. In what follows, I explain the differences in methods that Friedman and I have used and the sources of the gap between his estimates and mine. I have updated my analysis based on more recent information available in the Friedman estimates. Read More.



The Larger Problems of the Sanders Single-Payer Health Plan

Think about what a single-payer health plan means. The federal government pays for all health care for everyone. The pleasant thought is that all of your health expenses are being paid for. The unpleasant thought is that since all those expenses come out of the federal budget, your health care now depends on the decisions of Congress and the president. And an even more unpleasant thought—at least for progressives who may be inclined to support single-payer—is that people with progressive values will not always be in charge in Washington and therefore wouldn’t always be making those decisions. Read More.



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