A | “MEDICARE FOR ALL” has a wide range of meanings. In its purest sense, it would replace all current forms of healthcare insurance with a single-payer system administered by the U.S. government, without copays, coinsurance, and deductibles. Variations include some combination of universal insurance for basic healthcare, supplemented by private insurance for uncovered services. Costs have ranged from an additional ~$25 to ~$33 trillion in federal spending over 10 years, to much lower increases. These wide differences are based on assumptions of savings due to lower administrative costs and negotiated costs for drugs, doctors, etc., versus the vastly increased utilization that might be expected if everyone in the U.S. were insured. At the upper end, even doubling taxes would not be sufficient to pay for it. At the lower end, taxes might increase but be offset by rising wages as employers shift insurance dollars to salaries to remain competitive.
RON COHEN, M.D. is president, CEO, and founder of Acorda Therapeutics.