Question

A big topic in the debate over potential reforms to the US healthcare system is whether or not the US should switch to a single-payer system. Indeed, we already have such a system in Medicare. What’s more, Medicare is larger than most (if not all) existing national health systems. As most of you know our health spending per capita is much higher in the US than in other developed countries.

Question 1: explore the difference between the cost of Medicare (for elderly in the US) versus the costs of health care for the elderly in other countries like Canada, France, or Switzerland. The question is, “How can we make an apples-to-apples comparison?” How you could conceivably use existing information to get comparisons of the cost of healthcare for the elderly under Medicare versus care for just the elderly in some other country or countries. (Basically, how to break out just the elderly portion of the costs for the Swiss system, or the Canadians, etc.) Clearly, differences in the quality of healthcare delivery are a big issue and there are complex issues involved in comparing quality (for example, because of differences in obesity, murder rates, and genetics, it’s problematic to use population longevity as a measure of healthcare quality). But for this question you can ignore issues of quality.

Answer 1

the Center for American Progress (CAP), a Democratic party-affiliated thinktank, launched a proposal confusingly called “Medicare Extra for All”. For proponents of a Bernie Sanders-style single-payer “Medicare for All”, this might seem like a positive development. Well, yes and no.

On the one hand, “Medicare Extra” is a step to the left for CAP, suggesting that the Democratic establishment is following the lead of its galvanized base. On the other hand, this new proposal would exact sacrifices from patients to placate the insurance industry, and could serve to divert the single-payer movement, which has been rapidly gaining steam.

A debate over the next step on health reform has roiled the Democratic party. Some, like Hillary Clinton, have advocated incremental changes to Obamacare, such as a “public option”. Others, led by Bernie Sanders, seek to replace the hodgepodge of private and public health plans with “Medicare for All” – a single-payer program covering everyone without copays or deductibles.

Though Trump’s victory might have dampened support for the more radical road, it did just the opposite. The president swore to repeal the Affordable Care Act, and try he did – but apart from felling the individual mandate, the effort flopped in Congress. He did, however, rouse millions of Americans behind the cause of healthcare justice. Single-payer bills in both houses of Congress accrued record support in 2017, including a majority of House Democrats and more than a third of Democratic senators.

The political winds had shifted: progressives were out of power, but they were coalescing around a post-Trump plan – improved “Medicare for All” –overwhelmingly popular with the party’s base: about 69% of Democratssupported it, according to a September survey.