Economists conclude that Medicare for All (M4A) could be considerably less expensive than the curren
We are economists interested in public policy and healthcare. Some of us have worked to estimate the cost of alternative healthcare programs. Others have reviewed such estimates. We believe the available research supports the conclusion that a program of Medicare for All (M4A) could be considerably less expensive than the current system, reducing waste and profiteering inherent in the current system, and could be financed in a way to ensure significant financial savings for the vast majority of American households. Of course, the details would depend on the design of the M4A system.
Compared with the current system, Medicare for All would achieve considerable savings on administration and by reducing payments to monopoly drug companies and hospital networks. Within a few years of operation, M4A could save hundreds of billions of dollars per year from these sources. Additional savings will come when a rational healthcare finance system allows needed investments in coordinated care and preventive care, as well as reductions in fraudulent billing. Over time, global budgeting would slow the rate of future healthcare costs significantly, as has been done in Canada and other countries. Bending the cost curve could save more than $2 trillion over the next decade, and even more with a well-designed system. Costs will be predictable, enabling households and businesses to plan in a way that is impossible today.
There are added costs associated with Medicare for All. Universal coverage and increased utilization, coming from reduction or elimination of cost sharing, will add costs, but studies show that these added costs will be far less than the savings outlined above.
The need for increased public funds (replacing premiums) can be financed with some combination of payroll, income, and wealth taxes. By eliminating insurance premiums and out-of-pocket expenses, and lowering overall healthcare costs, Medicare for All will result in enormous savings for almost all households, all except the richest households who will pay more in taxes. Shifting the burden from per-person payments for premiums and cost sharing to income- and wealth-related taxation will magnify the savings for most households. The current system is particularly burdensome for middle-income working households who receive relatively little support through Medicaid or other public programs but are responsible for health insurance premiums either paid directly or by their employer as nonwage compensation. A system that cuts costs and shifts financing to income and wealth taxes will dramatically lower this burden, producing significant savings for workers and businesses.
The net financial savings will be accompanied by substantial improvements in productivity through improved health, and the elimination of “job lock” coming from the need to stay on a job to retain health coverage. Most important, Medicare for All will reduce morbidity and save tens of thousands of lives each year.
James G. Kahn, Professor, Institute for Health Policy Studies, School of Medicine, University of California, San Francisco
Jeffrey Sachs, University Professor and Director, Center for Sustainable Development, Columbia University
Anders Fremstad, Assistant Professor, Economics, Colorado State University
Robert Reich, Carmel P. Friesen Professor of Public Policy, Goldman School of Public Policy, University of California, Berkeley
Robert Pollin, Distinguished University Professor of Economics and Co-Director of Political Economy Research Institute, University of Massachusetts Amherst.
Leonard Rodberg, Professor Emeritus of Urban Studies, Queens College/CUNY
Emmanuel Saez, Professor of Economics, Director, Center for Equitable Growth, University of California at Berkeley
Gabriel Zucman, Associate Professor of Economics, University of California at Berkeley
Alison Galvani, Burnett and Stender Families' Professor of Epidemiology, Director of the Center for Infectious Disease Modeling and Analysis, Yale School of Public Health
Gerald Friedman, Professor of Economics, University of Massachusetts at Amherst
Katherine Moos, Assistant Professor of Economics, University of Massachusetts at Amherst
Lindy Hern, Associate Professor of Sociology, University of Hawaii at Hilo
Lawrence King, Professor of Economics, University of Massachusetts at Amherst
Michael Ash, Professor of Economics, University of Massachusetts at Amherst
Markus P. A. Schneider, Associate Professor of Economics, University of Denver
Jeff Helton, Associate Professor Health Care Management
College of Professional Studies, Metropolitan State University of Denver
Mark Paul, Assistant Professor of Economics, New College of Florida
Elissa Braunstein, Professor & Chair, Department of Economics, Colorado State University
Dean Baker, Senior Economist, Center for Economic and Policy Research and Visiting Professor of Economics, University of Utah
Darrick Hamilton, Professor of Economics and Sociology and executive director of the Kirwan Institute for the Study of Race and Ethnicity at The Ohio State University.
Stergios Skaperdas, Clifford S. Heinz Chair and Professor of Economics Director, Center for Global Peace and Conflict Studies University of California, Irvine
Ramaa Vasudevan, Professor of Economics, Colorado State University
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