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As the US gears up for 2020 Presidential elections, ‘Medicare for All’ has become a key agenda item for most of the Democratic contenders. Many Democrats are propagating ‘Medicare for All’ as the successor to Obamacare, in which ACA (Affordable Care Act) drastically brought down the number of uninsured Americans.
Medicare is federal government run health insurance program that covers all Americans 65 and older. This program is funded by taxpayers. A portion of Social Security goes toward Medicare to cover most services like hospital stays and doctors’ visits. Members can get additional coverages for services such as dental, vision and prescription drugs by paying a premium.
‘Medicare for All’ can be seen as being similar to the NHS in UK, which is sponsored by the British government and provides healthcare coverage to all, that includes doctor consultations as well as hospitalization.
In ‘Medicare for All’ people who are currently insured under their employers or have individual health insurance would move to a government sponsored plan. This plan would provide comprehensive coverage with very low out-of-pocket expenses.
While this would ensure health care coverage and access to all Americans, there are two major concerns:

  1. Who would bear the cost: The US government (Federal + State) currently spends around $1.6 trillion on health care per year. Conservative estimates peg the cost of ‘Medicare for All’ at $3 trillion plus. The difference will largely be borne by taxpayers
  2. ‘Medicare for All’ will lead to a single payor system. This could decrease in quality of care and long wait times due to a large increase of patients in the healthcare system. Additionally, commercial HealthCare Payors will shut down causing large scale unemployment.

The above downsides have not gone well with voters.
To give greater flexibility and lessen the possible tax burden, several variations are being proposed by some Democrat leaders. Some of these are ‘Medicare buy-in’ (allow younger Americans to buy Medicare like plans), ‘Medicaid buy-in’ (permit States to offer Medicaid like plans), ‘Medicare for America’ (create a federal universal program, but funding will primarily through member premiums).
So, while a true ‘Medicare for All’ program does not look feasible in the foreseeable future, there could very well be more options for government run health insurance programs depending on who takes the White House in 2020.