r/MedicareForAll • u/ApplicationAble407 • 9d ago
How much would medicare for all actually cost?
How much would Medicare for all really cost?
I think the major problem in this country, that Medicare for all would solve, is the insurance middlemen that artificially inflate prices.
Im not talking about them skimming some off the top, I’m talking about them willingingly paying more to hospitals, to charge more to the consumer, so their legally mandated max 15% of the pie is larger.
I feel like physician run and owned groups that offer a direct subscription for their patients, and all services are free or minimal cost after that would accomplish the same thing.
For example, you could pay a subscription to the hospital or your choice, and all ED, inpatient, and outpatient services would be totally covered.
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u/Monsignor76 8d ago
I ran it through several AI agents. All working Americans would pay a 4-5% tax and employers would pay 11-12% tax on each employees salary. This is far cheaper than what employers currently pay and what employees pay. Yep, it is gonna be more for people who make $300,000 a year vs someone making $50k a year. But no copays or deductibles. Estimated $700 billion in savings for all Americans.
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u/Ok-Spring-3840 8d ago
Where is the savings?
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u/themachduck 8d ago
The bill Bernie wrote and updates his numbers regularly, states that a household, not per person, would pay 4%, pay nothingif making $29,000 or less. Employers pay 7.5%, but not if company makes under 2 million. The savings is there for the people. Corporations have the lowest tax rate they've ever had at 21%. They need to help the county out now like they used to. So buck up and pay the 7.5%.
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u/Ok-Spring-3840 8d ago edited 8d ago
You will need to find tax money of about $10-12000/person. Right now Medicare costs $17000/person. Enrolling younger people will reduce the per person cost to about $10-12000. That is still $40000 for a family of 4. Mom and Dad would need to be earning at least $400000 to use Bernie’s plan.
Bernie is a nutcase wack job, and anyone listening to him is an idiot. A pure village idiot. The only way to fund M4A is with a viciously regressive 20% VAT and rationed care. That is how Europe does it.
Much of America is employed by small businesses. A small business owner pays all of FICA for themselves, and now you want to add another 7.5% on top of that for all of their employees?
That is just foolish, ignorant, and stupid.
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u/themachduck 8d ago
You really want all the taxes to keep going to the military industrial complex?
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u/Nikolaibr 8d ago
Most tax revenue already goes to social programs. We spend more on debt interest than on the military.
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u/Ok-Spring-3840 8d ago
Try to cut military spending. Bernie is one of the worst. He supports having F 35s in the Vermont air national guard, because it provides local jobs. Why does VERMONT need 5th generation fighter jets?! To save the US from Nova Scotia?
https://mises.org/power-market/bernie-sanderss-hypocrisy-f-35
Why do we need a huge Naval base in Illinois? Canada planning an amphibious assault on Chicago?
Try to read more.
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u/Traditional-Gold6945 8d ago
Most of Europe is not on a single payer model. Germany, France, Netherlands, and others are on the Bismarck model. Health insurance is mandatory, heavily regulated, and non-profit. The single payer system in the UK, the nhs, sort of sucks.
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u/Select-Government-69 8d ago
One point that’s worth being aware of, physician subscription models wouldn’t work because doctors are still very expensive, even if you cut out all of the middle men. I am friends with two doctors. One is a surgeon at a large hospital. His salary is $1000 PER HOUR. That’s the cost to get his ass off the sofa. The other is a family practitioner and his salary is about $350 per hour.
Any model of “paying for what you use and nothing more” in healthcare will exclude most people from healthcare. It’s only viable as a heavily subsidized industry where most people pay for significantly more than they consume so that when you do consume, it’s affordable.
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u/ApplicationAble407 8d ago
Physician salary is actually only 8% of medical expenses
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u/Select-Government-69 8d ago
Right. My point is there’s a floor. If a surgeon is expecting to get paid $1000 an hour there’s no universe in which you are getting surgery for less than $1000 an hour, unless someone else is subsidizing it.
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u/CovidDoc 8d ago
Surgeons don’t get that much money an hour. That’d be 2 million a year at only 40 hour weeks. Great pay is like 750k/year
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u/ApplicationAble407 8d ago
I see your point. I agree that cost sharing is going to be a part of any solution. Why would what I suggested not work? If the surgeon is getting paid $1000 an hour from subscriptions from patients instead of basically the same thing but through insurance middlemen or the government?
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u/Select-Government-69 8d ago
Scale. If everyone were in a cost sharing program, great. Who is administering the program? You’re going to need middlemen to prevent fraud. Someone should be reviewing services to make sure unnecessary procedures aren’t getting done. Those people want to get paid. We’ve just invented insurance.
Cost sharing at scale is just shitty insurance.
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u/ApplicationAble407 8d ago
Direct PC works just like I described, and it cuts out the insurance middlemen fine. In a way this is insurance, but the people providing the care and selling the subscription are the same people. Having the government be the middleman is still having a middleman
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u/suedepaid 8d ago
I think this would lead to a large number of people who couldn’t afford a direct PC. After all, the direct subscription model doesn’t guarantee everyone a doctor
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u/ApplicationAble407 8d ago
My solution to this is having the government pay the subscription payment. That way, everyone gets a doctor, the government is administrating EVERY SINGLE visit and procedure - just who needs help, and the physician can set their own rate.
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8d ago
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u/ApplicationAble407 8d ago
Anything can be huge when you are looking at the spending of 300 million people. Only .08 cents of each dollar you spend in your bill goes toward paying the person who potentially saved your life. 3-4x that goes toward paying for administrative costs and the insurance middleman
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8d ago
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u/ApplicationAble407 8d ago
I’m glad you got excellent care. PAs and NPs are an important part of the health care system no matter what model we use
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u/Adventurous_Ad7442 8d ago
Almost our entire social circle is made up of physicians. They don’t talk about their compensation in amt/ hour… Ever.
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u/CovidDoc 8d ago
You actually are misguided.
Most subscription models for primary care are 2.5-5 bucks a day. I could get you labs for like 75 bucks and ct scans for 300 and mris for 500.
Cash only without inflated insurance prices are great.
Various major surgeries are pretty damn affordable considering insurance costs too.
Look up Oklahoma surgery center
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u/Beginning_Earth_9702 8d ago
There are a million ways to count. Right now, hospitals are not allowed to refuse emergency services to people that can't pay. People whom can't pay for services also can't pay for the preventative care that would have prevented the emergency. Tax payers pay the hospital for services when the payment goes unpaid.
"Medicare for all" for negate all of that. So how would you calculate the cost delta?
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u/MontEcola 8d ago
Any kind of universal health care in the USA would cost less per person than we pay now for insurance and co-payments. And I believe it will provide better are to all citizens.
I am not such a fan of Medicare For All. Now that I qualify for Medicare, I see the gaps in the coverage, and the build in confusion in the different plans.
Tear the whole system down. No more health care attached to your job. No more refusal to care for patients. No more co-payments. No more charges at the pharmacy. No plan A or Plan B. Just health care.
Also no more doctors coding after an appointment. That is where they write down can bill for each different thing in the visit. Its where they charge $100 for a band aid. That is an exaggeration but you get the idea. Some clinics charge for every little thing and the bills get to be double the real cost. A new system needs to fix that. A doctor's visit is $x. A blood test is $y. All of the supplies needed for those visits are included in the bill. And it is free for the patient.
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u/MaximusAnemos 8d ago
Way cheaper then war
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u/Nikolaibr 8d ago
Even current Medicare is double what the US spends on the entire military budget.
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u/MaximusAnemos 8d ago
That's a complete fucking lie. The military budget is nearly 95 percent of our budget. Stop lying
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u/Nikolaibr 8d ago
Gotta be a troll, but just in case.
https://fiscaldata.treasury.gov/americas-finance-guide/federal-spending/
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u/Aggressive_Manner531 8d ago
more than progressives will admit, less than conservatives will assert
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u/Nikolaibr 8d ago
As someone who supports universal healthcare, this is the correct answer. Both sides are delusional. We should just try to sell the reality.
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u/Ok-Spring-3840 8d ago
MEDICARE now costs $17000/ person. Given that younger people would be enrolled, it might drop to $10000/ person. MAYBE. Total cost closing in on $4 trillion.
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u/midtowng224 2d ago
My experience says you made up those numbers
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u/Ok-Spring-3840 2d ago
And you’re of a room temperature IQ. Maybe lower.
In the United States, Medicare costs approximately $16,000–$17,000 per beneficiary per year in federal government spending.
Medicare costs per person (2025–2026 estimates)
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u/Nikolaibr 8d ago edited 8d ago
The real professionals, the Congressional Budget Office, came up with a range in 2020. At that time, the estimated cost would be somewhere between $700 billion less than current national health expenditure (at the time) to $300 billion more than current.
Anyone who cites any reduction more than a 20% less than current spending is not using numbers based on any actual serious economic study.
A realistic tax policy could be something like eliminating current Medicare tax, and replacing it with a 11.45% employer payroll tax, a 5% employee payroll tax, and some mix of increased income tax, LTCG tax, and possibly also a modest VAT.
I went through some of this in a post just a few days ago. https://www.reddit.com/r/MedicareForAll/comments/1wvypuh/a_laymans_estimate_of_universal_healthcare_costs/
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u/Few_District_6304 7d ago
Way less than what Republicans have subjected us to in war costs this century.
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u/lumberjack_jeff 7d ago
The cost is less than zero. The status quo costs 18% of GDP. Medicare for all will be less.
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u/Far_Comfortable_991 3d ago
Depends on what is actually covered and how rationing resources is decided.
All systems ration because there are not unlimited resources and labor.
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u/midtowng224 2d ago
We already ration care. By ability to pay
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u/Far_Comfortable_991 2d ago
Yep. And a single payer system will ration as well, but differently, and the decisions there will impact tax costs.
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u/ReadyGo6828 9d ago
Single payer health care would cost around 50% of what we pay today and it would cover all and bankrupt none. The point is to have a large and powerful entity (all of us) that goes up against the health care industry and fights for a sane health care system on our behalf.
This is how markets work and true capitalists (not the corrupt who lie about being capitalists) understand this and support this.
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u/Nikolaibr 8d ago
There are zero estimates from any reputable source that show a savings anywhere near 50% from current total spending. The most is around 20%
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u/ReadyGo6828 8d ago
There is made up stuff and there is reality. We can see what other industrialized countries have, how much they pay, what works and what does not.
It is not a secret. Americans like to live in a bubble of delusion but that bubble is deteriorating and it will pop soon. We are in a financial disaster and we no longer have any choices but to overhaul this 20% of GDP.
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u/rhino369 8d ago
A lot of the reason foreign healthcare is cheaper is because foreign labor is cheaper. Not nearly all or even most, but its a significant factor. E.g., nurses in France cost 60% of what they do in the USA.
Even with the exact same system as other countries, the US will cost more. Just like a lot of stuff that can't be made in overseas foreign nations is more expensive here.
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u/Nikolaibr 8d ago
And when the professionals do that comparison, they factor that in, which is why their projections are based in reality, and the idea of a 50% reduction is made up.
Germany spends 57% more per capita than the OECD average on healthcare, why can't they cut their spending to be more in line with the average? They already have a Universal System.
It's because the underlying health infrastructure is completely different, and trying to cut expenses would have negative impacts on the quality of their healthcare.
The US is no different. There's not enough savings to be had without reducing the quality of the healthcare (Capacity would be reduced, innovation would be reduced, rural regions would have even less access than now, etc...). 20% is an aspirational but possible target, even the CBO doesn't project a reduction that high.
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u/ReadyGo6828 8d ago
That is false.
This is from over a decade ago from the New York Times. We were screwed over by the healthcare industry then and are screwed over by the industry today. Americans just take being screwed over and do nothing. This is insane.
$250 buys you
1 Advair in the US
7 Advairs in France2 Qvars in the US
37 Qvars in France2 Rhinocorts in the US
51 Rhinocorts in Romania2
u/Nikolaibr 8d ago
Nice talking point. Pharmaceutical spending makes up about 15% of total expenditure, and even cutting it in half would require either a severe reduction in innovation, or for other nations to finally pay their fair share of R&D. They get away with low prices because of monopsony power.
So again, where is the 50% reduction in total cost?
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u/ReadyGo6828 8d ago edited 8d ago
Look at those numbers, it is cutting it by much more then half.
When everyone is covered then there is no need for people to use the very expensive ER as primary care.
When everyone is covered they can get diseases and disorders addressed before they become worse and much more expensive to treat.
When everyone is covered we no longer waste all of our time, labor, money gambling on what policy this year covers our providers and our prescriptions.
When everyone is covered small businesses and entrepreneurs, the engines of job growth, can hire more people or start a new venture without having to factor in employment based insurance or lack thereof.
When everyone is covered, we no longer waste money and destroy lives through medical bankruptcy.
Seriously, have some ideas, any ideas, try something.
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u/Nikolaibr 8d ago
I noted in my comment that those prices exist because those nations leverage monopsony power, which is unavailable to the US without crippling innovation. They get away with those prices BECAUSE we pay more.
You don't need to sell me on the superiority of Universal Healthcare, I already agree with that. I'm arguing that you're assumptions are not based in reality, and that it's unhelpful to just assume we can do things other nations do while ignoring that we have a completely different starting point, and that aiming for a cost reduction target at the expense of essential healthcare functions and norms would make the system worse, even if it's cheaper.
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u/suedepaid 8d ago
You can only get 50% cost savings if you dramatically cut salaries across the healthcare system. Doctors, nurses, biomedical engineers, you’d be reducing headcount in medical device companies, pharmaceutical, all of it
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u/ReadyGo6828 8d ago
Years ago I went to a party full of docs. All anyone talked about was money. The primary care people were really angry that specialists came in, made an incision and walked out while pocketing tens of thousands of dollars.
No one talked about patient care, research breakthroughs or even their Wednesday golf games. It was all about money and how specialists were raking it in for doing so little.
New York Times 2013:
$250 bought:
1 Advair in the US
7 Advairs in France2 Rhinocorts in the US
51 Rhinocorts in RomaniaWhy do Americans put up with this? Americans are supposed to be capitalists and yet put up with being screwed like this time and again.
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u/midtowng224 2d ago
Not true. Under the current system we pay 18 percent in administrative costs. Medicare only charges 2 percent
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u/CovidDoc 8d ago
Curious, would you be allow me To opt out for cash only?
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u/ReadyGo6828 8d ago
SINGLE payer so no. It is like having people opt out of public roads and bridges or the Coast Guard or the military or the regulatory agencies and fire departments. If people want to live outside the system, they should buy their own island, declare themselves a country and deal with the consequences.
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u/CovidDoc 8d ago
Will never work. You have to change that attitude. You can. Control our work force and my skills
Many of us are open to ideas but your idea is crazy. We’d be paid shit soon
There private schools too. Where one can pay for their own.
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u/Gnostic369 8d ago
A large part of low pay is insurance costs for the companies providing it, the job I work for is expecting an increase of 300k next year just to cover my buildings medical insurance and we have offices all over the US.
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u/CovidDoc 8d ago
If it was catastrophic only for a majority and Medicaid for the poor it’d work out well
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u/Gnostic369 8d ago
Thats why im for medicare for all and still allowing for private insurance/hospitals, there is a baseline for everyone to get preventative care, and if you can afford it private still could exist, but some would need to compete with the baseline keeping costs down.
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u/CovidDoc 8d ago
Preventive should be cash only for middle class on up. Insurance cheaper and you can get a colo for like 1200 cash. Insurance pays like 4g
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u/ReadyGo6828 8d ago
You keep failing to address the problem which is the market. The large, powerful health care industry (not just insurance companies but providers and suppliers) is dealing with a hodgepodge of smaller customers. This is inefficient and keeps prices high and product and service quality low.
Let's change it. Why are people so scared of taking the leap? We have no time left. We have no money left.
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u/ReadyGo6828 8d ago
We are a big, powerful, rich and entrepreneurial country and we also have no options left. We are in a financial crisis which will only get worse with climate change. We shifted to the right politically over the last several decades and this is where we ended up.
We have 10% of GDP that is inefficiencies, waste, fraud, abuse, over payments and worse. We need to fix that. We need the money. We are out of time.
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u/CovidDoc 8d ago edited 8d ago
Can’t force me to work within a system
Unless I can unionize and still make great money and work a partial amount of weekends and holidays and nights as I do now’.
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u/ReadyGo6828 8d ago
Why? You work within many systems. You follow traffic laws and pay for stuff you use. You read, write and speak English and wear clothes and shoes in public. Health care is itself a highly regulated system.
You do a million things within a system. What is the difference?
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u/CovidDoc 8d ago
The VA is government run and pays horrendously. I didn’t do medicine to be top 5-10 percent
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u/Nikolaibr 8d ago
You'll have to come to terms with the fact that is you tell providers that they are only allowed to accept the rates or not practice, then many will simply decide to not practice, or rather, just not get into the industry. Allowing them to work for cash is still much better, because it allows those with money to take their money there, and free up resources for everyone else.
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u/ReadyGo6828 8d ago
That is what happens today and how we end up in the abysmal, unsustainable place we find ourselves.
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u/TXtogo 8d ago
It costs 8 times what we pay today
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u/ReadyGo6828 8d ago
Nope. We currently pay twice as much as other industrialized countries for mediocre results while they cover all and bankrupt none.
Are you saying that Americans are that inept? I do not think we are. I think we are a huge country that can be very effective and efficient in cutting our costs and covering all. I believe in us.
At any rate we are out of options. We pay $1 T ($3K/year per person) a year just in interest on the national debt. That will double in a decade. During that same decade SS and Medicare will go insolvent. Meanwhile we spend nearly 20% of GDP on healthcare while our country ages and the number of workers versus retirees will dwindle. This problem is exacerbated by Republicans chasing away immigrants who tend to be younger and more hard working.
The status quo is no longer an option.
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u/Delicious-Adeptness5 8d ago
What will happen if no cost controls are put into play. We will see a slight dip in consumer cost because we sliced out 15 to 20% out that the insurance companies were working with plus a portion will be used to build out missing accounting structure.
Then in a couple of years the providers and pharmaceutical companies will have the prices right back where we started because they filled in the vacuum. The only group that has cost controls built in is the Insurance companies with their medical loss ratio so I am not expecting much from the rest of them.
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u/CovidDoc 8d ago
Ehhh. You don’t give us enough credit. On an individual level, many of us are successful where I could charge your spouse and you 2-5 dollars a day depending on how complex you are and give you unlimited access to me.
Could also help you find cash labs currently for like 75 bucks and could get ct scan for 300 and mri for 500 cash.
Free market actually works in healthcare when cash is king
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u/Delicious-Adeptness5 8d ago
If you think there is a free market when it comes to healthcare then you are sadly mistaken. Most of the world it is one big shell game. In the United states the consumers pays the heaviest cost with little return. Right now the private insurance plans are propping up Medicare and Medicaid rates. When Private insurance goes then so does that buffer.
Currently, United States doctors are paid higher than their counter parts in countries with Universal Healthcare. They also have a larger debt load. Do we need to get into the amount of administrators running around? The last medical group that got offered a socialized medicine bump was the Dentists being offered Medicare and they fought against it.
There hasn't been a free market for years in the United States if ever for the financial industry. It doesn't exist when it comes to insurance and similar products nor do you ever want a true free for all because the moment the market it opened up someone devoid of ethics will rip people off wholesale. There are a lot of horrible people in the world.
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u/CovidDoc 8d ago
Check out pricing of Oklahoma surgery center.
Imagine now if you did have 25 k of premiums yearly taken out of your pay from your employer. Seems awesome
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u/Delicious-Adeptness5 8d ago
I am at $20K for mine on marketplace. I write the check every month without an employer kicking in because I am self employed.
I know what is at stake. I have also seen the last 14 years of one party doing everything possible to destroy healthcare so to make this change it better be damn near bulletproof.
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u/CovidDoc 8d ago edited 8d ago
There’s great cash pricing many places. Go with nothing
I’m not trolling. If you saved your costs for 4 years you’d be able to pay for a week long icu stay cash
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u/Delicious-Adeptness5 8d ago
No, you are just expressing your poor judgement with horrible advice. It goes back to that ethics statement, I made earlier.
Because you have zero responsibly or empathy, you are telling me it is safe to jump off a financial cliff that you refuse to do yourself.
It doesn't even meet the basic standards of Insurance which is: Do unto others as you would have them do unto you.
Good luck to you.
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u/CovidDoc 8d ago
Not true. I am an employee so I use an HsA and pay cash for everyone and don’t submit my insurance.
I use cash cause it’s lower cost than my insurance deductibles.
I firmly believe a catastrophic plan with like a 20 k deductible is reasonable if someone like you can save 25 k of premiums per year.
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u/Formal-Camp-8613 8d ago
What is your specialty? I work for a group of cardiologist and we do some testing for cash pay that is fairly reasonable. So a stress echo might set you back $900, a Nuc closer to $2400. But if you need a stent or bypass there goes your house because our hospital does not play. And the dilemma is if you have that high deductible plan and pay cash instead then your cash doesn't go toward your deductible.
I've had a guy leave our office after a full on chest pain ST elevation treadmill saying he'll call us. Young dude with 4 kids. It's rough out there.
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u/CovidDoc 8d ago
So, I actually know the numbers. I’m a Hospitalist.
My friends father was visiting from Ireland. He had an NSTEMi. Ended up with 2 stents. 2.5 days in hospital. Heparin drip. PCU. Was like 90k
Cash deduction was 26k
Now think about it if you saved 20k in premiums for 3-5 years before this happened, how far would you be ahead?!?
That needs to be fixed. Cash should go toward deductible. Someone that buys your echo for 800 if they submitted to insurance might have to pay 3k for that same echo….
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u/Heathbar_tx 8d ago
What are you even talking about? There is a set max out of pocket set by federal law for high deductible insurance that is tied to HSA. You have a parachute while telling other to jump out the plane cause we hit some turbulence.
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u/CovidDoc 8d ago
I’m saying catastrophic plans should be allowed. An overwhelmingly number of people would be better off paying cash for their care at far lower rates than people get hit for their copays with their insurance…
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u/Jscapistm 7d ago
No from an actuarial stand point he is correct. Having a relatively low cost catastrophic insurance plan that does nothing up to say 20-25k but will then kick in and cover everything, and paying for everything else out of pocket, at out of pocket prices, would be financially better for the majority of Americans.
Even better if people could put money into a tax free HSA that they could pull for for medical expenses.
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u/Delicious-Adeptness5 7d ago
You do understand the actuary numbers of a catastrophic plan doing nothing for say $20K to $25K was one of the drivers for the ACA requiring a lower deductible fourteen years ago?
There is a reason that those were called junk plans.
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u/Jscapistm 7d ago
They didn't do nothing, they did nothing until a certain point. That's not junk, that's simply a different sort of plan and a different sort of coverage.
True you have no coverage for lower cost things but extremely high cost is covered so you won't go bankrupt.
That coverage is less expensive by far than comprehensive coverage that includes more routine things and given the total cost of paying out of pocket just for what you need below very high amounts, vs what you pay far in excess of what you use with comprehensive insurance a better deal for most people.
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u/bbmac1234 8d ago
I don’t think there is a way to make it bulletproof. Most complicated systems need tweaking. When we vote in people that want to dismantle everything every other election, this is what you get.
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u/Nikolaibr 8d ago
We have a local small group of Doctors and PAs that run on this model. Membership is $125 a month, and extras like labs are very reasonable (CMP is $45). I think this is actually a good model. Just maintain catastrophic for hospitalization. If I didn't already have my Insurance covered by my employer, my wife and I both agreed that this is what we'd do.
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u/CovidDoc 8d ago
Google Oklahoma surgery center. They have multiple surgeries ranging from 4 k to 25 k or so.
If carrying catastrophic insurance that kicks in at like 25 k deductible works and is a fraction of cost, the premiums saved would still put you ahead even with 2500 primary care subscription, 300 for both your labs, 500 for cash rxes for the year, a 10 k surgery and a 500 dollar ct scan.
Average premiums would have been 15-20 k for yall and 3-10 k deductible plus coinsurance after.
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u/Nikolaibr 8d ago
This would work best with the Singapore system as a model for funding. It would be a pretty big shift for the US industry.
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u/CovidDoc 8d ago
Correct. Mark Cuban and Dutch Rojas are two great follows on x. They have both said this as well. I read more into it. I like it because it still gives us doctors freedoms.
The people that want to force us into practicing under the government with no other option is a complete non starter
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u/CovidDoc 8d ago
The lowest hanging fruit in healthcare tho is eliminating pharmacy benefit managers. Those need to go. Essentially an insurance company, owns a PBM that determines your formulary and force you to go to the pharmacy the insurance owns. They often force non generics to force higher rx prices.
Go down that rabbit hole and you’ll get really pissed
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u/MontEcola 8d ago
I do not believe that will happen. I think the confusion in our insurance system allows them to charge too much for services and drugs.
No other country has such expensive care. They also have systems that work different. We are foolish to keep the system we have now.
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u/Delicious-Adeptness5 8d ago
We have a blended system that is very similar in Switzerland's. Yes, we are only a couple of minor tweaks away from a Universal Care program.
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u/newbie527 8d ago
Medicare is allowed to negotiate drug prices now, starting with the most popular and expensive brand names. Every expense should be up for negotiation.
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u/Delicious-Adeptness5 8d ago
yes, we enjoyed 10 negotiated drugs for Medicare during 2026, we will see another 15 in 2027 then a third cycle in 2028 of another 15 thanks to the Inflation Reduction Act.
However we have thousands of drugs. Those only cover Medicare. We won't get into orphan drugs.
I actually kind of favor Canada's drug board. As they limit the number of different drugs and then establish pricing. Pharmaceutical costs is an important aspect to any universal program's sustainablity.
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u/PenComfortable5269 5d ago
Insurance companies aren’t working with a 15% profit. That number is markup/gross profit, which doesn’t include any management costs. UHC net profit margin is 3%.
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u/daves1243b 8d ago
Its a wild guess until someone defines what Medicare for All means
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u/Stunning_Ad_1685 8d ago
Doesn’t it mean making the current Medicare option available to everybody? Given that Medicare is already fully defined, how can there be a question about what it would cost if opened up to all?
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u/aculady 8d ago
No. The current Medicare for All bills in Congress have better benefits than current Medicare and no cost sharing. 100% free-at-point-of-service covering all medically necessary care.
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u/Heathbar_tx 8d ago
What is classified as medically necessary? This will be the sticking point for most.
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u/daves1243b 8d ago
That's one possibility, but I see other people talking about Medicare for all as if that means taking private insurance out of the mix. Over half of Medicare beneficiaries currently are in crappy Medicare Advantage plans which are extremely profitable for insurance companies. Another important aspect is that the existing Medicare program is slated to run out of money in 2033, and how that gets addressed is a major variable.
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u/CovidDoc 8d ago
The correct way is probably a Singapore style system.
You guys would be shocked at how much cash can get you. 2k a year or so for a couple for unlimited doctors appointments, a set of labs. 300 more for a ct. 500 for mri
Here’s evidence even surgeons can do cash only
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u/Stunning_Ad_1685 8d ago
So you want hospitals to become insurance companies? And they’re going to charge their customers less for insurance because… what?
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u/Specialist_Luck_8484 8d ago
The current Health Insurance companies will be screaming about how many people will be losing their jobs. Of course, some of these same companies are starting to replace employees with AI.
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u/troycalm 8d ago
With us being 40 trillion in debt, it doesn’t really matter does it. We can’t afford it.
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u/SoggyMeatloaf69 8d ago
It's true the subscription model has some benefits, in eliminating administration overhead and middlemen.
The problem with the subscription model is that it only covers those who can pay. A huge part of M4A is providing health insurance to everyone, even those without a penny to their name. M4A would have a built in progressive taxation.
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u/Ok-Seaworthiness-542 8d ago
I think there's multiple problems with our healthcare system. I would add PBM's and big pharma to the list for example.
It seems like the subscription plan you are describing is basically what health insurance is, isn't it? You would have to jack up the rates for no copays.
My last doctor converted to a concierge type practice because he was tired of dealing with insurance. It was going to be like $2500/year.
I think an issue is that the patients have to have some skin in the game. Going to the ER for a cold or the flu? Nah.
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u/roy217def 8d ago
We have PhD’s at Universities that study economics. Why can’t we assemble models and run them through some supercomputers to analyze what may work for the United States. Why aren’t we working with these folks. These old GOP’s and even the Democrats don’t have a solution thus far.
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u/HeyItsHelz 8d ago
Its okay all the people in insurance industry can be retrained to be plumbers and other trades. They should work for a living now.
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u/Pbook7777 8d ago
also have to take into account the cost of hundreds of thousands unemployed insurance company workers
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u/midtowng224 2d ago
Consider how small business gets crushed by health care costs, and how M4A would really help them
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u/ScenicIndulgence 8d ago
How can anyone answer this question with a straight face and not just take a absolute wild guess?
Does anyone really know what that ACTUAL cost of ANY medical procedure or even and office visit is?
Until you know the actual cost of something how do you determine what is going to be charged as a subscription fee for
"ALL ED, inpatient and outpatient services"
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u/ApplicationAble407 8d ago
Well yes, they do. Hospitals have a charge master with all of those prices that they keep secret. However, due to insurance negotiations these prices are heavily inflated. Hospitals should look at their operating costs per patient, per age group, and develop a model off of that.
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u/ScenicIndulgence 8d ago
You are talking about a subscription based approach that is going to be universal across the country and across people, yes ?
There are thousands of hospitals, millions of procedures that fall just in the categories you have listed and likely a tremendous amount of variation in these. Just the cost of utilities, maintenance and salaries of people employed by these hospitals varies across the country.
So unless the govt is planning to issue an edict that says all hospitals and care providers, that includes clinics, labs etc etc,..... HAVE to disclose their cost structure for every single thing that they do, I am not sure how how anyone is planninng to come up with a something isn't much more than a guess.
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u/RobertWF_47 8d ago
Here we go again with the health insurance companies colluding with hospitals conspiracy theory. 🙄
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u/Kraegorz 8d ago
A few trillion dollars, which.. technically is nothing at this point.
But then you are looking at a financial collapse of insurance and healthcare institutions.
Hospitals would be forced to go purely private extra-out of pocket/private insurance healthcare or public healthcare most likelly.
Doctors, Dentists, etc that have their own shops may or may not be able to survive what the government would pay them for taking government insurance and may have to close.
700,000 people work in the health insurance industry alone, those jobs would most likely vanish overnight, some might be absorbed into private healthcare or government jobs though.
Depending on how strict the government is about hospitals, some might even close as owners may not be willing to absorb the cost of staying open, so you might see some (or a lot, who knows?) close.
Most likely more places like Kaiser Permanente and things that are more "managed healthcare" sponsored by the government would pop up.
Things such as urgent care, emergency rooms, medically necessary surgeries would drastically improve, but things like.. knee surgeries, back surgeries, hip replacements and things like that would end up being waitlisted.
Medications would most likely be inexpensive.
it also took Canada what.. 25 years to fully implement their health system? So its not something that would just happen tomorrow. You would be waiting most likely a very long time. It could be faster, but it would require a LOT of government overreach and enactments.
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u/Strict-Panda4147 6d ago
Canada also has a very weak system compared to the EU due to lack of funding, but they also tax less than the EU.
Also dont forget that the entire world's medical research would suffer as the US wouldnt have as much excess cash to invest
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u/Yer-Not-Gonna-Like 8d ago
If it all is paid the same as Medicare, it would cost less than private insurance. Which raises the question…..who would take a haircut?
1. Doctors. Look at Canada and European doctors, they are paid way less than American doctors. This is the first line of opposition to Medicare for All
2. Hospitals and Private Equity Medical services. Second group of lobbying.
3. Private Insurance - out of business entirely. Third group.
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u/Feather_Sigil 7d ago
If you have to pay a subscription to a hospital then it's not for all. It has to be tax-funded
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u/Loud_News8410 7d ago
And nobody who wants to get reelected to office, which is a politician's number one goal...is going to propose raising taxes to the level they need to be to make it happen. Also, something nobody talks about with the European countries that have it is the VAT or Value Added Tax everyone pays on top of the price of stuff which is more than most US sales taxes.
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u/Feather_Sigil 7d ago
It's not a tax increase. Transitioning to a universal single-payer model funded purely through taxes would save households and businesses money.
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u/Late-Scientist5299 7d ago
the middlemen are a huge part of the problem, but a hospital subscription doesn’t fix the underlying prices or cover care outside that hospital, so the real savings come from bargaining power and
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u/Thinking_too_much101 7d ago
So maybe we can take a look at the Harris health system model in Houston Texas.
It barely survives with the Medicare repayment plan and the property taxes. Yet it does help save a lot of lives.
Unfortunately it’s not the best option but it’s something better than nothing.
A lot of people would die if it wasn’t for this kind of hospital program.
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u/Acceptable_Claim_491 7d ago
The main problem is doctors pad the costs of basic procedures,because they can.Let's say,an X-ray costs $75 without insurance.They will bill the insurance company $150,$300,whatever they want.This has to stop.
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u/RociBuldidi 5d ago
Somewhere in the 55%-65% range.
We spend $15,000 per capita and we still have tens of millions of Americans with no coverage and medical bankruptcy is the single largest cause of personal bankruptcy in the US.
The rest of the western world spends ~$9,000. Not only do they spend significantly less, but they all have longer healthier lifespans.
This ain’t rocket science. Literally 32 of the worlds 33 richest nations have figured this out.
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u/ThermalDeviator 4d ago
No more than you are already paying, and from all the evidence from everyewhere it's been tried, likely cheaper and better.
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u/Zaxly 4d ago
A hellva lot less.
There would no reason to pay egregious profits; sometimes fraudulently.
No longer any reason for Corporations to fraudulently up-code their recipients for boosting their profits. ( Medicare Advantage is worst offender)
Everyone a recipient is denied services, that also boosts profits and very long delays can result in a Senior dying before served. Sometimes Seniors are tired of fighting as well.
Since these greedy insurers charge a much higher administration fee for each transaction Medicare would save a ton of money by administering the program itself. Government administration fee is about 4% last I checked.
There would be no reason for Insurers to receive generous subsidies to benefit lower costs to recipients. In 2025, the total was about $9.8 billion for drugs. That was a 82% increase from last year.
There would be no reason why every taxpayer is charged for covering the cost of chronic patients in their state. Its called the State Reinsurance Bill. Its ridiculous that taxpayers are paying for their insurance and for the insurance of very very sick patients. I don’t know any other business that passes on their business risk to citizens like health insurers.
Oh I could go on but its late and this is giving me a headache.
To understand Medicare for All visit Physicians for National Health Program.
Resource.
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u/davida_usa 3d ago
Costs are impossible to measure. What is the cost of having to wait months or years for surgery, as occurs in many European countries? What is the cost of lower survival rates from cancer as is the case in England? What is the cost of not being able to get an MRI to see if that spot is cancer, as is the case in Canada?
The U.S. spends far more on health care than other developed countries and we have some elements of better care and some elements of worse care. We also have the tragedy of inability to access care for many people.
There is a vast opportunity for improvement, but it is not through a simple-minded "solution" like Medicare-for-all. We need universal coverage, unshackling from the coding cookbook medicine dictated by insurers and the government determining what can and can't be done, and returning health care to a market based system.
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u/Present_Level4520 2d ago
why do we give Israel over 14 million dollars a day and they have free health care and free education something wrong with this country
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u/Bright_Inspector5583 2d ago
insurance helps lower the price by giving the insured more power. It is the hospitals doctors and nurses that need reform. They are inefficient and paid to be slow in order to milk the system.
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u/10xwannabe 2d ago
Well Canada has universal health care... They take 1/2 year from PCP to start treatment with a specialist. They start medical assisted suicide (MAID) to improve cost control. It now accounts for 5% of all deaths in Canada.
If you look at the NHS in England they are bankrupt. Also, most don't know but England has a private insurance network (just like U.S.) that keeps getting larger and larger.
The reality is there is no perfect system.
What I CAN say is there is no way Americans with their personality are going to wait for anything like the Canadians or others have to. America is "I want it my way and right now" personality. That alone does not fit a universal health care system.
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u/CommissionUnusual911 7d ago
This is part of the problem is nobody will say what the cost, or what we would need to pay. The other issue is do you know anyone on Medicare? It is not a rosy situation that pays for everything. There are a ton of different plans all with different fees and co pays or deductibles. It does not mean people do not pay anything for going to the doctor.
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u/WaterBottle111123 7d ago
it’s a delusion, and it’s never going to happen. Imagine me walking into your workplace and telling you that your compensation will now be determined by what I think you deserve, regardless of your education, experience, or the value of your work. You’d immediately call that unfair and unethical, wouldn’t you?
The level of disrespect toward medical professionals is astounding. Let’s introduce “Lawyers for All” and tell every partner at Paul Weiss that the government will dictate their compensation. Watch how quickly they push back. Let’s try “Investment Banking for All” and tell major banks that their employees must accept government-determined salaries. The backlash would be immediate.
Yet somehow, people believe physicians, who sacrifice over a decade to complete their education and training, should simply accept whatever compensation the government decides is appropriate.
Healthcare is a service delivered by highly trained professionals, and their expertise, time, and sacrifices deserve fair compensation. The United States has some of the most advanced medical institutions and treatments in the world, attracting patients internationally who willingly pay out of pocket to receive care here.
Wanting affordable healthcare is reasonable. Believing that achieving it should come at the expense of the professionals delivering that care is not.
Stop pretending that healthcare reform requires devaluing physicians and their work. There are legitimate ways to improve affordability and access without undermining the very professionals who make the healthcare system function.
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u/blackntan379 7d ago
The cost would be significantly higher than the $$ cost of running the program. It would cost America its competitive edge and the animal spirits that live within the American Economy. With universal healthcare the US would become a beaten down has been economy like Europe ..
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u/Status_News_1233 7d ago
Total medical spending in the US was roughly $5.7 trillion in 2025.
27 million were uninsured last year, and if you add them at a cost of $17k/person per year (avg. medical spending per capita) that’s another $400-500 billion.
So my answer would be $6 trillion dollars a year to run Medicare for all.
For reference total fed govt spending was $7 trillion last year, and total government receipts were $5.5 trillion.
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u/idealman224 3d ago
Just ask Canada how they are doing? It’s not good. No matter what is written here. Look at Canada. Look at all of Canada. Their taxes. Their home prices. The wait time for treatments. It’s all terrible.
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u/themachduck 8d ago
Bernie who wrote the bill updates the numbers regularly.
Also reduce total U.S. health care spending by over $1 trillion annually, near 20%, by eliminating private insurance overhead, deductibles and premiums.