Medicare for All offers comprehensive solution for our broken system

As policymakers consider legislative solutions to address our broken healthcare system, one core principle must be made abundantly clear: Our solution must match the scale of the crisis we face. Now is not the time for half-measures.

Today in America, we spend over 18% of gross domestic product on healthcare, and yet our health outcomes are abysmal, including declining life expectancy and the worst infant and maternal mortality rates among our peer countries. In the last decade, families and businesses have seen private insurance premiums skyrocket while wages stagnate. By 2029, our current annual healthcare spending of $3.9 trillion will increase to a staggering $6 trillion. Over 70 million people are uninsured or underinsured, with medical bills as the leading cause of bankruptcy.

We need a bold solution to transform our broken healthcare system to guarantee universal coverage and bring down costs. That solution is my Expanded and Improved Medicare for All Act, which guarantees comprehensive healthcare for everyone while ensuring financial sustainability and removing the profit motive from our system. Medicare for All builds on Medicare, which provides reliable coverage for seniors and has been tested over 54 years. But because Medicare does not go far enough—leaving out essential benefits such as vision, hearing, dental and, of particular importance, long-term care that is essential for seniors and people with disabilities—my bill improves Medicare by extending these critical benefits to current beneficiaries and then expands Medicare to cover everyone with a guaranteed government insurance plan.

In addition, and critically important, Medicare for All takes on costly waste and inefficiency in our current healthcare system, unlike current half-measure alternatives. A 2017 study estimated that over 30% of total health expenditures are administrative costs. Because of the complex requirements of our for-profit insurance system, private insurance spends, on average, 12% of revenue on maintaining claims and billing processes, rather than on actual healthcare services. Hospitals spend even more: 25% on overhead costs. In contrast, Medicare’s administrative costs are only 1.1%, or 6% to 7% if you include its private plans. Comprehensive economic studies have shown that taking out the middleman, as Medicare for All does, dramatically drives down costs. In addition, moving from expensive curative care to a preventive system, in which it’s easier for people to seek services when they first become ill, will allow us to realize even more savings.

To correct a common misunderstanding, my Medicare for All bill does not state providers must be paid under current Medicare rates. It allows, as former CMS Administrator Dr. Donald Berwick explained, for a payment structure that maintains hospital viability, simplifies payment rate-setting, increases transparency and significantly lowers administrative costs. My bill also uses global budgeting, paying hospitals and providers their revenue upfront—as is done in Canada and Australia—and allowing providers to focus on value and efficiency. It’s also worth emphasizing that Medicare for All would be particularly helpful for rural and safety-net hospitals, which have a significant share of uninsured and Medicaid patients. Guaranteeing higher provider compensation for rural and safety-net hospitals, while eliminating the enormous administrative costs of dealing with multiple insurance companies, levels the playing field and serves patients best.

Since I introduced my bill in the House of Representatives in February, momentum continues to build, with 119 co-sponsors, two historic all-day congressional hearings in major committees and unprecedented support in diverse communities across the country. Medicare for All is no half-measure. It is a serious and comprehensive policy response to the massive healthcare crisis facing our country—and it deserves serious consideration. Millions of lives depend on it.

More commentaries from members of the 116th Congress on the state of healthcare