Medicare for All: A Citizen's Guide

An excellent summary of the argument for Medicare for all. Well written and well researched. Definitely the least dishonest book on the subject I’ve managed to find.Some minor quibbles:The book cherry picks cost comparisons between private insurance and Medicare to imply that public health insurance is inherently more efficient than private insurance. Covering people over 65 is a lot different than covering those under 65, and the cost structure is very different. A more honest comparison would be between private insurance and Medicaid.The book claims that M4A would function as a monopsony, and it could control prices because a single purchaser of a product can control the market. But it also implies that patients would be free to choose any provider. That means that the patient makes the actual purchase decision, and that M4A is a broker that acts on the patient’s behalf. This is not how a monopsony works. The book essentially concedes this, and instead argues that M4A control costs through price controls and regulatory approval. But every M4A alternative is able to use price controls and regulatory approval.More seriously, the book massively overstates the administrative costs of private insurance, claiming that insurance companies waste $812 billion per person per year. That is 4% of US GDP! The figure they link to is an accounting term that does not mean what the book claims it means. In reality private insurance does spend somewhat more on fraud and duplicate payment detection than Medicare and Medicaid, but Medicaid and Medicaid have significantly higher fraud rates.The major advantages to M4A, monopsony and lower administration costs, aren’t that important.Some major quibbles:The book very carefully avoids endorsing any specific set of proposals that would allow an actual cost to be determined. In chapter 4 they argue that the details are all “political questions” to be determined later, but in chapter 5 they argue that none of the studies have accurate assumptions, so they can assume that it will just leave most people somewhat better off.CBO scoring, apparently, is just something that happens to other people.They do reference Elizabeth Warren’s “plan for that”, but fail to mention how politically toxic that plan was. M4A advocates railed against it for not going far enough, health care economists railed complained that the numbers were off by trillions, and the political choices it made were toxic for everyone.One suspects that every M4A detailed enough to score is politically toxic. It is really difficult to allow corporations to stop spending trillions on employee healthcare and still end up with a progressive result.My chief issue is chapter 6, where they compare M4A in its maximal form with incremental alternatives presented in isolation. Naturally, no single incremental change is as progressive as a single massive change, especially if you ignore money, politics, and feasibility.A more honest approach would be to compare M4A to other long term progressive solutions. There are many different normcore progressive plans that are actually achievable (politically and financially), and are vastly more progressive then M4A.My personal favorite is building on the ACA fixes in the CARES act, implementing a public option, completing Medicaid rollout in the hold out states. Building on what we have now we can get to a point where everyone has access to affordable coverage, and we can drive the uninsured rate as low as possible.Then (as a thought experiment) raise taxes on the wealthy by $20 trillion (over ten years) using progressive taxation, and use most of it to send a check to everyone who choose to purchase comprehensive health insurance. Use the remaining cash to fix climate change.Finally, make sure that anyone can sign up for health insurance at their doctor’s office before receiving treatment.This is vastly more progressive than spending the entire $20 trillion on M4A, which is my best guess at the total price tag. I would rather have a complicated (but more progressive) health care system and climate change progress then waste the bulk of it on corporate profits.

Everyone should read this book!

Normally I read books and I love the subject matter. Yet, with this book I had to drop it midway. It's saying a lot without actually saying anything. It should just get to the point on Medicare for all and skip the diatribe it puts readers through the first half.

Amazing guide to our healthcare system. The authors make an incredibly complicated topic digestible. Despite being quite liberal, I had my doubts about a single payer system, but this book convinced me otherwise! Highly recommend.

I am nearly finished with this book and could not recommend it more highly to anyone who actually cares about healthcare in America. People directly involved in the healthcare system, providers, managers, billers, etc. are often so caught up in day to day tasks that they have no idea of what is going on in the big picture. Consumers often only understand our system in terms of how it affects them personally or people they actually know. Moreover both these groups tend to be influenced by their political leanings. This carefully researched bird’s eye view of how the industry has morphed over recent decades fairly lays out how crucial the need is to adapt our system to fit today’s needs. It fairly discusses the pros and cons of our current system, a full blown Medicare for All single payer system, and various intermediary plans as they would affect all parties. Most importantly this book calls for consideration of HUMAN VALUES as a crucial component in our healthcare decisions - a concept that seems to have escaped our notice in recent decades.

I've been a Medicare for All activist with PNHP (Physicians for a National Health Program) for about 4 years and wish this excellent book had been available then, as getting my head around this complex topic was very difficult without all the information in a single place. The authors have done a superb job of presenting things in very logical and readable form. It's a testament to their good writing that they did this without a single graph or chart, so non-scientists will have no trouble grasping all the concepts. This is not a liberal tirade; it's a very balanced and clear examination of the terrible fix our healthcare non-system is in and the best way to make it better. We truly can cover everyone and lower costs for most households and businesses, while also addressing unconscionable racial healthcare inequities. Business leaders and politicians should read this book and move rapidly to pass Medicare for All.

This guy is a politician not a doctor and he’s a joke!!!!