How to explain Sanders’ single-payer healthcare plan to that one Facebook friend

On Wednesday, with the support of one-quarter of Democrats in the Senate, Bernie Sanders introduced his single-payer healthcare plan that aims to wipe out private insurers and cover every single American. It’s an incredibly ambitious proposal that goes further than any other nation’s single-payer systems in terms of coverage, and as Sanders said long before releasing the details of it, it has little, if any chance of passing the current Republican-led Congress.

What the bill does is set lofty goals with the ambition that, when the time comes to compromise on specifics, those compromises won’t give up too much ground to conservatives. Former Senator Max Baucus, who helped shepherd through the Affordable Care Act, regrets ruling out single-payer from the get-go because it immediately moved the middle ground further right. Sanders does not want to make that same mistake.

And to be sure, the bill will face fierce opposition — not just from the GOP, but from health insurance lobbyists, PACs, and likely even Democrats, who will use the specter of “socialism” to argue the plan is impossible, pie-in-the-sky, and the reality of it will mean worse healthcare for you and yours. Those arguments are likely to be oft-repeated in forwarded emails from your aunt and/or uncle and misspelled Facebook rants from that one friend (you know the one). So here’s a little guide to explain just how Sanders’ single-payer system works.

Your benefits are likely going to be better than they are now

The Sanders Medicare-for-All plan covers hospital visits, primary care, medical devices, lab services, maternity care, and notably, prescription drugs, vision and dental benefits, with no out-of-pocket costs (except for some charges for prescription drugs). No copayments, no deductible to be met. Nada. You go to the doctor, the emergency room — whatever — you walk out without paying a dime. That’s more comprehensive than any other nations’ healthcare plan (like Canada’s and Australia’s), which usually do not cover vision or dental, and/or require some percentage of specialty visits to be paid by the patient.

Ask your Facebook friend how often they’ve been frustrated to go in for their annual, no-cost physical, only to find they get charged by their insurance hundreds of dollars for the visit because the doctor’s office accidentally labeled it as something else because you noted you had a sore throat? Or the doctor recommended blood work they said would be covered by your plan, when it in fact wasn’t? All of that would be gone under Sanders’ plan.

Employer-provided, private health insurers will cease to exist

In country’s like Canada and Australia, private insurers still cover elective services as well as vision and dental plans. However, under Sanders’ plan, all private insurers will be eradicated. The reasoning is part ethical, part economical. Private insurance companies allow CEOs to profit off the healthcare system while needlessly complicating it. The reason why you might pay $586 dollars for an MRI at one hospital under one insurance provider, and $58,600 at another hospital under another provider is because thousands of private insurers currently exist and they’re all negotiating their own pricing systems with individual hospitals.

That results in both wild disparities in the level of care available to Americans and billions of wasted dollars. Healthcare providers end up devoting half their staff to figuring out billing inquiries for patients, as detailed by Vox:

One 2003 article in the New England Journal of Medicine estimates that the United States spends twice as much on administrative costs as Canada. A 2011 study in the journal Health Affairs estimates American doctors spend four times as much dealing with insurance companies compared with Canada.

With a single-payer plan that doesn’t have to compete with private insurers, healthcare services get one, standardized price nationwide. For prescription drugs, the government will be able to negotiate with drug companies the way every other country in the world does, without the worry of a private insurer undercutting them, meaning lower drug prices.

Ask your Facebook friend if they’ve ever had to shop around different hospitals and providers for a service, only to be driven to their wit’s end because getting a quote for care ahead of time is nearly impossible. Or how confusing it is picking from the different plans an employer might offer every year — with different premiums, co-payments, and deductibles. Or how soul-crushing it can be to stay at a lousy job because it’s the only way you can get coverage for yourself or a loved one? All of that would be gone under Sanders’ plan.

You can keep your doctor

Your Facebook friend has heard this one before, but this is another advantage of eliminating private insurers. Right now, you can only affordably go to certain doctors because different doctors only accept certain plans. But there will be only one plan under single-payer, one that, as previously mentioned, will save doctors immensely in terms of administrative costs. There will be no in or out-of-network providers — there’s only one network. Get sick on vacation in Florida? No problem. The point is, you can see who you want, where you want to. As Sanders puts it: “What’s going to change is the wording on the card that you have. It will no longer be United Health Insurance or Blue Cross Blue Shield. It’ll be Medicare-for-all.”

Sound too good to be true?

Well, as it’s currently laid out, it might be. Single-payer healthcare plans are in no way impossible — don’t fall for that. Canada has one. Australia has one. Spain has one. Tons of countries have them. And all of those countries spend half as much per person to provide better care for all of their citizens than the United States does while still leaving millions uninsured. But as mentioned, none of those plans are as ambitious as the one Sanders is proposing. The senator proposes paying for this system through a combination of the vast savings it will generate in spending costs and increased payroll and income taxes. The wealthy will shoulder the majority of the burden, with Sanders pledging that middle-class Americans will end up spending less than they currently do in taxes, premiums, and out-of-pocket expenses combined.

This is going to be a hard one to argue with your Facebook friend as it stands, because the details aren’t ironed out. But as previously mentioned, this is likely not the plan we will end up with. It’s the plan you shoot for. What it evolves into is going to depend on CBO scores, mid-term elections, and public pressure. Other countries have single-payer systems that work great, and they are likely not exactly what their plans’ architects originally envisioned them to be. Sanders’ is aiming big. Now the work begins.

[photo: Getty]