The Lancet has no
political ax to grind.
Its expertise is in
The American Spark
Why Sanders’ Favorite Medicare-For-All Study Is Sound
By Cliff Montgomery - Feb. 29th, 2020
Yesterday, the American Spark discussed a study just released by The Lancet, one the world’s top medical
journals, on the benefits of a Medicare-for-All system. The report states that such a system would create
savings for U.S. citizens “equivalent to more than US$450 billion annually (based on the value of the US$ in
Perhaps understandably, the report has become a favorite talking point of U.S. Senator and presidential
candidate Bernie Sanders on the campaign trail.
Thus others saw a need to offer their two cents on the report published by The Lancet. A week ago, an article
in the Washington Post worked to put its Jeff Bezos-financed spin on the matter.
The Post pointed out that in final costs, the Lancet study promises “a new system that would cost about $3
trillion a year, instead of the $3.5 trillion that is being spent now.”
The article adds that the Lancet report estimated “that to fully fund Medicare-for-all, the federal government
would have to bring in an additional $773 billion a year relative to current revenue levels.”
The Lancet study finds “this could be paid for, in part, by a 10 percent payroll tax that would bring in $436
billion annually,” states the Post. But “given that current employer contributions to health care work out to
about 12 percent of payrolls,” the Post points out “this would still be about $100 billion less than what
employers currently pay.”
The Post adds that “remaining funding could be paid via a 5 percent tax on household income, yielding $375
billion a year.” But “the elimination of employee contributions to existing health insurance premiums” means
that “the average household could expect to save well over $2,000 a year — and have no co-pays or
deductibles to worry about.”
But the Post thinks it detects a problem with all this. It states that other research groups have claimed the
annual cost of a national health care system for the U.S. would be higher than the Lancet study’s $3 trillion
estimate. The Post article points out the estimates of “the libertarian Mercatus Center ($3.8 trillion per year)
and the more centrist-oriented Urban Institute ($4.2 trillion per year) and RAND Corporation ($3.9 trillion).”
A word to the wise: When U.S. corporate reporters use the word “libertarian” to describe a person or group,
they mean right-wing extremist; and when they say, “centrist-oriented,” they mean near-conservative. It’s a
cute and somewhat misleading way of hiding the proven biases of these entities.
The Lancet is different. It has no political ax to grind. For almost 200 years, the Lancet has dedicated itself
solely to publishing sound and sober medical reports. Its expertise is in medicine, not political spin.
The Post then proclaims that “all of these estimates — [the ones published in The Lancet] included — are built
on various assumptions,” which all pretend to know “how costs and payments and patient behaviors would
work in the real world with a Medicare-for-all plan in place.”
So the Washington Post assumes the cherished American fantasy that a national health care system has
never been put into practice in the real world. ‘Gosh, who knows what might happen if some country were to
give it a try?’ they almost childishly suggest.
But national health care systems have existed for years, in every economically developed country in the world
- with the singular exception of the United States. Thus the economic and social effects of such a system are
well documented, and their merits and demerits are beyond doubt.
As far back as 2009, the American Spark brought to light a major comparison of the cost of health care
among member countries of the Organization for Economic Cooperation and Development (OECD). The
results were enlightening.
“The United States spends more money on health care than any other country in the Organization for
Economic Cooperation and Development (OECD). The OECD consists of 30 democracies, most of which are
considered the most economically advanced countries in the world,” declared a 2007 study released by the
Congressional Research Service, a non-partisan research group that compiles studies on important issues for
all members of the U.S. Congress.
“According to OECD data, the United States spent $6,102 per capita on health care in 2004 — more than
double the OECD average and 19.9% more than Luxembourg, the second-highest spending country,” added
the 2007 CRS report.
“In 2004, 15.3% of the U.S. economy was devoted to health care, compared with 8.9% in the average OECD
country and 11.6% in second-placed Switzerland,” stated the CRS study.
One last thing. Americans also spend far more for their health insurance than most other democracies.
“Spending on health administration and insurance cost $465 per person in the United States in 2004, which
was seven times that of the OECD median,” declared the study.
But has all that spending produced outstanding health benefits for U.S. citizens? Not at all.
“Research comparing the quality of care has not found the United States to be superior overall. Nor does the
U.S. population have substantially better access to health care resources, even putting aside the issue of the
uninsured,” stated the CRS study.
Since member OECD countries appear to have maintained the same health care systems in the last decade
or so, there’s little reason to believe much has changed.
In fact, the most recent (2019) OECD health comparison report points out that “since 2009, average health
spending as a share of GDP has remained relatively stable across the OECD at around 8.8%,” adding that
“growth in health spending has remained in line with overall economic growth since the economic crisis.”
And U.S. health care costs continue to soar in comparison to other OECD countries.
“At 17.1%, the United States spent the highest share of GDP on health in 2017, while Turkey allocated
around 4.2% of its GDP in the same year,” added the 2019 OECD study.
So why is cost still an issue for a U.S. national health care system? We suspect the answer may rest on a
perennial truth: It is very hard to discuss facts with people who earn their paychecks denying those facts.
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