Viewpoint: How to consider 'Medicare for All'

Medicare for All proponents will have to create a movement for the proposal to gain traction in U.S. healthcare policy, argues James A. Morone, PhD, professor of political science and public policy at Brown University, in a New England Journal of Medicine perspective piece.

In Sept. 2017, Sen. Bernie Sanders, I-Vt., and his colleagues proposed Medicare for All, which aims to recognize healthcare as a right, regardless of patients' income. Dr. Morone recognizes that the proposal, like Medicare before it, has been met with skepticism and assesses the proposal by addressing four key questions.

1. Does everyone have a right to healthcare? Dr. Morone argues that for Medicare for All to work, the public must be persuaded by the ideal that healthcare is a universal right. "It will become a serious policy proposal if it creates a major surge in public opinion," Dr. Morone wrote.

2. Will the cost savings of Medicare for All eventually convince skeptics? Proponents must work to convince skeptics in Congress that adopting Medicare for All, a less conventional approach to solving healthcare costs, can control costs and offer more reliable access to healthcare if current approaches continue to fail, Dr. Morone wrote.

3. What about the taxes? Medicare for All offers politicians a way to directly address tax issues. "It would lift a substantial financial burden from low- and middle-income families — their health insurance premiums — and shift the weight to wealthier Americans by raising their taxes," Dr. Morone wrote.

4. Is Medicare for All plausible in a time when public trust in government is unstable? In the current political climate, where the public lacks stable trust in government, a less conventional idea such as Medicare for All could be more likely to gather a following, Dr. Morone noted. People who are dissatisfied with how the government is currently handling healthcare may support Medicare for All as a way to express need for a major policy change.

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