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The Medicare for All Bill Is a Winner


The Medicare for All Bill Is a Winner

Jeffrey D. Sachs

Rep. Pramila Jayapal introduced a sweeping Medicare for All (MFA) bill on Wednesday (H.R. 1384), and the national debate on healthcare is bound to intensify through the 2020 election.



Dear, Good, Estimable Doctor Sachs,

I must disagree with your central claim - that Americans “will support a new system that convincingly shows the way to fair and reasonable healthcare costs;” or, that, as you rephrase it later, “cost containment will be the critical issue that either makes or breaks each MFA proposal.”

Although you mention “fair[ness],” it comes in second in an article focused on free market vs. single payer medical costs.

The fate of Medicare for All will NOT depend on its ability to “convincingly” demonstrate to Americans its superior “cost containment.” Rather, the “critical issue” determining MFA’s fate will be popular understandings of inequality and fairness.

Your numbers are no doubt correct - even I as a layperson with no particular aptitude in mathematical or economic models - can grasp how private insurance and the free market increase the cost of healthcare delivery. Indeed, if government-supported healthcare were not obviously cheaper, the whole question would not be on the table in the first place.

But what will drive medicare for all - and what will “determine its fate” - is a “fairness”-driven movement for it.

Lacking such a movement, the keenest, most intellectually elegant arguments will not carry the day. Hands will be shaken, attendees will be thanked and asked to contact their legislators or the members of their respective organizations. But nothing will change because the profoundly disenfranchised and miseducated masses needed to force it to happen will not have been reached.

Economics can assist, and I am grateful for the numbers…but those numbers will not be determinative in arousing or mobilizing the suffering masses needed to make it happen.

The arguments in favor of MFA will only be taken seriously when and if they are supported by the force and outright demands of mass movements.