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Senator Bernie Sanders wants Medicare-for-all in the United States.


On a flight back to Montreal last month, I sat beside a recent college grad from Vermont. He’d just spent six months travelling on a shoestring budget. He also had a big gash on his leg from a moped accident in Thailand. He needed to get it looked at by a doctor back home, where he was covered under his parents’ health-insurance plan.

As we crossed the ocean, I waded into a topic I usually avoid on plane rides: U.S. politics. Was he a fan of Senator Bernie Sanders, I asked. “I’ve met him a few times,” he said, quipping that almost everyone in Vermont (pop. 626,000) has. “But I don’t think his ideas are very realistic.” Nor did he think Mr. Sanders could beat President Donald Trump, whom he despised.

This wasn’t quite the answer I was expecting from a 22-year-old from Burlington, a liberal enclave nestled in the Green Mountains that twice elected Mr. Sanders as its “socialist” mayor. I expected the young man to be more excited about the prospects for a progressive breakthrough in 2020, and about electing a president from his home state. But he had no illusions about that.

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I thought of my seatmate this week as I surrendered six hours and two evenings to watch 20 candidates for the Democratic Party nomination duke it out on stage in Detroit. Would he have come away encouraged by what he saw, or would he have wondered what planet these aliens had come from?

After all, most of them might as well have been running for president of Mars given the fantastical notions they espoused about health care and immigration and “taxing the hell” out of the rich.

Both debates featured long, esoteric discussions about the mechanics of Medicare-for-all, Mr. Sanders’s big idea for replacing the current public-private U.S. health-care system with a single-payer public model akin to Canada’s, but which has zero chance of passing Congress.

Most Americans agree their health-care system is ridiculously expensive and shamefully unequal. They also agree it’s the best system in the world. And for the 160 million Americans with employer-provided insurance, it is the best in the world. They’re not about to give it up just to dump Mr. Trump. Besides, there are better ways to help the uninsured and underinsured, and ones that actually have better odds than a snowball’s chance in hell.

If Mr. Sanders, Massachusetts Senator Elizabeth Warren and the other Democrats on the Medicare-for-all bandwagon think they can win the White House by telling voters their private health insurance will soon become illegal, they’re lying to themselves.

As former congressman John Delaney explained it to them, millions of working-class union members count on the employer-provided insurance they believe they’ve earned. By telling them they can’t keep it, Democrats just give them another reason to vote for Mr. Trump.

Mr. Sanders wants to put every American on Medicare, instead of only those over 65, as is the case now. Yet, most Americans know that Medicare, while acceptable by Canadian standards, is inferior insurance to what they already have. That’s why most Americans over 65 who can afford it buy supplemental private insurance, which Mr. Sanders would ban.

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Mr. Delaney, whose days in the race are numbered anyway, went too far in saying “many hospitals in this country would close” under Mr. Sanders’s plan. Fact-checking website Politifact, taking him literally, rated his statement as “false.” But he was correct in saying that Medicare pays doctors and hospitals far less than private insurers. That’s why many doctors refuse to accept Medicare patients, and many hospitals will accept only a limited percentage of Medicare holders.

“It is undeniable that Medicare pays hospitals a fraction of what private, employer-based insurance pays them,” Politifact conceded, noting that a recent Rand Health study found private insurers in 2017 paid hospitals 241 per cent of the prices Medicare paid, on average.

The only way Mr. Sanders’s plan could work is if every health-care professional in the United States agreed to take a massive pay cut. Otherwise, Medicare reimbursement rates would have to rise substantially, leading to a massive tax increase. Neither option is a vote-getter.

The Democratic front-runner (for now), former vice-president Joe Biden, knows this. His plan is to build on the Affordable Care Act adopted under his former boss Barack Obama, which subsidizes the purchase of private insurance by low-income Americans.

The Biden plan isn’t good enough for Mr. Sanders and Ms. Warren and the other insurgent Democrats on the left. Their hate-on for private enterprise has cut them off from the mainstream United States. Instead, they seem to have embarked on a kind of space odyssey 2020.

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