Medicare for All could take center stage in 2020. What that means

Woolhandler cited a bill sponsored by Sen. Bernie Sanders of Vermont as an example of Medicare for All. That legislation advocates a single-payer plan that will cover everyone in one non-profit public system. A separate Medicare for All type bill also has been introduced in the House of Representatives.

Woolhandler said she sees a new system as a way of eliminating the frustrations she encounters as a primary care physician practicing in the South Bronx in New York City. Often, the treatments or medications patients need are not available to them because of their insurance, she said.

Under a Medicare for All system, health care in America would look a lot like it does in Canada, where all patients can see a doctor and generally do not have to pay a bill. Canada also spends about half what the U.S. does on health care on a per-capita basis, Woolhandler said.

“The evidence is fairly strong that, over the long run, you save a lot of money with single payer,” Woolhandler said.

Some health-care experts are not sold on the Medicare for All idea.

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Katy Votava, president of and a Medicare expert, cautions against using the word Medicare to describe a public single-payer system.

That is because most of the current Medicare system is actually private insurance, though it is regulated by the government, Votava said. And the coverage people get from Medicare typically comes after they have paid into that system for 40 or 50 years.

Once they are covered by Medicare, patients are often confronted by high costs and confusing rules, Votava said.

“We can provide more reasonable health insurance for all and health services for all,” Votava said. “I know we can.

“But it involves breaking down some old ways.”

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