Bernie Sanders' healthcare plan isn't necessarily the best way to universal American healthcare


Tags: Politics

In the UK, the NHS is taxpayer-funded and free at the point of access. 1 It is great. And it sounds a lot like Bernie Sanders’ plan for Medicare for All with a government-provided healthcare program providing all Americans with healthcare coverage.

One difference between the British system and Medicare for All is that Bernie Sanders’ plan is to completely dismantle America’s private healthcare insurance system in less than four years. In Britain, there’s a private sector that you can use if you can afford it and want to pay for it. I don’t personally know anyone who does this though.

Unlike Britain, private health insurance is common in America. Over half of Americans have private health insurance of some sort. It’s a big ask to get rid of it so quickly.

Something like Pete Buttigieg’s plan for Medicare for All Who Want It is actually much closer to the UK system. (Other candidates have plans similar to this but Buttigieg’s plan has a name I can remember.)

Buttigieg’s plan gives everyone access to government-funded healthcare, but doesn’t abolish the private system straightaway. He costs it at $1.5 trillion over 10 years. That’s a lot less than the $52 trillion over 10 years that Elizabeth Warren says her plan – very similar to Sanders’ – would cost. $50.5 trillion pays for a lot of other progressive things that you want a Democratic president to do!

Buttigieg thinks the lower costs to the individuals and families as well as the more efficient service you’d get in a government-backed programme would probably lead to lots of people switching away from private insurance. But he’d rather give people the choice.

There’s a good reason that people might want the choice. Trade unions in America have spent decades securing high quality healthcare for their members through generous employee-funded insurance. Many of them are understandably nervous about giving that up.

I’ve noticed British people seem to assume Bernie Sanders’ plan is to bring the NHS to America and don’t realise the bit about abolishing the private sector completely. And British people who’re on the (broadly-defined) left seem to assume the candidates who’re labelled as moderates or centrists are opposite to Sanders and therefore probably oppose healthcare for everyone.

But I’m not sure there’s a Democratic candidate who doesn’t support healthcare for everyone. Sanders, Buttigieg, Klobuchar, Warren, Biden. They all support it. (Maybe Bloomberg doesn’t. I haven’t looked into him.)

Part of this confusion is probably down to British progressives not realising quite how successful Sanders has been in the 2016 primaries against Clinton and since then. He’s moved the common ground of healthcare policy in the Democratic party towards him. Another reason is that the candidates are exaggerating their differences for political gain.

Basically everyone in the Democratic party agrees on universal healthcare. There’s just disagreement on how to get it done, whether you should force people to lose their existing private insurance, how to get the legislation passed, how quickly to do it, how much is a reasonable amount for the state/tax-payers to pay for it.

Sanders’ healthcare plan is one way to get universal healthcare in America. It could do a lot of good and make America a much better place to live in. It’s not really the British system. And there are alternatives that would have the same impact on people who can’t currently afford healthcare for a lot less money without disrupting people who are happy with their current situation. Other candidates exist and they are good. Let’s not make this a purity test.


  1. You have to pay an expensive surcharge if you’re in the UK on a visa. Most people have to pay about £10 for each prescription. Dentistry is subsidised but not free. There are probably other exceptions that I’m not thinking of.