As the presidential campaign talk-talk-talk grows into hundreds of thousands of words and more volume, voters are likely to hear the slogan “Medicare for All” supported by some Democrat contenders.

But what does it mean?

One of missions at the Antelope Valley Press is to explain what things are all about, so we are providing excerpts from an NBC news release that provides an explanation of what “Medicare for All” is and where some candidates stand on it. This is not an endorsement or a non-endorsement of the program, but is dedicated to a better understanding among citizens.

NBC provided four highlights of the plan:

• A single-payer, government-run health care program in which all Americans are covered and which replaces almost all other existing public and private plans.

• Many Democratic presidential candidates back some version of “Medicare for All,” although there are differences in their approaches.

• Supporters say it’s the best way to cover all Americans and hold down costs.

• Critics say the cost will be astronomical, ask how it will be paid for, and question whether the government can effectively manage such a massive undertaking.

The nuts and bolts

“Medicare for All” typically refers to a single-payer health care program in which all Americans are covered by a more generous version of Medicare, the health-insurance program for the elderly, that would replace all other existing public and private plans, with few exceptions.

Several 2020 Democratic candidates have campaigned on instituting single-payer health care. Other candidates have described a single-payer health care system as a broad goal and even so sponsored Medicare for All legislation in the Senate and the House, but have campaigned on less-sweeping alternatives. This can make discerning their position confusing, especially because some argue that their incremental approach will eventually lead to Medicare becoming the default insurance option.

Under a single-payer bill sponsored by Sen. Bernie Sanders, (I-Vt.) Medicare for All would cover essential treatment with no premiums or deductibles. It would also expand the categories of benefits under the current Medicare system to include areas such as dental and vision coverage, as well as long-term care.

After a four-year transition, private insurers would be barred from selling plans that offered similar coverage, effectively banning them as an alternative. Instead, private insurers could offer supplemental plans that cover items excluded from Medicare, such as cosmetic surgery. Some federal health programs, such as the Veterans Health Administration and Indian Health Service, would continue.

What Medicare for All might cost

A RAND study estimates that total health care spending would increase by about 2% with Medicare for All, but the sources of that spending would change dramatically from private insurance to the government.

The various proposals could range from $1-4 trillion.

There are several different versions of Medicare for All, including a separate House bill sponsored by Rep. Pramila Jayapal, (D-Wash.), with 12 co-sponsors, all of them Democrats.  

Many Democrats also back more modest proposal, which they sometimes also refer to as Medicare for All, that would expand access to Medicare and Medicaid without ending the private insurance system the way that Sanders’ plan and similar ones would.

Most of the alternatives involve allowing individual or employers to purchase a Medicare-like “public option,” a government insurance plan that would compete with private plans rather than replace them.

President Barack Obama pursued a difference approach with the Affordable Care Act, which focused on covering people who were unable to get insurance through their job or existing federal programs.

Under the ACA, the government offered subsidies for individuals and families to buy private plans through a government exchange. It also expanded Medicaid, the program for low-income people, to cover more Americans.

Supporters of Medicare for All argue the ACA’s approach didn’t go far enough. While the law broadened coverage to millions, about 27 million people are still uninsured, according to the Kaiser Family Foundation and there are signs that number is growing.

The NBC analysis provides more pages of explanation. We encourage Americans to study other informational publications so that voters can support plans that best solve their personal problems. And listen to the candidates try to explain the ramifications of various proposals.

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