Skip to main content

Why are the billionaires always laughing?

Because they know the corporate media will never call bullshit on their bullshit.

Why are the billionaires laughing?

It’s easy to laugh when the corporate press treats you as a glorious success instead of the epitome of a broken social order. They laugh because they know the corporate media prefers to fawn over them rather than hold them to account.

Today, we ask you to support our nonprofit journalism because we are not impressed by billionaires flying into space, their corporations despoiling our health and planet, or their vast fortunes safely concealed in tax havens across the globe. We are not laughing.

We are hard at work digging out the truth. Please support this independent journalism today by donating to our critical Fall Campaign. We cannot do it without you. Thank you. -- Craig Brown, Co-founder

Support Our Work -- Join the small group of generous readers who donate, keeping Common Dreams free for millions of people each year. Every donation—large or small—helps us bring you the news that matters.

"Other countries currently provide good health care to residents at a fraction of the U.S. cost," writes Pollin. "As of 2017, the U.S. spent $3.3 trillion on health care—17% of gross domestic product. Germany, France, Japan, Canada, the U.K., Australia, Spain and Italy spent between 9% and 11% of GDP on health care. Yet some measures—like those based on the amenable mortality rate, which tracks medically preventable deaths—rank the U.S. well below those countries." (Photo: National Nurses United/Flickr/cc)

"Other countries currently provide good health care to residents at a fraction of the U.S. cost," writes Pollin. "As of 2017, the U.S. spent $3.3 trillion on health care—17% of gross domestic product. Germany, France, Japan, Canada, the U.K., Australia, Spain and Italy spent between 9% and 11% of GDP on health care. Yet some measures—like those based on the amenable mortality rate, which tracks medically preventable deaths—rank the U.S. well below those countries." (Photo: National Nurses United/Flickr/cc)

Healthcare for Everyone and It Will Cost Less: The Economic Case for Medicare for All

You'd be able to keep your doctor with no premiums or copays, and overall spending would decline.

A single-payer health-insurance system can finance good-quality coverage for all U.S. residents while still reducing overall health-care spending by roughly 10%, according to a study I co-authored last November. All Americans would be able to get care from their chosen providers without having to pay premiums, deductibles or copayments.

Other countries currently provide good health care to residents at a fraction of the U.S. cost. As of 2017, the U.S. spent $3.3 trillion on health care—17% of gross domestic product. Germany, France, Japan, Canada, the U.K., Australia, Spain and Italy spent between 9% and 11% of GDP on health care. Yet some measures—like those based on the amenable mortality rate, which tracks medically preventable deaths—rank the U.S. well below those countries.

"Under Medicare for All [prescription-drug] prices could fall, conservatively, by about 40%."

The U.S. ranks so poorly in large part because so many Americans lack access to health care. Roughly 30 million people, 9% of the U.S. population, are uninsured. Another 26%, 86 million people, are underinsured—they have insurance but are unable to access medical care because their deductibles or copays are prohibitively high. If all these people were covered under a single-payer system, our study estimates that the overall cost of treatments would rise by about 12%, from $3.3 trillion to $3.6 trillion. Our 12% figure draws from our literature review and the 2016 estimates of Kenneth Thorpe of Emory University. It is modestly higher than the 11.3% estimate the Mercatus Center reported last July.

But Medicare for All could also eliminate 19% of total health-care spending. The largest saving, about 9% of total system costs, would come from dramatically reduced administrative costs in contracting, claims processing, credentialing providers and payment validation—all of which would be unified under one federal agency. Private insurers spend about 12% of their collective budget on administration, while Medicare operates much more efficiently, with administrative costs at around 2%.

Dramatic administrative cuts would mean far less paperwork for doctors and nurses. But administrative simplification would also entail large-scale job loses for the roughly two million people employed both by private health insurers and on the management side of hospitals and doctors’ offices. Our study proposes generous transitional support for these displaced workers, including income, retraining and relocation funds and pension guarantees. We estimate the full cost of this support would amount to about $120 billion, equal to a roughly 2% increase a year in total system costs if spread over a two-year transition phase. 

The second major saving our study identified would come from the government negotiating down prescription-drug prices, which would eliminate about 6% of total system costs. Prescription-drug prices in the U.S. are about twice as high as in other advanced economies. Under Medicare for All these prices could fall, conservatively, by about 40%. Further savings would result through operating Medicare for All under a global budgeting system like the one in Canada. Such systems allow regulators to oversee billing and expenses industrywide, allowing them to control fees for physicians and hospitals, reduce unnecessary treatments and fraud, and encourage preventive care.

"Taking the cost reductions and expanded coverage into account, we estimated that Medicare for All could operate with an overall budget of $2.93 trillion—nearly 10% less than current spending."

Taking the cost reductions and expanded coverage into account, we estimated that Medicare for All could operate with an overall budget of $2.93 trillion—nearly 10% less than current spending. To finance this, the government begins with $1.9 trillion already in hand—nearly 60% of the total needed—that pays for Medicare, Medicaid and smaller public programs. The government would therefore need to take about $1 trillion out of what businesses and families now pay to private insurers. 

Our study has a few ideas to generate those funds. We propose that all businesses that currently purchase health insurance for their employees be mandated to pay 92% of what they now spend into Medicare for All—saving 8% of their health-care expenditures. Larger firms that haven’t provided coverage for every worker would pay $500 for each uninsured worker, while small businesses would be exempt from these premiums. This measure would raise more than $600 billion. After two or three years, this system could make a transition to a 1.78% tax on gross receipts or an 8.2% payroll tax, either of which would generate the needed $600 billion.

The remaining $400 billion would come from two measures: a national sales tax of 3.75% on nonnecessities, which would generate about $200 billion, and a wealth tax of 0.38%, after exempting the first $1 million of all families’ net worth, for another $200 billion. We also propose taxing long-term capital gains as ordinary income. The sum of these revenue streams will allow Medicare for All to operate with a 1% budget surplus.

Families would pay these taxes instead of premiums, deductibles and copays to private insurers. Except for those in the highest income brackets, this will produce significant savings for families as well as for businesses. Net health-care spending for middle-income families that now purchase insurance for themselves would fall by fully 14% of their income.

Add it all up and Medicare for All is actually the cheaper option for good-quality care in the U.S.


© 2021 Wall Street Journal
Robert Pollin

Robert Pollin

Robert Pollin, a professor of economics and co-director of the Political Economy Research Institute at the University of Massachusetts, is co-author of Green Recovery: A Program to Create Good Jobs and Start Building a Low-Carbon Economy.

This is the world we live in. This is the world we cover.

Because of people like you, another world is possible. There are many battles to be won, but we will battle them together—all of us. Common Dreams is not your normal news site. We don't survive on clicks. We don't want advertising dollars. We want the world to be a better place. But we can't do it alone. It doesn't work that way. We need you. If you can help today—because every gift of every size matters—please do. Without Your Support We Simply Don't Exist.

Schumer Endorses 'Inspiring Community Leader' India Walton as Buffalo's Next Mayor

The U.S. Senate majority leader's move comes as some key New York Democrats refuse to back the democratic socialist.

Jessica Corbett ·


'Who Will You Throw Overboard?' Manchin Targeted for Trying to Sink Democratic Agenda

West Virginians gathered at the senator's yacht to demand that he stop blocking the "popular and needed" Build Back Better package.

Jessica Corbett ·


'We Shouldn't Do It at All': Manchin Admits He's the Enemy of Democrats' Ambitions

The right-wing West Virginia Democrat and fossil fuel investor has previously confessed his intent to quash his own party's sweeping $3.5 trillion Build Back Better package.

Brett Wilkins ·


After Getting 'Stealth Bailout' During Pandemic, US Corporations Try to Kill Proposed Tax Hikes

"When it's time to finally put workers first, big businesses are spending millions to maintain their advantage and preserve the status quo," said Kyle Herrig of Accountable.US.

Jessica Corbett ·


'Disgraceful': Just 9 Republicans Join With Dems to Hold Steve Bannon in Criminal Contempt

The vote "reveals just how far the Republican Party has fallen" since Trump took control as GOP's de facto leader, said one pro-democracy advocate.

Jon Queally ·

Support our work.

We are independent, non-profit, advertising-free and 100% reader supported.

Subscribe to our newsletter.

Quality journalism. Progressive values.
Direct to your inbox.

Subscribe to our Newsletter.


Common Dreams, Inc. Founded 1997. Registered 501(c3) Non-Profit | Privacy Policy
Common Dreams Logo