NEW YORK (Reuters Breakingviews) - Americans are already freaked out about healthcare. The coronavirus is adding a new urgency. The two Democratic party’s main candidates for president, Vermont Senator Bernie Sanders and former Vice President Joe Biden, have very different ideas for tackling the issue.
The U.S. healthcare system is one of the costliest in the world. Little wonder it’s the No. 1 priority for voters, according to a survey conducted by the Kaiser Family Foundation in February. Fears about Covid-19 and a Supreme Court case in the fall that could dismantle the Affordable Care Act (ACA) are sure to keep the topic at the center of the debate as people head to the polls both in the remaining primaries as well as November’s general election.
About a quarter of Americans – 78 million people – have either inadequate insurance or none at all. Then-President Barack Obama’s ACA a decade ago got more people covered by expanding public options. But in part because of assaults on the Obamacare legislation by President Donald Trump’s administration, the system is now weaker.
Biden wants to augment it to insure an estimated 97% of the country. A signature plank is to give people a government-funded plan, even if they have access to employer-sponsored plans. The cost would be tied to household income, with middle-class families getting a tax credit to help pay for coverage. Biden intends to pay for it by increasing capital-gains taxes and bumping up the top rate of income tax to almost 40%.
Sanders’ promise to create government-run universal healthcare, dubbed “Medicare for all,” is at the heart of his campaign. There would be no doctor networks to worry about, no premiums, no deductibles, no co-pays – and no private networks. That would slash by 75% the $800 billion a year the current fragmented healthcare industry spends on administrative expenses, according to a study in the Annals of Medicine.
The senator’s proposal, though, is scant on details, not least how much would be needed to run a national health service. The Committee for a Responsible Federal Budget reckons his overhaul would cost Uncle Sam almost $13 trillion over 10 years, compared with just $800 billion for Biden’s plan.
Biden’s success in several primary elections on Tuesday has made him the favorite to win the nomination. But the rapidly spreading coronavirus that threatens to overwhelm the current system may mean Sanders’ more expensive healthcare plan survives the contest.
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