What the evidence says about Medicare for All and other single-payer healthcare plans


Single-payer health care — in which the government pays citizens’ medical bills — is a divisive issue this campaign season. Such a system is, in the popular mind, more or less synonymous with socialism, but the idea has been around since health insurance went mainstream during World War II.

Insurance, pharmaceutical, doctor, and hospital lobbyists have stifled efforts to adopt a single-payer system ever since, even as nearly every other developed democracy in the world has moved to a single-payer system or to multiple payers with identical rules and rates. The United States has health outcomes that are no better, and often worse than those in countries with single-payer systems.

The Democratic presidential primary debates have seen continued sparring over whether and how to refine the Affordable Care Act or combine all insurance into a single improved “Medicare for All.” A series of UCSF events are taking a serious look at the costs and benefits of single-payer systems to offer quality evidence and analysis for the debate. One such event, on January 24, was a day-long conference called “Medicare for All: How to Do It Right.” The conference, chaired by James Kahn, MD, professor emeritus at the Philip R. Lee Institute for Health Policy Studies, was held at the International House at UC Berkeley in 2020. It brought in many U.S. and international experts to discuss the benefits of a US single-payer healthcare plan.

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