There’s a reason any mention of cost is notably absent from the recent CBO report on single-payer health care proposals. That’s because Democrats specifically asked for a report without cost estimates. They’re aware that the American public is unlikely to get behind their plan to outlaw private health insurance and launch a government takeover of the U.S. health care system. According to Emory University health economist Kenneth Thorpe, more than 70% of working Americans who have private insurance would wind up paying more for health care under a version of “Medicare-for-all” very similar to the one Sanders has introduced in the Senate.

The Medicare for All plan embraced by leading 2020 Democrats appears more lavish than what other advanced countries offer, compounding the cost but also potentially broadening its popular appeal. The plan from Vermont Sen. Bernie Sanders would charge no premiums, copays or deductibles, allowing only limited cost-sharing for some prescription drugs. It would cover long-term care, dental, vision, hearing coverage and much more. But while other countries do guarantee coverage for all (but with often significant restrictions in access to actual care), the promised benefits vary significantly—and none are as comprehensive. [Supporters of the plan might want to read this scathing review of a book, “The Socialist Manifesto,” that chronicles the disasters that have ensued from this utopian political philosophy.]

Dr. Chuck Blahous, who testified (with Grace-Marie Turner) before the House Rules Committee last month on Medicare for All, lists key findings:

  • New federal costs under M4A would be unprecedentedly large
  • We do not know how or whether the federal government could successfully finance its additional spending under M4A
  • The projected additional costs of M4A’s coverage expansion would exceed the potential savings from eliminating private health insurance administration
  • Current M4A proposals would sharply cut payments to health providers while increasing health service demand, most likely causing supply shortages, and disrupting Americans’ timely access to health care, and
  • The costs of M4A would be borne most directly by health providers and those most in need of health services.

In Britain, both health insurance and the delivery of health care is socialized. But the NHS is no paradise. Open a random edition of a British daily newspaper and you will likely encounter an article about some egregious problem that the NHS has failed to solve. For example: NHS doctors routinely conceal from patients information about innovative new therapies that the NHS doesn’t pay for, so as not to “distress, upset or confuse” them; terminally ill patients are incorrectly classified as “close to death” so as to allow the withdrawal of expensive life support; NHS expert guidelines on the management of high cholesterol were intentionally not revised after becoming out of date, putting patients at serious risk in order to save money.

The latest liberal policy idea would effectively end all private health care for many Americans. The proposal, the Medicare for America Act, first appeared as a 2018 paper by the Center for American Progress. It’s been called “the Democratic establishment’s alternative” to Sen. Bernie Sanders’s single-payer scheme and has been framed as a moderate proposal. But the bill is anything but moderate. When Rep. Rosa DeLauro (D-CT) reintroduced Medicare for America legislation on May 1, she included a new, radical provision. The revised bill prohibits any medical provider “from entering into a private contract with an individual enrolled under Medicare for America for any item or service coverable under Medicare for America.” Essentially, this would bar program enrollees from paying for health care with their own money.

On Wednesday, the Congressional Budget Office released a 30-page report analyzing a single-payer health insurance plan. While the publication explained some policy considerations behind such a massive change to America’s healthcare market, it included precious few specifics about such a change—like what it would cost. Sen. Bernie Sanders (I-VT), perhaps single-payer’s biggest supporter, serves as the ranking member of the Senate Budget Committee. If he asked the budget scorekeepers to analyze his legislation in full to determine what it would cost, and how to go about paying for the spending, CBO would give it high-priority treatment. To the best of our knowledge, that hasn’t happened.

To pay for Medicare for All, Democratic presidential candidates have focused on taxing the rich. But many of the plans they’ve put on the table would require across-the-board tax increases that would hit middle-earners as well as the wealthy, public policy analysts say. None more than Medicare For All. Raising the more than $30 trillion needed to fund Sanders’s health plan over a decade would require doubling all personal and corporate income taxes or tripling payroll taxes, which are split between employees and employers, said Marc Goldwein, a senior vice president at the non-partisan Committee for a Responsible Federal Budget.

Democrats asked CBO to lay out some parameters of how to set up single-payer, hoping to elude analysis of any one bill in Congress. The latter would carry political accountability—and a price tag. Instead CBO walks through “key design components and considerations” in a report that aims to bore and deploys the word “could” 209 times. Yet even this limited analysis is instructive about the “major undertaking” of single payer, as CBO puts it in hilarious understatement. CBO acknowledges, for example, that a transition that includes moving 160 million people from employer-sponsored coverage to single payer would be “complicated, challenging, and potentially disruptive” to health care and the economy. You don’t say.

People who switched from traditional Medicare to private Medicare Advantage plans in 2016 spent $1,253 less in 2015, on average, than beneficiaries who remained in traditional Medicare, after adjusting for health risk. Even among traditional Medicare beneficiaries with specific health conditions, those who shifted to Medicare Advantage in 2016 had lower average spending in 2015, including people with diabetes ($1,072), asthma ($1,410), and breast or prostate cancer ($1,517).

Colin Rogers, 55, suffered a basilar artery occlusion on April 14, which he could have survived if he had undergone surgery which removes a blood clot from the brain. The University Hospital of Wales in Cardiff could have performed the procedure, but enough specialists staff were reportedly not available. Rogers died on April 18. His son Callum, 26, stated, “Although we don’t know what the outcome would have been, this potentially could have saved his life. My dad was denied the chance of survival as Wales does not have access to this treatment and doesn’t have any units. We were also told [by a stroke consultant] that if he fell ill on a weekday they would have had a chance to transfer him to a specialist unit in England. Because this was a Sunday it was impossible. To find this out is just gut-wrenching.”