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.”

A mother in Nova Scotia living with cancer is challenging Premier Stephen McNeil to meet with her after a years-long battle with the province’s health caresystem. In an emotional video posted to her Facebook page this week, Inez Rudderham said her cancer went undiagnosed for two years because she couldn’t access a family doctor to get a referral to an oncologist. By the time she was diagnosed, her cancer had progressed to its third stage. “I dare you to take a meeting with me, and explain to me, and look into my eyes and tell me that there is no health care crisis in my province of Nova Scotia,” said Rudderham, 33. Rudderham said she was turned away from emergency departments three times before her concerns were taken seriously.

House Democrats on Wednesday unveiled a more moderate proposal for expanding health care coverage than M4All legislation supported by a number of the party’s 2020 presidential candidates. The Medicare for America Act, sponsored by Reps. Rosa DeLauro (D-CT) and Jan Schakowsky (D-IL), would not move the entire country into a single government-sponsored health plan. It would preserve employer-based coverage but allow Americans to enroll in an expanded Medicare plan, with caps on what people would have to pay in premiums.

The core appeal of the 2020 Democratic presidential candidate’s Medicare for All proposals, whether it’s optional buy-ins floated by moderate Democrats or Sen. Bernie Sanders’s comprehensive single-payer reforms, is the notion that enormous savings could be generated by dispensing with private insurance. Advocates claim that that insurer profits, as well as costs associated with managing risk and advertising plans, could be dispensed with, and that hospital fees could be greatly reduced by imposing Medicare rates, which are 40% lower under the M4All plans.Yet, it is notable that no such savings ever have materialized—even under the most propitious of circumstances.

Creating a single-payer healthcare system in the U.S. would be a “major undertaking that would involve substantial changes” to medical coverage, according to a report issued by the Congressional Budget Office. The nonpartisan agency that evaluates the potential budgetary, economic and other effects of legislative proposals didn’t assess any specific bill or estimate costs. “The transition toward a single-payer system could be complicated, challenging and potentially disruptive,” the CBO said on Wednesday.

More than 100 House Democrats have endorsed Rep. Jayapal’s Medicare for All Act of 2019. Fourteen Democratic senators have co-sponsored a similar bill from Sen. Bernie Sanders (I-VT). The title is deeply misleading. It implies that the current Medicare system would be extended to all Americans. In fact, Medicare for All differs from Medicare in fundamental ways. While America needs a debate about health care, it should be based on an accurate description of the alternatives.

Americans are frustrated with the current health care system. Care costs far too much. Millions are priced out of the insurance market, and even those with insurance say premiums and deductibles are so high they might as well be uninsured.  But when government officials make decisions about what services will be covered, how much providers will be paid, and how much citizens must pay in mandatory federal taxes, consumers will have even fewer choices and less control than they do today.  M4All will reduce access to new technologies, stifle innovation, and result in a near-doubling of the tax burden.  The Left is undaunted with its promises of free virtually unlimited health care for everyone and has an answer for everything. The House Rules Committee hearing on Tuesday, where Chuck Blahous and I testified, showed what we are up against.