Overview

On Wednesday, December 20th, 2023, Congressman Dean Phillips officially signed on to HR 3421: The Medicare for All Act of 2023, originally proposed to Congress by US Representatives Pramila Jayapal (WA-07), Debbie Dingell (MI-06) and US Senator Bernie Sanders (VT).

By co-sponsoring the bill, Congressman Phillips is committing as President to pursue the creation of a Medicare for All system with the benefits outlined in the bill with no copayments, no deductibles, and no other cost sharing. Phillips’s path to transitioning to a Medicare for All system by the end of his first term is detailed below.  

This commitment is a result of a personal journey and evolution for Dean Phillips, as someone who has always been supportive of universal healthcare, who lived through major health challenges and scares within his own family, and who listened to tens of thousands of everyday Americans on both sides of the aisle as a Congressman and presidential candidate. Dean Phillips is an original co-sponsor of Congressman Ro Khanna’s H.R. 6270, a bill to permit states to implement a single-payer health insurance system. Phillips also co-sponsored the same legislation in the last Congress, signing on June 23, 2022.

Dean believes that we need affordable healthcare for all Americans, and Medicare For All is the best way to deliver that vision.

The Problem

We are facing an affordability crisis in America, and healthcare costs are at the heart of the problem. According to a poll conducted by the Kaiser Family Foundation, in the past five years, more than half of US adults have gone into debt to pay for medical expenses. An estimated 100 million Americans have amassed almost $200 billion in medical debt – a number that still isn’t the full picture as not all medical debt is reported to consumer debt reporting organizations.

Beyond the huge toll that medical affordability has on Americans’ pocketbooks, Americans are increasingly facing worse health outcomes than their counterparts in other wealthy nations. While per capita the US spends nearly $13,000 on healthcare, double the average for comparable countries, the US is experiencing plunging life expectancy and an increasingly widening gap in lifespan between rich and poor citizens – an effective look at those who have access to insurance and those who do not. A 2019 study found that 13% of Americans know someone who died because they didn’t have health insurance. 

Other reporting reveals that far from being part of the solution, the private health insurance industry is part of the problem – routinely rejecting valid claims through largely automated processes that overrule the judgments of a patient’s treating physician. In addition, America’s patchwork system of payers with wildly varying administrative requirements are a key factor in the exorbitant cost of healthcare in the United States. As previously noted, the US spends roughly twice as much per capita as other wealthy countries, and it spends even more comparatively on administrative costs topping four times the rate of other nations.

As a business person, Dean Phillips believes the United States should not be settling for a bloated bureaucratic healthcare system that is failing to keep our people healthy. It is a system built for insurance bureaucrats and drug company profiteers who charge Americans many times more than they charge people in other countries. 

The Solution

As president, Dean Phillips would make reimagining America’s broken medical system his first priority – pushing us from “sickcare” to real healthcare that gives every American access to affordable, effective, and compassionate care. This is a human issue that we cannot allow partisan politics to derail.

To do this, Dean will work with Congress to develop a Medicare for All national health insurance program to provide everyone in America with comprehensive healthcare coverage, free at the point of service. This system would eliminate deductibles, copays, and surprise bills for a broad umbrella of medical coverage including dental, vision, hearing, mental and emotional health, substance abuse treatment and recovery, reproductive and maternity care, long-term care, in-patient and out-patient services, prescription drugs, and more. Alongside the implementation of Medicare for All, Dean will end the pharmaceutical industry’s price-gouging of hardworking Americans by implementing a 90% excise tax on any price incremental to what is offered to our neighbors, Canada and Mexico. Americans will no longer accept this inequitable policy.

Getting To Medicare for All

There’s no doubt Medicare for All makes sense from an economic, healthcare, and moral perspective. However, there are still many who have been fed misinformation and disinformation from those who profit from the complexity and waste in the U.S. health system. Dean Phillips believes that, if given the choice to participate in the Medicare for All plan called for in H.R. 3421, the people and the businesses of the United States will rapidly and voluntarily abandon the current wasteful and expensive sick care non-system.

Private health insurance just cannot compete with Medicare for All in terms of cost savings, in terms of putting doctors and patients back in control of healthcare decision-making, and in improving the health and wellness of Americans.

Under Congressman Dean Phillips's transition strategy, the public option program created in H.R. 6270 to transition to Medicare for All would eliminate all co-payments, all deductibles, and all other cost-sharing over three years. This would create a public health insurance program with the exact benefit structure of Medicare for All. Other federal health programs other than the VA and the Indian Health Service would then be integrated into the Medicare for All plan.

Dean Phillips’s plan is fundamentally different from so-called “public option” plans that call for the creation of a public plan that mirrors the benefit structure of private plans in the health care exchanges including deductibles, copayments, and other cost-sharing.

Private plans could continue to offer services in “competition” with Medicare for All. However, businesses and individuals could leave the private market and move to Medicare for All at any time.       

“If private health insurers really have to compete with Medicare for All’s no copayments and no deductibles, in a very short period most of America will voluntarily move to Medicare for All. Some people think they want to keep their 20th century insurance plans. If so I say to them, go right ahead. Once they see the cost savings and the increased benefits of Medicare for All – a program for the 21st century and beyond – I’m confident they will have a change of heart.” 

– Dean Phillips

How We Pay for It

Frankly, the question is not how we can afford to implement Medicare for All. The question should be how can we afford not to. The truth is, we’re already paying enough for every person in America to have comprehensive quality healthcare with no copayments and no deductibles. We just need to spend the money that’s already in the American healthcare system on healthcare, and not on bureaucracy and being wildly overcharged for products like prescription drugs. 

We spend twice as much per capita as other countries and yet we still have people who are uninsured and underinsured. Medicare for All will make our spending more efficient, saving money and lives.

Dean’s Vision Saves Costs

According to a February 15, 2020 study by epidemiologists at Yale University, the Medicare for All that Dean supports will save over $450 billion in healthcare costs. In fact, nearly two dozen studies show Medicare for All saves money.   

As insurance moves from the private health insurers and people’s bank accounts to a single government insurer, the financial resources that now flow to private insurers will move to finance the new system – but at less overall cost.  Nothing is free, even healthcare.  Anyone who says they can provide everyone with free healthcare just isn’t being honest. Dean Phillips will fight to fund Medicare for All in a way that reflects the ability of people to pay.  

The exact funding strategy and mechanisms for funding Medicare for All will need to be determined by Congress. But we do know that federal and state governments pay for about half of healthcare in the United States already. Thus, new funding for Medicare for All needs only to cover the amounts currently paid by private insurers or out of pocket by consumers. That amount will be further reduced by the tremendous savings that will be realized by going to a single provider, allowing us to offer care at a lower cost than what we're currently paying.

In addition, some of the options for replacing private insurance and out of pocket costs that have been proposed by Medicare for All proponents in the past include:

• Income-based premiums. Planned income-based premiums would be a fraction of what people with private insurance already pay. These premiums would be structured so that people receiving subsidized insurance through, for instance, Medicaid or a subsidized plan on the exchanges, would not be paying more than what they currently pay.

• Business premiums based on payroll. These premiums would be lower than what businesses are currently paying. Plus, there would be a payroll exemption of more than $1 million, so micro-enterprises like small retailers would be exempt.

• Other revenue sources. These could include those that target wealthy taxpayers and large companies by closing tax loopholes and making sure everyone is paying their fair share.

Whatever the financing mechanism, Americans and American businesses will be paying less for healthcare under Dean’s Medicare for All plan.

Dean’s Vision Saves Lives

Perhaps the most critical savings from Medicare for All, though, is not how we finance healthcare as a nation, but rather how we continue ignoring the pain, financial burdens, and death caused by our current system. According to a 2022 study, Medicare for All would have saved 338,000 lives during the COVID-19 pandemic. Study after study has found that in our current system, the uninsured are about 20% more likely to die than their insured counterparts in the US medical system. The previously mentioned Yale University study on Medicare For All determined that this plan would prevent 68,000 unnecessary deaths – every year.

Under Dean’s vision – we will finally say enough is enough. American lives are worth more than the profits of health insurers and pharmaceutical companies - entities we respect and value, and expect reciprocation.

The shift to Medicare for All will occur over multiple years, and thus the full cost of the transition to a single payer won’t happen immediately. Americans with various employer plans, quality union plans, and others who may initially wish to continue on previously existing healthcare plans will help to ease initial costs for the plan. While it is expected that within a decade almost every American will participate in Medicare for All, there may end up being a few legacy private plans operating on the fringes.

The issues preventing Medicare for All are not costs. In fact, we can’t afford to not pass Medicare For All. And when Dean is president, he will make this his top priority.