Everyone loves the party game/icebreaker “two truths and a lie.”

Can you identify which of the following is NOT true about the “Medicare for All” plan championed by Democratic presidential candidate Bernie Sanders?

A.    The new, government-run single-payer healthcare system proposed by Sanders would replace virtually all other insurance options.

B.    The Canadian single-payer system — which Sanders used as a model for his own plan — has abolished out-of-pocket healthcare spending while reducing wait times since the early 1990s.

C.     Over the long term, Medicare’s current financial structure is unsustainable.


Let’s take these statements one at a time:


PolitiFact has confirmed that the Medicare for All legislation Sanders introduced in 2017 would “replace all other insurance, with limited exceptions, such as cosmetic surgery.”

That means it would replace, not only private health insurance and the Affordable Care Act, but also the existing Medicare program.

“When fully implemented,” says PolitiFact, “Sanders’ version of Medicare for All would replace private insurance, along with Medicaid and Medicare. The Affordable Care Act — former President Barack Obama’s signature health care accomplishment — would go away.”


Speaking to CBS News in February, Sanders made a provocative comment about Canada’s government-run healthcare system. “In Canada,” he said, “they have provided quality care to all people without out-of-pocket expenses.”

That would be extraordinary if it were true. But it’s not.

In 2017, Canada’s out-of-pocket health expenditures amounted to more than 1.5 percent of GDP, according to OECD data. The equivalent ?gure in America was just under 1.9 percent of GDP.

However, out-of-pocket expenditures accounted for a larger portion of all health spending in Canada (nearly 15 percent) — and in most Western European countries, including the Nordics — than they did in America (11 percent).

Here’s PolitiFact: “In Canada, if you actually go into a hospital and get treated there, it is free. Across the country, hospital visits and care at the doctor’s office are covered 100 percent. But prescription drugs and some outpatient care are a different matter entirely.”

What about healthcare wait times? The Vancouver-based Fraser Institute calculatesthat, in 2018, the median waiting time in Canada’s single-payer system — that is, the time “between referral from a general practitioner and receipt of treatment” — was 19.8 weeks, up from 9.3 weeks in 1993. For some treatments, the wait times were much longer. Indeed, the median waiting time between referral from a general practitioner and receipt of orthopedic surgery was a staggering 39 weeks.


There are many ways to illustrate the need for Medicare reform. As Urban Institute scholars Eugene Steuerle and Caleb Quakenbush have shown, both current and future retirees will receive dramatically more in Medicare benefits than they will pay in Medicare taxes. For example, Steuerle and Quakenbush project that a married, one-earner couple with an average income who turn 65 in 2030 will pay $93,000 in lifetime Medicare taxes but receive $645,000 in lifetime Medicare benefits (net of premiums).

Click here to read more about Medicare for All and why it’s the wrong solution to America’s healthcare challenges.