- The piece discusses the issue of Medicare for All in the Democratic primary.
- Medicare for All aims to replace the current multi-payer system with a government-funded, single-payer program.
- Critics argue that Medicare for All would be too expensive and increase the federal budget significantly.
- The plan is generous and covers vision, dental, long-term care, and drugs.
- Consolidating health insurance under one roof would allow the government to negotiate prices and potentially reduce costs.
- The piece addresses concerns about wait times and rationing of care under Medicare for All.
- International comparisons of wait times for non-emergency surgeries are complex and vary.

- The international wait times for non-emergency surgeries are often exaggerated and Americans also face delays due to the high cost of care.
- Many Americans have had to put off or skip care due to cost, leading to worsened medical conditions.
- Uninsured individuals often have to wait in long lines for free care from aid groups like Remote Area Medical.
- The UK and Canada have strong support for their healthcare systems, with only a small percentage believing they need to be rebuilt completely.
- The current US healthcare system limits choices and forces people to make difficult decisions based on cost.
- Medicare for All would eliminate out-of-network doctors and provide more equitable access to care.
- The public option, as proposed by Pete Buttigieg, would leave many problems of the current system intact.
- Implementing universal healthcare would be challenging but necessary to address the flaws of the current system.

As presidential candidates continue to discuss Medicare for All, John Oliver explores how much it might cost, what it will change, and who it will help.

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-♪ ♪ -♪ ♪ We thought we'd talk about an issue that has dominated the Democratic primary.

And I'm not talking about why Tom Steyer doesn't look richer, but why doesn't he, though?

His skin's sallow, his clothes don't fit right, and he seems to only have 1 tie, what is this man doing with all his fucking money?

It's the hot buzz phrase for Democrats running for president, Medicare for all.

Now there's a lot of talk about Medicare for all.

From a great judge and an even greater human being.

And to answer the question from Ruth Bader Ginsburg's inevitable successor, what is Medicare for all?

Well, right now, we have what's called a multi-payer system.

What that means is maybe your health care is covered by private insurance purchased by you or your employer.

Or maybe it's covered by a government program like Medicare or Medicaid, or maybe you're 1 of the 27 million Americans with no insurance, in which case, you're fucked.

The basic idea behind Medicare for All is that all of this will be replaced by a government-funded, single-payer program.

And the goal of universal health care coverage is extremely appealing.

Both Bernie Sanders and Elizabeth Warren have put out versions of Medicare for All, but other Democrats have been much warier of it, and conservatives absolutely hate the idea.

This is the end of America as we know it economically.

I think, literally, 90% of hospitals would go under tomorrow.

Nationalized health care is a disaster when rich, famous people get sick.

They don't fly to Canada, they don't fly to Cuba, they come here because we have the best medicine in the world.

America does have 1 of the best health care systems in the world for rich, famous people.

Unfortunately, too many people are born in this country with a terrible pre-existing condition called not being Beyoncé.

And for so many Americans, our system is badly broken.

And I'm not just talking about the 27 million without health insurance, but the nearly 44 million more who are underinsured.

People with high deductibles and copays that can end up bleeding them dry.

The majority of people who file for bankruptcy cite medical expenses as a factor.

And you probably already knew that deep down from just how often you see GoFundMe campaigns online from worried parents of sick children or your friend who got a pineapple stuck up his ass and needs help paying the doctors to stop laughing and get it out.

And incidentally, for all the heartwarming success stories that you see, a study found 90 percent of crowdfunding campaigns for medical expenses fail to meet their goal.

And when they fall short, it can be crushing.

Watch as 1 family struggles to raise $10,000 for expenses arising from their two-year-old daughter's eye disorder.

Sheila's fundraiser isn't going as well as they'd hoped.

Early morning on the day of Shayla's surgery, her parents are still trying to get the word out.

Okay, so we're gonna make her sign, hashtag, Eyes for Shayla.

Think about what you're looking at there.

It's a pretty dystopian society that we're living in.

If your physical and financial well-being depend on whether your crowdfunding campaign can get a signal boost from Jiff Pond the Pomeranian.

I've been trying to get him to post our gerrymandering piece for months now, and he won't do it.

Come on, Jiffpom, throw us a fucking bone, you arsehole!

-♪ ♪ -♪ The point is, any solution that might put an end to that is worth at least considering, surely.

And To be honest, I personally think there is a lot to be said for Medicare for All.

Not the politics of whether it can pass, but what it actually is.

And whenever the subject comes up, you tend to hear 3 major criticisms of it concerning cost, wait times, and choice.

And let's start with cost, because critics will tell you that Medicare for All will simply increase the federal budget too much.

This sicko socialism would cost roughly 32.6 trillion dollars over 10 years.

Even if you doubled tax collections from individuals and corporations, yes, that means you'd be paying twice what you already do in taxes.

Look, I-I know that sounds dramatic, but Sarah Palin's fourth attempt at cloning herself actually has a point there.

Medicare for all would undeniably be expensive, but that fact needs a lot of context around it.

For starters, it would increase the federal budget, yes.

But it would also eliminate employer spending on premiums and your spending on out-of-pocket costs.

The answer is, No 1 can possibly know for sure.

There are just too many variables involved.

The Times asked 5 prominent experts to estimate national health care spending under Bernie's plan, and they compared that to what we spend now.

And the results range from, it would actually cost us less, to it would cost about the same, to it would cost a fuck of a lot more.

And I know that extra shading does not look like very much, but believe me, it's a fuck of a lot.

But look, let's say, just for argument's sake, our overall spending did go up.

We would be getting a lot for that money.

Remember, 27 million more people would be covered, and they'd be covered well.

It covers vision, dental, long-term care, and drugs.

In fact, Medicare for All is a misleading title because Medicare requires some co-pays and out-of-pocket expenses.

And Bernie will excitedly tell you his plan eliminates those.

Under the Medicare for All bill that I wrote, premiums are gone.

All the things you hate in this world will be gone, and all that will remain is universally accessible healthcare and Laura Dern.

Bernie's plan isn't just more generous than most current private insurance plans.

It's more generous than the policy of any single-payer country on Earth.

And there is a good case to be made that even if national spending wound up higher, we might wind up wasting less.

Right Now, a lot of our health care spending doesn't go to health care.

It goes to administrative costs that come with having a vast insurance industry.

And consolidating all health insurance under 1 roof would give the government far more leverage to negotiate prices down.

Because look, it is no secret, prices for procedures and drugs are out of control in the United States.

It is so bad, 1 insurance provider in Utah recently started offering some of its participants cash if they were willing to travel a little further than their local pharmacy to fill out their prescription.

PEHP puts patients on a plane and flies them to San Diego.

From there, a private car takes them across the border to Tijuana, Mexico, where their prescription is waiting for them.

The only difference, the prescription costs roughly half the price.

Will give people willing to travel an additional $500 back.

It's cheaper for us to pay for the drug down there, send them down there, and then give them $500.

Giving you $500 to go to Mexico to buy drugs is not what your insurance provider should be doing.

It's what your sketchy friend Meredith should be doing.

Because she wants to make Brianna's bachelorette party a total rager.

I'd go myself, but I have outstanding wires.

-♪ ♪ -♪ Under Medicare for All, the government would be a much stronger negotiator.

Now, you wouldn't want it to set prices so low that it stifles innovation or bankrupts doctors, but that is a balance that you would need to strike.

Overall, you can't definitely say that it would be more expensive, but even if it was, I personally would argue that it's worth it.

And either way, cost is a lot more complicated an issue than just going on TV and saying, $32.6 trillion, like Tina Fey doing her best Doctor Evil impression.

Anyway, the next major criticism of Medicare for All concerns wait times.

Specifically, that it would result in rationing and delays to care.

If you think it's fun to wait in line at DMV, you're gonna love Bernie Sanders' wait times for Medicare for All.

It leads to the kind of care that people now have in England or Canada where you have to wait in line.

It means people not getting the health treatments they need.

Okay, I get that no 1 likes waiting in line for anything.

Most people see the line at Trader Joe's and either abandon their cart or pull the fire alarm and sneak out with their groceries undetected.

I'm not saying I've ever done that, I'm just saying I had a show to do tonight and who wants some peanut butter pretzels?

But look, as with cost, comparisons of wait times are very complicated.

For 1 thing, the international wait times that you hear about most often are for non-emergency surgeries, such as knee replacements.

And while, yes, people in other countries do sometimes have to wait slightly longer for some care, it's not like Americans aren't having to do that right now anyway.

Americans are just sometimes forced to wait due to the expense.

Adults say they or a family member put off or skipped care in the past year because of the cost.

And about 1 in 8 say their medical condition got worse because of that delay.

As for the uninsured, they can wind up having to wait on a literal line, seeking care with aid groups like Remote Area Medical, an organization that travels the country, setting up mobile clinics to treat people for free, and which draws massive lines wherever it goes.

Having got their place in line, many camped out for the night.

Before dawn, this was the moment they were waiting for.

1 by 1, patients are let in for their chance of a visit to a doctor, a dentist, and an optician.

At first, Ram focused on communities in remote areas of developing countries.

But Stan says he gradually came to realize the depth of need in the U.S.

It's unbelievable to me that that is the case.

Normally, Americans hate it when a British person comes over to diagnose what's wrong with you.

Believe me, 6 seasons of YouTube comments have made that very fucking clear.

And for all critics' talk of wait times abroad, it is worth knowing less than 10 percent of Britons or Canadians say that their health system needs to be rebuilt completely, compared to 23 percent of people here in the United States.

In fact, when London hosted the 2012 Olympics, the opening ceremony featured a 4 and a half minute celebration of the National Health Service, featuring swing dancing doctors and nurses, and children jumping up and down on hospital beds.

As for Canada, they adore their health service so much that when they had a contest for the greatest Canadian of all time, this was the result.

The greatest Canadian as decided by you is...

The mother of all national titles goes to the father of Medicare.

mean, his master's thesis, The Problems of the Subnormal Family, endorsed eugenics, but we're gonna ignore that, because it was the 1930s and no one's perfect!

then there is the final big criticism of Medicare for All, which involves choice.

Specifically, that it would take away our ability to choose the sort of health coverage that we receive.

When I hear that health care is a right, what I hear is health care will no longer have choices.

Under Medicare for All, your choice of health coverage disappears.

We're not socialists, we're not communists, we like choice.

And we like to have choice in health care especially.

It's why the number 1 rated series on Netflix is 40 Minutes of Looking Through the Menu for Something Good.

It's basically America's new national pastime.

And the fact you're applauding that is a full cosine on that concept.

But the fact is, the fact is our current system limits Americans' choices far more than it expands them.

For starters, as a practical matter, most of us don't choose our health insurance.

And because of that, choices like changing jobs can become significantly harder, and not just that.

Oftentimes, your choice of doctors and hospitals is severely limited by which ones your insurance will cover.

Going out of your insurance network can be prohibitively expensive.

That is why people bend over backwards to stay in network.

And even when they do that, it can still all go horribly wrong.

While campaigning in 2018, Democratic Congresswoman Katie Porter's appendix burst.

Her first thought, how much would it cost?

I didn't call an ambulance, because I knew it could cost a lot if you call an ambulance.

And I had specifically had my manager drive me, not to the closest hospital, but to the in-network hospital.

Even though the hospital was in her network, the surgeon who helped save Porter's life was not, and she got a bill for nearly $3,000.

You can get fucked by taking an ambulance.

You can get fucked by going to the wrong hospital, or you can get fucked by going to the right hospital, but getting the wrong surgeon.

The American health care system gives you so many choices as to how you want to get fucked.

It truly is the karma sutra of healthcare.

And under Medicare for All, that scenario would not happen.

No doctor would be out of network because there wouldn't be a network at all.

And the truth about America's current illusion of choice is that too often, because of cost, the choices our current system forces people to make are ones like this.

I prioritize the hard stuff over the insulin because the hard stuff is more immediate.

I know over time, you know, diabetes will kill me, but it'll take a longer time.

And I know that without the heart failure drugs, I only have 13 percent function of my heart.

A humane healthcare system should not require people to pick their favorite organ.

Although, for the record, if you're ever asking me my favorite organ, I'm going spleen every time.

Now, I know the brain and the heart get all the attention, but I'm telling you, when it comes to filtering blood, you can't go wrong with the spleen.

Those are the 3 main criticisms of Medicare for All.

And I should say, it is not just people on the right who raised them.

Pete Buttigieg, for instance, prefers a different concept to Medicare for All, but with a catchily similar name.

My health care vision is Medicare for all who want it.

Let every American have the choice to walk away from the corporate private plans and towards something better.

But when they're ready, because I trust Americans to make that right choice.

You trust Americans to make the right choice?

You know Americans choose to drink Bud Light, right?

Which doesn't taste like beer, so much as it tastes like if beer somehow died and was discovered in its apartment 3 weeks later.

But what Buttigieg is referring to when he says, Medicare for all who want it, is basically the public option.

That is where the government doesn't replace the private insurance system, it just introduces its own plan that would compete with it.

And it would definitely be an improvement over what we have now.

The problem is, it would leave so much of our current insurance infrastructure with all of its problems intact.

So that's kind of like being offered either a shit sandwich or a slightly smaller shit sandwich with guac.

I mean, I guess I'll take the second 1 if you're asking, but honestly, the lack of guac wasn't really my main fucking concern.

--LAUGHTER, APPLAUSE AND CHEERING --And I'm not saying any of this would be easy.

A lot would have to be figured out, from how to impose the taxes to pay for it in an equitable way, to the consequences of eliminating the entire private health insurance industry, which by 1 estimate, could displace 1.8 million workers.

That is a legitimate thing to be concerned about.

And any plan would have to be designed and rolled out very, very carefully.

That is why both Warren and Sanders talk about the need for transition plans for workers in their proposals.

It is human nature to prefer the devil you know over an uncertain alternative.

But 1 thing Britain does well is the National Health Service.

I'm not gonna swing dance on a fucking bed about it.

But I will be honest with you, I've never had a bad experience, and I don't know anyone who has.

But, since moving to America, I don't think I have met anyone who doesn't have at least 1 insurance industry horror story.

National anthem should just be everyone in the stadium yelling about their insurance company for 2 and a half minutes.

So, for what it is worth, personally, I am in favor of some version of carefully designed universal health coverage.

And I will own all the things about it that are difficult, including the fact that politically, it would be incredibly hard to get past.

But in return, anyone who is resistant to significant change is going to have to own all the flaws of our current system.

1 in which when Americans get sick, they can find themselves comparison shopping with a burst appendix, flipping a coin between life-saving medications, and praying they can come up with a catchy enough hashtag to cover their care.

Although, for what it's worth on that 1, until we fix this fucking mess, if anyone gets a ruptured spleen, please feel free to use hashtag, Yaaaah spleen.


Speaker 0: -♪ ♪ -♪ ♪ We thought we'd talk about an issue that has dominated the Democratic primary. And I'm not talking about why Tom Steyer doesn't look richer, but why doesn't he, though? His skin's sallow, his clothes don't fit right, and he seems to only have 1 tie, what is this man doing with all his fucking money? No, we're not talking about that. Instead, we're gonna talk about this.

Speaker 1: It's the hot buzz phrase for Democrats running for president, Medicare for all. We will have Medicare for all.

Speaker 2: We have a chance for Medicare for all.

Speaker 1: Medicare for all. Medicare for all.

Speaker 2: Now there's a lot of talk about Medicare for all. What does that mean?

Speaker 0: --LAUGHTER --Great question... From a great judge and an even greater human being. And to answer the question from Ruth Bader Ginsburg's inevitable successor, what is Medicare for all? Well, right now, we have what's called a multi-payer system. What that means is maybe your health care is covered by private insurance purchased by you or your employer.

Or maybe it's covered by a government program like Medicare or Medicaid, or maybe you're 1 of the 27 million Americans with no insurance, in which case, you're fucked. The basic idea behind Medicare for All is that all of this will be replaced by a government-funded, single-payer program. And the goal of universal health care coverage is extremely appealing. Both Bernie Sanders and Elizabeth Warren have put out versions of Medicare for All, but other Democrats have been much warier of it, and conservatives absolutely hate the idea.

Speaker 3: We cannot afford Medicare for all. This is the end of America as we know it economically.

Speaker 1: I think, literally, 90% of hospitals would go under tomorrow.

Speaker 4: Right. Medicare for all. I lived in England, Sean. Nationalized health care is a disaster when rich, famous people get sick. They don't fly to Canada, they don't fly to Cuba, they come here because we have the best medicine in the world.

Speaker 0: Look, look, I will give that man this. America does have 1 of the best health care systems in the world for rich, famous people. Unfortunately, too many people are born in this country with a terrible pre-existing condition called not being Beyoncé.

Speaker 5: Some of us, many of

Speaker 0: us in fact, are Solange. And for so many Americans, our system is badly broken. And I'm not just talking about the 27 million without health insurance, but the nearly 44 million more who are underinsured. People with high deductibles and copays that can end up bleeding them dry. The majority of people who file for bankruptcy cite medical expenses as a factor.

And you probably already knew that deep down from just how often you see GoFundMe campaigns online from worried parents of sick children or your friend who got a pineapple stuck up his ass and needs help paying the doctors to stop laughing and get it out. And incidentally, for all the heartwarming success stories that you see, a study found 90 percent of crowdfunding campaigns for medical expenses fail to meet their goal. And when they fall short, it can be crushing. Watch as 1 family struggles to raise $10,000 for expenses arising from their two-year-old daughter's eye disorder.

Speaker 6: Sheila's fundraiser isn't going as well as they'd hoped. About a month in, it's only raised $610. Early morning on the day of Shayla's surgery, her parents are still trying to get the word out.

Speaker 7: Okay, so we're gonna make her sign, hashtag, Eyes for Shayla. Very good.

Speaker 0: Think about what you're looking at there. It's a pretty dystopian society that we're living in. If your physical and financial well-being depend on whether your crowdfunding campaign can get a signal boost from Jiff Pond the Pomeranian. And good luck with that, by the way. I've been trying to get him to post our gerrymandering piece for months now, and he won't do it.

Come on, Jiffpom, throw us a fucking bone, you arsehole! -♪ ♪ -♪ The point is, any solution that might put an end to that is worth at least considering, surely. And To be honest, I personally think there is a lot to be said for Medicare for All. So tonight, let's take a look at it. Not the politics of whether it can pass, but what it actually is.

And whenever the subject comes up, you tend to hear 3 major criticisms of it concerning cost, wait times, and choice. And let's start with cost, because critics will tell you that Medicare for All will simply increase the federal budget too much.

Speaker 8: This sicko socialism would cost roughly 32.6 trillion dollars over 10 years. Even if you doubled tax collections from individuals and corporations, yes, that means you'd be paying twice what you already do in taxes. That still doesn't cover the tab. My God, free health care is expensive.

Speaker 0: Look, I-I know that sounds dramatic, but Sarah Palin's fourth attempt at cloning herself actually has a point there. Medicare for all would undeniably be expensive, but that fact needs a lot of context around it. For starters, it would increase the federal budget, yes. But it would also eliminate employer spending on premiums and your spending on out-of-pocket costs. Now, would those balance each other out?

That is a good question. The answer is, No 1 can possibly know for sure. There are just too many variables involved. The Times asked 5 prominent experts to estimate national health care spending under Bernie's plan, and they compared that to what we spend now. And the results range from, it would actually cost us less, to it would cost about the same, to it would cost a fuck of a lot more.

And I know that extra shading does not look like very much, but believe me, it's a fuck of a lot. But look, let's say, just for argument's sake, our overall spending did go up. We would be getting a lot for that money. Remember, 27 million more people would be covered, and they'd be covered well. Bernie's plan is incredibly generous.

It covers vision, dental, long-term care, and drugs. In fact, Medicare for All is a misleading title because Medicare requires some co-pays and out-of-pocket expenses. And Bernie will excitedly tell you his plan eliminates those.

Speaker 1: Under the Medicare for All bill that I wrote, premiums are gone. Co-payments are gone. Deductibles are gone. All out-of-pocket expenses are gone.

Speaker 0: He's right. Hospital bills are gone. Co-payments are gone. Cell phone payments, gone. Flat tires, gone.

Geico commercials, gone. All the things you hate in this world will be gone, and all that will remain is universally accessible healthcare and Laura Dern. Finally, life as it should be. Bernie's plan isn't just more generous than most current private insurance plans. It's more generous than the policy of any single-payer country on Earth.

And there is a good case to be made that even if national spending wound up higher, we might wind up wasting less. Right Now, a lot of our health care spending doesn't go to health care. It goes to administrative costs that come with having a vast insurance industry. That is clearly wildly inefficient. And consolidating all health insurance under 1 roof would give the government far more leverage to negotiate prices down.

Because look, it is no secret, prices for procedures and drugs are out of control in the United States. It is so bad, 1 insurance provider in Utah recently started offering some of its participants cash if they were willing to travel a little further than their local pharmacy to fill out their prescription.

Speaker 7: It's called pharmaceutical tourism. Here's how it works. PEHP puts patients on a plane and flies them to San Diego. From there, a private car takes them across the border to Tijuana, Mexico, where their prescription is waiting for them. The only difference, the prescription costs roughly half the price.

P.E.H.P. Will give people willing to travel an additional $500 back.

Speaker 9: It's cheaper for us to pay for the drug down there, send them down there, and then give them $500.

Speaker 0: That's fucking crazy! Giving you $500 to go to Mexico to buy drugs is not what your insurance provider should be doing. It's what your sketchy friend Meredith should be doing. Because she wants to make Brianna's bachelorette party a total rager. I'd go myself, but I have outstanding wires.

-♪ ♪ -♪ Under Medicare for All, the government would be a much stronger negotiator. Now, you wouldn't want it to set prices so low that it stifles innovation or bankrupts doctors, but that is a balance that you would need to strike. Overall, you can't definitely say that it would be more expensive, but even if it was, I personally would argue that it's worth it. And either way, cost is a lot more complicated an issue than just going on TV and saying, $32.6 trillion, like Tina Fey doing her best Doctor Evil impression. -♪ ♪ -$32.6 trillion.

Anyway, the next major criticism of Medicare for All concerns wait times. Specifically, that it would result in rationing and delays to care.

Speaker 1: If you think it's fun to wait in line at DMV, you're gonna love Bernie Sanders' wait times for Medicare for All.

Speaker 10: It leads to the kind of care that people now have in England or Canada where you have to wait in line.

Speaker 11: Just take a look at Canada or the UK. It means long waiting lines. It means people not getting the health treatments they need.

Speaker 0: Okay, I get that no 1 likes waiting in line for anything. I get it. Most people see the line at Trader Joe's and either abandon their cart or pull the fire alarm and sneak out with their groceries undetected. I'm not saying I've ever done that, I'm just saying I had a show to do tonight and who wants some peanut butter pretzels? But...

But look, as with cost, comparisons of wait times are very complicated. For 1 thing, the international wait times that you hear about most often are for non-emergency surgeries, such as knee replacements. And while, yes, people in other countries do sometimes have to wait slightly longer for some care, it's not like Americans aren't having to do that right now anyway. Americans are just sometimes forced to wait due to the expense. About half of U.S.

Adults say they or a family member put off or skipped care in the past year because of the cost. And about 1 in 8 say their medical condition got worse because of that delay. As for the uninsured, they can wind up having to wait on a literal line, seeking care with aid groups like Remote Area Medical, an organization that travels the country, setting up mobile clinics to treat people for free, and which draws massive lines wherever it goes.

Speaker 12: Having got their place in line, many camped out for the night. Before dawn, this was the moment they were waiting for.

Speaker 13: Number 1, come on down. Number 2. Number 3.

Speaker 12: 1 by 1, patients are let in for their chance of a visit to a doctor, a dentist, and an optician. At first, Ram focused on communities in remote areas of developing countries. But Stan says he gradually came to realize the depth of need in the U.S.

Speaker 13: Today, oh, 80% or more of what we

Speaker 14: do is here in the United States.

Speaker 0: It's unbelievable to me that that is the case. Normally, Americans hate it when a British person comes over to diagnose what's wrong with you. Believe me, 6 seasons of YouTube comments have made that very fucking clear. The Internet is mean. And for all critics' talk of wait times abroad, it is worth knowing less than 10 percent of Britons or Canadians say that their health system needs to be rebuilt completely, compared to 23 percent of people here in the United States.

In fact, when London hosted the 2012 Olympics, the opening ceremony featured a 4 and a half minute celebration of the National Health Service, featuring swing dancing doctors and nurses, and children jumping up and down on hospital beds. As for Canada, they adore their health service so much that when they had a contest for the greatest Canadian of all time, this was the result.

Speaker 7: The greatest Canadian as decided by you is...

Speaker 0: ♪ ♪

Speaker 5: Tommy... Douglas!

Speaker 7: The mother of all national titles goes to the father of Medicare.

Speaker 0: -♪

Speaker 5: I'm a woman, I'm a woman, I'm a woman... ♪ -♪ I'm a woman, I'm a woman... ♪ Yes!

Speaker 0: Tommy Douglas!

Speaker 5: Yes! Whoo! I mean, I

Speaker 0: mean, his master's thesis, The Problems of the Subnormal Family, endorsed eugenics, but we're gonna ignore that, because it was the 1930s and no one's perfect! Give it up for Tommy!

Speaker 5: Whoo! -♪ Whoo!

Speaker 0: ♪ -♪

Speaker 5: Whoo! And look,

Speaker 0: then there is the final big criticism of Medicare for All, which involves choice. Specifically, that it would take away our ability to choose the sort of health coverage that we receive.

Speaker 14: When I hear that health care is a right, what I hear is health care will no longer have choices.

Speaker 1: Under Medicare for All, your choice of health coverage disappears.

Speaker 3: Americans are still Americans. We're not socialists, we're not communists, we like choice. And we like to have choice in health care especially.

Speaker 0: Right, right. Americans are Americans. It's true. And they do like having choices. It's why the number 1 rated series on Netflix is 40 Minutes of Looking Through the Menu for Something Good.

It's basically America's new national pastime. And the fact you're applauding that is a full cosine on that concept. But the fact is, the fact is our current system limits Americans' choices far more than it expands them. For starters, as a practical matter, most of us don't choose our health insurance. We get what we get through our employer.

And because of that, choices like changing jobs can become significantly harder, and not just that. Oftentimes, your choice of doctors and hospitals is severely limited by which ones your insurance will cover. Going out of your insurance network can be prohibitively expensive. That is why people bend over backwards to stay in network. And even when they do that, it can still all go horribly wrong.

Speaker 2: While campaigning in 2018, Democratic Congresswoman Katie Porter's appendix burst. Her first thought, how much would it cost? I didn't call an ambulance, because I knew it could cost a lot if you call an ambulance. And I had specifically had my manager drive me, not to the closest hospital, but to the in-network hospital. Even though the hospital was in her network, the surgeon who helped save Porter's life was not, and she got a bill for nearly $3,000.

Exactly.

Speaker 0: You can get fucked by taking an ambulance. You can get fucked by going to the wrong hospital, or you can get fucked by going to the right hospital, but getting the wrong surgeon. The American health care system gives you so many choices as to how you want to get fucked. It truly is the karma sutra of healthcare. And under Medicare for All, that scenario would not happen.

No doctor would be out of network because there wouldn't be a network at all. And the truth about America's current illusion of choice is that too often, because of cost, the choices our current system forces people to make are ones like this.

Speaker 15: I prioritize the hard stuff over the insulin because the hard stuff is more immediate. I know over time, you know, diabetes will kill me, but it'll take a longer time. And I know that without the heart failure drugs, I only have 13 percent function of my heart. I don't want to play with that.

Speaker 0: That's obviously terrible. A humane healthcare system should not require people to pick their favorite organ. Although, for the record, if you're ever asking me my favorite organ, I'm going spleen every time. Now, I know the brain and the heart get all the attention, but I'm telling you, when it comes to filtering blood, you can't go wrong with the spleen. Hashtag, I'm a spleen-stang.

Hashtag, yeah, spleen! So... So those are... Those are the 3 main criticisms of Medicare for All. And I should say, it is not just people on the right who raised them.

Some Democrats have reservations too. Pete Buttigieg, for instance, prefers a different concept to Medicare for All, but with a catchily similar name.

Speaker 16: My health care vision is Medicare for all who want it. Let every American have the choice to walk away from the corporate private plans and towards something better. But when they're ready, because I trust Americans to make that right choice.

Speaker 0: Okay, well, hold on there. You trust Americans to make the right choice? You know Americans choose to drink Bud Light, right? Which doesn't taste like beer, so much as it tastes like if beer somehow died and was discovered in its apartment 3 weeks later. But what Buttigieg is referring to when he says, Medicare for all who want it, is basically the public option.

That is where the government doesn't replace the private insurance system, it just introduces its own plan that would compete with it. And it would definitely be an improvement over what we have now. The problem is, it would leave so much of our current insurance infrastructure with all of its problems intact. So that's kind of like being offered either a shit sandwich or a slightly smaller shit sandwich with guac. I mean, I guess I'll take the second 1 if you're asking, but honestly, the lack of guac wasn't really my main fucking concern.

--LAUGHTER, APPLAUSE AND CHEERING --And I'm not saying any of this would be easy. A lot would have to be figured out, from how to impose the taxes to pay for it in an equitable way, to the consequences of eliminating the entire private health insurance industry, which by 1 estimate, could displace 1.8 million workers. That is a legitimate thing to be concerned about. And any plan would have to be designed and rolled out very, very carefully. That is why both Warren and Sanders talk about the need for transition plans for workers in their proposals.

And I get that big change is scary. It is human nature to prefer the devil you know over an uncertain alternative. But the devil you know is still a devil. And it is easy to forget that. I shit on Britain a lot on this show.

And I'm not gonna stop any time soon. But 1 thing Britain does well is the National Health Service. It's not perfect, of course. I'm not gonna swing dance on a fucking bed about it. But I will be honest with you, I've never had a bad experience, and I don't know anyone who has.

But, since moving to America, I don't think I have met anyone who doesn't have at least 1 insurance industry horror story. At this point, the U.S. National anthem should just be everyone in the stadium yelling about their insurance company for 2 and a half minutes. So, for what it is worth, personally, I am in favor of some version of carefully designed universal health coverage. And I will own all the things about it that are difficult, including the fact that politically, it would be incredibly hard to get past.

But in return, anyone who is resistant to significant change is going to have to own all the flaws of our current system. 1 in which when Americans get sick, they can find themselves comparison shopping with a burst appendix, flipping a coin between life-saving medications, and praying they can come up with a catchy enough hashtag to cover their care. Although, for what it's worth on that 1, until we fix this fucking mess, if anyone gets a ruptured spleen, please feel free to use hashtag, Yaaaah spleen. That's all yours. Good luck with it.

-♪ Ooh, ooh, ooh, ooh... ♪ -♪

Speaker 5: Ooh, ooh, ooh, ooh... ♪ Thank you.

5. What is Jon Oliver’s response to each of the following concerns about “Medicare for all?” a) Cost b) Wait times c) Choice

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Medicare for All: Last Week Tonight with John Oliver (HBO)