The Democratic Socialists of America’s (DSA) recently released “Workers Deserve More” program is full of silly policies that will probably never come to full fruition, fortunately. However, one of the more “mainstream” policies of the program, Medicare for All, absolutely could become the law of the land.
Medicare for All is popular because it drips empathy and means different things to people. There is no distinct definition. To some, it means a single-payer system. To others, it means providing subsidies to those who cannot afford healthcare.
Specifically, the DSA’s Medicare for All plan would “guarantee universal healthcare at no cost to individuals, including complete access to reproductive and gender-affirming care.”
Keep in mind, this is not the Medicare model because Medicare does not cover all healthcare costs.
According to the federal government’s Medicare website, “Medicare covers things like inpatient hospital care, doctors’ services and tests, and preventive services.”
It does not cover “eye exams,” “long-term care,” “cosmetic surgery,” “massage therapy,” “routine physical exams,” “hearing aids and exams for fitting them,” “Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care),” and “most dental care.”
In 2025, 87 percent of Medicare recipients purchased “supplemental coverage” like Medigap and Medicare Advantage to cover prescription drugs and several services.
So, when DSA candidates refer to Medicare for All as universal healthcare, they are not honest.
Medicaid for All is a more accurate term.
Another daunting problem the DSA does not address is the fact that the Medicare Trust Fund, “which provides coverage to about 70 million Americans aged 65 and older and people with disabilities,” is already facing “serious fiscal challenges.”
In short, “Medicare spending is projected to continue increasing faster than Medicare payroll taxes and faster than the overall economy, resulting in projected insolvency of the HI trust fund in the next seven years.”
I am not a mathematician nor an actuary, but even I clearly understand that expanding Medicare to all Americans when it is on the verge of insolvency means rationing of care and shortages will soon follow.
Nevertheless, the DSA asserts that Medicare for All can be fully funded by enacting “aggressive wealth taxes on the richest individuals and corporations.”
Sen. Bernie Sanders (I-VT) claims that Medicare for All would reduce overall healthcare spending by $1 trillion per year. But that is hard to believe considering the trajectory that Medicare spending has skyrocketed in recent years.
A much more probable projection of the total cost of Medicare for All was conducted by the Paragon Health Institute. Unsurprisingly, it found that Medicare for All “would increase federal spending by roughly $44 trillion over its first decade.”
Moreover, the report notes that “extending taxpayer-funded coverage to individuals residing in the country illegally,” which is exactly what the DSA intends, adds “$1.8 trillion in additional federal costs to cover them.”
To put those numbers into context, consider that the total national debt is $39.9 trillion.
Adding to the absurdity, the federal government is on pace to run $2 trillion annual deficits over the next decade. This year alone, interest payments on the national debt surpassed $1 trillion!
Long story short, the United States cannot afford the DSA’s so-called Medicare for All program.
Based on the track record of single-payer systems in places like Canada and the U.K, this should be celebrated by Americans who desire prompt, effective, state-of-the-art healthcare.
The American healthcare system needs massive reform. But placing the federal government in charge of delivering healthcare to all Americans is a bridge too far.
Instead of seeking a one-size-fits-all system that will not fit any individual or family, the U.S. healthcare system should embrace ingenuity, innovation, and individual freedom.
Americans ought to demand that we the people and the states, not the federal government, determine healthcare policy.
Although a single-payer structure might seem simpler compared to the complicated third-party system in place, centralization and consolidation of power always make things even more byzantine, costly, and complex.
We need the opposite of Medicare for All. We need a truly free-enterprise system with abundant choices that prioritizes the unique healthcare needs and circumstances for all Americans.
Chris Talgo (ctalgo@heartland.org) is editorial director at The Heartland Institute.