Is Bernie Sanders right about health care?

Published 9:00 AM EST, Sun January 24, 2016

Story highlights

Sanders is right that a single-payer health care system would be an improvement, says H. Gilbert Welch

Welch: Since it would boost taxes, it's not politically feasible -- but should it be?

Editor’s Note: H. Gilbert Welch is a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and the author of “Less Medicine, More Health – 7 Assumptions that Drive Too Much Medical Care“. The opinions expressed in this commentary are his.

CNN —  

If the question is about health care, Sen. Bernie Sanders is the only presidential candidate able to give a short answer: Medicare for all.

In a world of health-savings accounts, interstate insurance sales, exchanges, silver or gold plans and accountable health care organizations, he dusts off a proposal from the 1980s: universal coverage by a single payer – the federal government.

H. Gilbert Welch
H. Gilbert Welch

It sounds so quaint. But could Bernie actually be right?

Our current system of multiple payers is supposed to foster competition, which in turn is supposed to make health care more affordable, more accessible and have higher quality. How could a single payer ever improve on that?


First, multiple payers multiply the complexity for patients. Sure there are many choices, but patients may not understand the tradeoffs involved