Medicare for All—Running Down a Dream

In the 2016 Democratic presidential primary, Senator Bernie Sanders (D-VT) ran an insurgent campaign against front-runner Hillary Clinton. Sanders's signature proposal was a call to establish “Medicare for All,” replacing the byzantine web of public and private insurance sources from which Americans obtain health coverage—and that leaves millions of people without any coverage at all—with one government-run program. Medicare for All promised to remedy the myriad shortcomings and consequences of America's health insurance arrangements: inequity, inefficiency, insecurity, unaffordability, complexity, poor health outcomes, and more. Sanders's invocation of Medicare for All, rather than the more opaque single-payer insurance label that reformers had previously bandied about, swaddled sweeping change within the familiar grasp of a popular, long-established program (namely, Medicare); instantly conveyed the core, seemingly straightforward idea behind the plan (extending Medicare's federal insurance to all Americans); and, crucially, located the model for reform within the United States rather than across the...