The Yale study doesn’t prove Medicare for All will save $1 trillion—it is a model projection, not an observed result, and it depends heavily on ambitious estimates and assumptions. It is has not yet been peer reviewed. It assumes very large cuts in payments to doctors and hospitals.
A major source of savings comes from paying doctors and hospitals at or near Medicare rates, which are generally below commercial insurance rates. The Yale researchers themselves acknowledge that their analysis does not model how providers would respond—meaning, would they drop patients or drop out altogether.
Lower payments will create hospital financial problems, doctor shortages, and service cuts. There will be pressure to raise taxes or pressure to raise the politically feasible payment rates—reducing the projected savings.
It also likely underestimates that people would use much more care. Giving everyone comprehensive coverage with little or no cost-sharing will likely increase things like doctor visits, tests, elective procedures, and other utilization. Critics of the earlier Yale/Lancet model argued that this additional demand was not fully captured.
It also leaves out transition costs. Yale explicitly says the estimate does not account for transition costs or administrative job losses.
Moving roughly the entire U.S. health-insurance system—1/6th of the U.S. economy—into a new government program would involve massive system changes, displaced/fired workers, new tax collection mechanisms, and potentially significant implementation costs.
The $1 trillion is likely also understated because it doesn’t capture tax hikes. Medicare for All could likely dramatically increase federal government spending. Taxes would replace premiums, employer contributions, and out-of-pocket payments. So “saves $1 trillion” does not mean government spending falls by $1 trillion or that every household pays less in taxes.
Previous analyses have reached very different conclusions. One review of 5 Medicare-for-All cost studies/estimates found that, after correcting what its authors considered errors and inconsistencies in several models, estimated savings averaged much smaller—about $207B or 3.9% of baseline national health spending. That’s a lot of upheaval for savings about the size of 4 EPAs. @x@ap@reuters@ReutersBiz@FoxBusiness@FoxNews@EveningEdit@RobertKennedyJr@RoKhanna@BernieSanders@CBSNews@ABC@NBCNews@WSJ@nytimes #BREAKING #BreakingNews #news @WhiteHouse
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