Posted on 06/07/2026 10:00:54 AM PDT by Twotone
Billionaire progressive activist and California gubernatorial candidate Tom Steyer recently remarked: "Health care companies only care about one thing: profits. Single-payer now." This is the same Tom Steyer who opposed single-payer when he ran for president in 2020. "Bernie Sanders was right," he says. "Boy, was I wrong."
He still cannot explain how to pay for it. Can anyone?
Single-payer health care has been the progressive left's signature domestic demand for four decades. It has generated presidential campaigns, mass rallies, congressional cosponsors, and an inexhaustible supply of Twitter righteousness. What it has never generated once is a workable legislative proposal.
Brookings Institution economist Jessica Riedl has spent years waiting for one. Her challenge is simple: Show us a progressive bill that specifies (a) a provider payment system that actually saves money under America's existing, already expensive health infrastructure, and (b) a financing mechanism to replace the roughly $32 trillion in private premiums and out-of-pocket costs that would need to be covered by federal taxes over the next decade.
Despite hundreds of legislative proposals and multiple presidential campaigns built around the issue, no one has met the challenge.
It's not for lack of pretending. Sen. Bernie Sanders (I–Vt.) and Rep. Pramila Jayapal (D–Wash.) have bills that people trumpet as serious legislative vehicles. But as Riedl notes, the proposals are only aspirational. They enumerate generous new benefits with great enthusiasm and then instruct the secretary of Health and Human Services to figure out the rest. The phrase "The Secretary shall" appears 62 times in the Sanders bill alone.
OK, but what about Europe and Canada? Progressives inevitably say: They made it work! This is a rhetorical sleight of hand that collapses on contact with basic facts.
European countries built modest, government-controlled health infrastructures from the ground up over several decades. They contained costs—meaning, among other things, they rationed care—as they expanded access. America did the opposite.
We built the most expensive, technologically advanced, sprawling health system in human history, which consumes nearly 20 percent of gross domestic product (GDP), under mostly private incentives and market pricing. As Riedl puts it, "We cannot simply pay European prices for the more vast American health infrastructure that exists."
The central theory of single-payer savings has always been this: Slash payments to providers to offset the surge in the use of universal, no-cost-at-point-of-service coverage. The Congressional Budget Office (CBO) took a serious look at this fantasy. Its conclusion was that national health expenditures might actually rise, and demand for care would outrun supply. The final result would be European-style rationing, delays, and forgone services, all leading to worsening health care.
Then there's the inconvenient question of how to get the tax revenue needed for a single-payer system to replace private health care premiums, out-of-pocket expenses, and state health programs. Although neither Sanders nor Jayapal has an answer, the Committee for a Responsible Federal Budget does. Financing a Sanders-style system would require a new 32 percent payroll tax, a 25 percent income surtax, or a 42 percent value-added tax, more than doubling every individual and corporate income-tax rate.
The CBO found that such a system would reduce GDP by 6 percent to 10 percent by 2030. From a movement that claims to care about working Americans, that number deserves more than silence.
The state-level record confirms what the nasty arithmetic and voters' disgust tell us. Vermont passed single-payer legislation in 2011 and assigned an expert commission to make the numbers work. After three years of failure, Gov. Peter Shumlin abandoned the plan, admitting that the required 11.5 percent payroll tax per company plus the 9.5 percent income tax per Vermonter (with small businesses paying both) would be politically unsurvivable even in Sanders' home state. Colorado voters rejected their single-payer initiative in 2016 after analysis showed that even tripling taxes wouldn't cover the costs.
Back in California in 2022, the state's nonpartisan legislative analyst estimated that the proposed single-payer system created by the California Guaranteed Health Care for All Act would cost between $494 billion and $552 billion annually. Imagine the taxes needed to more than double that state's spending overnight.
After the bill died without a vote, Assemblymember Ash Kalra (D–San Jose) reintroduced it in February 2026, and it failed to advance again a few months later. California has now killed single-payer twice in four years.
The absence of a workable plan after 40 years tells you everything you need to know. This is Riedl's essential insight and the one that cuts deepest. It's unworkable. It's expensive. And it will kill the supply of health care. Steyer knew all this in 2020 when he ran for president. The only thing that's changed is politics.
Dear FRiends,
We need your continuing support to keep FR funded. Your donations are our sole source of funding. No sugar daddies, no advertisers, no paid memberships, no commercial sales, no gimmicks, no tax subsidies. No spam, no pop-ups, no ad trackers.
If you enjoy using FR and agree it's a worthwhile endeavor, please consider making a contribution today:
Click here: to donate by Credit Card
Or here: to donate by PayPal
Or by mail to: Free Republic, LLC - PO Box 9771 - Fresno, CA 93794
Thank you very much and God bless you,
Jim
Because a single payer health care system always becomes more expensive with less service. Look where they have this such as the UK and Canada.
Strict rationing and Death Panels will solve some of the major issues.
How to pay for it?
Why, tax the rich of course.
Don’t forget Cuba.
Cuba has a beautiful, socialist health care system.
Of course, they don’t have electricity in the operating rooms.
Why, tax the rich of course.
Then kill them and harvest their organs.
“Health care companies only care about one thing: profits. Single-payer now.”
There are other options, and much better. Health care should not be for profit, but as a service. And not a government service.
Bullshit.
Pay as you go, lean on preventive and naturopathic medicine instead of pills that cover up symptoms.
And live free.
What the hell does that mean? Should the Doctors and nurses working for your non profit be paid? Should the hospital be allowed to make enough money to buy new equipment of build new facilities? So you don’t want shareholders. Who then watches over these non profits.
One thing you need to understand… Non Profits are some of the most profitable businesses in existence. Look at any major university health system. Non profits all and paying their CEOs millions.
China, Does not have a truly socialist Healthcare system. Let that sink in. Having used it, I can say it works pretty well in the major cities at least.
Rather than the failed UK/Canadian model maybe the left here should look at the Chinese model?
Note one difference is the pay scale for doctors and medical staff between here and there. But also no malpractice lawsuits
In terms of cost to benefits, the US is the worst in terms of life expectancy, child mortality, etc., and somewhat better for exotic cancer treatments. That's our sole bright spot.
In terms of ordinary health care, Americans are simply being robbed blind and a smaller and smaller percentage of the working population can afford a decent health plan, one that doesn't have thousands in deductible and a max out of pocket that would bankrupt many.
When you see private equity buying out health groups and physicians' practices, that should tell you all you need to know.
Hadn’t been able to do it in the last 40 years....
That’s 1986 isn’t it?
Big Pham and pay for profit hospitals and corporate medicine had been growing and price gouging since the 1960’s...
That’s why they can bill you $25 for a box of tissue now and keep a strait face.
Can you say institutionalize fraud?
You are describing Doctors, Nurses and Medical Technicians as slaves. I trust my Doctors because they earn their pay.
Forty years? Try almost 78 years when it comes to the UK’s NHS.
>> He still cannot explain how to pay for it. Can anyone?
I can! Just follow Canada’s lead. You pay for it with long wait times for (crappy) care, increased “medical tourism”... and last but not least, with rampant, fulminant M. A. I. D.
It is a practice in countries where government pays for healthcare to pay the doctors under the table.
Otherwise, they will not care too much!
“Single-payer” simply means “no competition on the basis of application of cost/benefit ratios to medical treatment”.
With single-payer, there is no incentive to keep costs down, there is only incentive to ration or deny health care altogether.
If these single-payer advocates had any brains (doubtful, I know) they would RUN to the MAHA movement. No amount of money on Earth is enough to care for a fat, diabetic, sedentary, demented and ill-fed population. The ONLY hope is that people take care of their own health, so there’s enough money to take care of the things we can’t prevent, like injuries, cancers, and the unfortunate ones like MS and ALS.
The point is government takeover and inferiority.
Universal health care is like a menu in a Chinese diner:
- You can cover everyone.
- You can cover everything.
- It can be inexpensive.
You can only pick two.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.