This is a thoughtful, well-researched article, and I look forward to reading the rest of the series. My one criticism stems from the notion that the Taiwanese single-payer system is tantamount to "Medicare-for-all". Not only is this a gross oversimplification of both models, it requires making comparisons that just don't make sense. A more compelling argument would highlight specific attributes of the Taiwanese health system, and map those to relevant U.S. counterparts.
For example, the VA health system would be a more apt comparison if we're talking about a single-payer system operating within a common regulatory framework (all VAs are on federal property). If we're considering funding vis-à-vis taxpayer vs. employer contributions, the Taiwanese model starts to look more like Hawaii (maybe also Oregon). If we're interested in a solution that is known to scale up to 25-30 million individuals, it would be best to focus on the regulatory landscape in the state of New York. Factoring in the flexibility of higher-income individuals to purchase supplemental insurance, the Taiwanese system looks most like traditional Medicare (i.e. fee-for-service) in combination with a supplemental insurance market. Of note (and to the best of my recollection) the "Medicare-for-all" plan championed by Bernie Sanders specifically outlaws private insurance in order to avoid a scenario where we end up with a two-tier system (i.e. one for the rich, and one for everyone else).
TL;DR: A single-payer system is not Medicare-for-All. Single-payer solutions in and of themselves do not inform how we, as a country, should resolve the substantive policy differences inherent to our patchwork regulatory landscape without undermining states' rights and/or ballooning our national debt.
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[ 3.6 ms ] story [ 20.3 ms ] threadFor example, the VA health system would be a more apt comparison if we're talking about a single-payer system operating within a common regulatory framework (all VAs are on federal property). If we're considering funding vis-à-vis taxpayer vs. employer contributions, the Taiwanese model starts to look more like Hawaii (maybe also Oregon). If we're interested in a solution that is known to scale up to 25-30 million individuals, it would be best to focus on the regulatory landscape in the state of New York. Factoring in the flexibility of higher-income individuals to purchase supplemental insurance, the Taiwanese system looks most like traditional Medicare (i.e. fee-for-service) in combination with a supplemental insurance market. Of note (and to the best of my recollection) the "Medicare-for-all" plan championed by Bernie Sanders specifically outlaws private insurance in order to avoid a scenario where we end up with a two-tier system (i.e. one for the rich, and one for everyone else).
TL;DR: A single-payer system is not Medicare-for-All. Single-payer solutions in and of themselves do not inform how we, as a country, should resolve the substantive policy differences inherent to our patchwork regulatory landscape without undermining states' rights and/or ballooning our national debt.
Like obamacare, medicare for all, doesn't fix anything.
It hikes taxes and balloons the deficit. Aside from that it produces little or no tangible benefits.