Medicare For All, often referred to as M4A, is a dream to some and pure fantasy to others. The vision is hard to disagree with.
Everyone — all Americans — would have health care coverage, including dental, vision and hearing benefits, with zero co-pays. No premiums. No deductibles. No annual or lifetime limits. No surprise bills from insurance companies. Coverage from birth to death. Health care would be a right, not a privilege.
Then comes the hard part. The cost. Sen. Bernie Sanders, Medicare for All's leading proponent, says the federal government would cover it with tax dollars.
Sanders floats a number of options, including:
— A 7.5 percent income-based premium paid by employers. Revenue raised: $3.9 trillion over 10 years.
— A 4 percent income-based premium paid by households. Revenue raised: $3.5 trillion over 10 years.
He also wants to raise taxes on higher-earning Americans' income and capital gains and limit tax deductions. That would raise $1.8 trillion over 10 years.
But here's the issue: If implemented, M4A would add approximately $32.6 trillion to the federal budget over its first decade, according to a study from George Mason University. Even doubling all projected federal individual and corporate income tax collections wouldn't cover the cost.
The George Mason researcher says his estimates are conservative because they assume the legislation would achieve Sanders' savings goals of reducing payments to health providers, lowering drug prices and cutting administrative costs.
Sanders, in response, noted that the research center at George Mason is tied to the Koch brothers — who are opposed to M4A.
To hammer out the final details, Sanders has called for a "vigorous debate." Some math will definitely be involved. One thing's for sure: The idea isn't going anywhere any time soon. M4A has the support of about half of Americans and several leading Democrats.