So where will the extra $16 trillion come from to pay for Sanders' plan?

[ehrnst]

138. We are not the UK.

First, it's easier to keep costs down than it is to slash them.

Second - they've been developing this for 70 years. They didn't start out with what they have now - much like our own Social Security.

Third - It's one thing to build a system from scratch than it is to upend a system that is 60 years old - no matter how bad that system may be. One way of looking at it: Towns in the Midwest (that were laid out after the Louisiana Purchase) were planned and laid out in grids. It's much easier to navigate, and to get first responders where they need to be. Road maintenance is easier and less expensive, due to fewer curvy roads, easier to plow, etc. If someone said, "Let's do this in Boston! Chicago has it! Why can't we have that here?" You would understand know the obstacles to "having what Chicago has."

There will be an enormous cost to demolish and rebuild the health care funding system, especially in just 8 years like Sanders claims. If you think that slashing physicians' pay, nurses' pay and other medical professionals pay will not be met with huge resistance, you are sadly mistaken - it's easier to hold costs down than to slash them.

The most politically realistic way forward is to incrementally expand the ACA - let people buy into Medicare at 55 for more than they would at 65, but less than a private plan. Let that settle out for a few years to become popular and work out the kinks in the expansion. Then you expand coverage to all children up to 18. Let that settle out for a few years to become popular and work out the kinks in the expansion.

Fourth - We are a much larger country than the UK, with a much more diverse population. They also have gotten used to the health care there. I lived in the UK, and I was grateful to have health care, as an uninsured student. The little clinic in the neighborhood where I want was a bit shabby - more like a DMV than a private doctor's office in the U.S. People in the U.S. have very different expectations, and that has to be dealt with. If people who have private insurance now (which is the majority of citizens) think that going to the doctor will be anything like going to the DMV, and you know that the GOP will tell them that, "Government run health care" will go no further.

That is what Hillary was proposing. And she was right - single payer isn't going to happen. Not in our lifetime. Canada didn't go federally single payer until all the provinces had their own universal health care systems in place, then a liberal adminstration was elected and they added a federal layer to them. It took nearly 20 years for that to happen, and Green Mountain Care, Coloradocare and California single payer have all failed to get off the ground, so we haven't even started down the road Canada took to get to where it is.

We had a chance to start back in '72. Ted Kennedy took a single payer plan to Nixon. Nixon wanted a compromise. Ted was encouraged by his colleagues to turn down any compromise. Kennedy said it was one of the great regrets of his career. He thought that if he had reached a compromise, we might be way closer to what Canada has by now.

I loved my health care in the UK. And I think that people just don't understand the enormous differences between countries that started 70 years ago from scratch, and the US, with it's system of tangled roads. I wish it was different, but we don't have time to waste on this. We need to get the ACA - which is the furthest down the road we have ever been to UHC -back on track.