"the Sanders campaign is simply pulling numbers out of the air."

[Recursion]

72. Structurally our system is similar to the Netherlands' and Germany's already

Mandated private insurance (in Germany it's generally through regional or industry-wide co-operatives, which is something I'm in favor of looking at; this was actually proposed by Baucus, of all people, and I wish it had gotten more attention) paying for most health care.

The big missing piece is we need prices from providers to come down; we spend twice as much per capita on physicians and two and a half times as much per capita on hospitals as the OECD average.

And as much as I hate to say this, Medicare is actually in the way here. Hear me out.

Private insurers mostly start with the Medicare rates as their basis for negotiations. But the Medicare rates have been subject to regulatory capture, because physicians and hospitals lobby Congress to keep their reimbursements high (google "Medicare Doctor Fix&quot with the threat of accusing anyone against those rates of "cutting Medicare". Private insurers mark up those prices slightly to insure acceptance. But they're far too high (much higher than in Canada or Europe) to begin with.

For all of the problems with private insurance, its one big advantage is that unlike Congress, it can't be lobbied. That's why Germany and the Netherlands and Switzerland keep private insurance around. Canada, meanwhile, does this by a pricing board that is politically independent -- that's also a great idea.

But, at any rate, that is the magical step the US is missing: some board somewhere that sits around and says "A leg MRI can cost $500, period, no matter who's paying for it". (Or, alternately, we can pay providers by capitation, though that also has its own problems.)