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Today brings the first-ever hearing in Congress on the idea that the U.S. government should provide “Medicare for all.” And it isn’t a moment too soon. Already seven separate bills to expand Medicare have been introduced. And most of the 21 people vying for the Democratic Party’s presidential nomination have come out in favor of vastly broadening it.Legislation isn’t imminent. Even so, opening the official discussion will be useful if it can show the country what’s at stake — and just how disruptive to the U.S. health-care system a full-fledged conversion to a single-payer system would be. (4/30)

Covering all uninsured Americans, and replacing our wasteful, often incomprehensible patchwork of insurance with comprehensive, no-cost coverage under a trusted public program is indeed tantalizing. ...But there are risks in “Medicare for all.” First, major service bottlenecks are sure to arise, as 20 million uninsured Americans gain coverage — or 30 million, if immigrants’ advocates win the battle — and another 210 million move from the cost-sharing of the current Medicare and private insurance systems to free medical care. (Michael Stein and Jon Kingsdale, 4/30)

As Democratic presidential candidates disingenuously promote “Medicare for All” recent information suggests these actors time would be far better spent focusing on the welfare of current and future beneficiaries of "Medicare as it Is." On April 22, the Medicare Trustees released their 2019 report on the financial and actuarial status Medicare’s Hospital Insurance (“Part A) and the Supplementary Medical Insurance (“Part B” and “Part D”) Trust Funds. The picture isn’t pretty. (Roger D. Klein, 4/29)

Last year, Americans borrowed approximately $88 billion to pay for health care. One in four of us skipped medical appointments because of concern about costs. Such statistics reflect a trend that has been going on for decades. In 1970, the U.S. spent $74.6 billion on health. By 2000, this figure had risen to around $1.4 trillion and by 2017 it was $3.5 trillion. Not incidentally, medical debt is now the number one cause of personal bankruptcy in the U.S. This question — Are we paying too much for health? — has defined much of the health conversation in the U.S. over the years. Unfortunately, it is the wrong question. Here’s the right one: Is our spending making us healthier? The answer, sadly, is no. (Sandro Galea, 4/30)