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Our only agenda is to publish the truth so you can be an informed participant in democracy. We need your help. More Info ### I would like to contribute One Time Monthly Yearly Join Now ![](\\" ![](\\" Bernie Sanders stated on February 25, 2020 in in remarks during the South Carolina Democratic primary debate: “(A recent study) said ‘Medicare for All’ will lower health care costs in this country by $450 billion a year and save the lives of 68,000 people who would otherwise have died.” ![\\"true\\"](\\" mostly-false/6a6ef6075c162fdccf5eb960e683dcd1.jpg.\\") ![\\"barely- true\\"](\\" false.jpg\\") * Corrections and Updates * Health Check * Bernie Sanders By Shefali Luthra February 26, 2020 # Bernie Sanders embraces new study that lowers ‘Medicare For All’ price tag, but skepticism abounds #### If Your Time is short * Many of the study\'s assumptions are flawed, and experts uniformly told us it overestimates the potential savings. * It cherry-picks data in calculating mortality effects. See the sources for this fact-check **UPDATE:** This story was updated to include more information about recent studies the Sanders\' campaign referenced regarding the costs of single-payer. This update does not change the rating. Defending his signature health plan — a single-payer system known \"Medicare for All\" that would move all Americans to government-funded coverage — Vermont Sen. Bernie Sanders argued that the massive health care expansion would actually save the system hundreds of billions of dollars. Sanders’ figures come from a study published Feb. 15 in The Lancet, a British medical journal. \"It said ‘Medicare for All’ will lower health care costs in this country by $450 billion a year and save the lives of 68,000 people who would otherwise have died,\" Sanders said at the Feb. 25 Democratic presidential debate. The price tag of Medicare for All has been fiercely debated, and some previous analyses have suggested that the proposal would increase health spending, not decrease it. But Sanders is relying on the Lancet paper — which has a cost estimate that is the lowest, in the neighborhood of $17 trillion over 10 years — to argue that the suite of financing mechanisms he has proposed would more than cover the cost of his health bill. (Funding would include taxes on high earners, a new payroll tax, and 4% income premiums for the majority of families.) Most other estimates place the cost between $30 trillion and $40 trillion over a decade, which would make paying for it far more difficult. So we decided to take a closer look. We reached out to one of the study’s authors, but never heard back. A spokesperson for the Sanders campaign said the paper is \"similar to 22 other recent studies that have also shown that moving to a single-payer healthcare system will cost less than our current dysfunctional healthcare system.\" (We asked for those 22 other studies but, as of publication, hadn’t received them from the campaign. However, an independent researcher provided us with this related analysis.) But other independent experts were skeptical of the Lancet study\'s estimate — arguing it exaggerates potential savings, cherry-picks evidence and downplays some of the potential tradeoffs. \"I don’t think this study, albeit in a prestigious, peer-reviewed journal, should be given any deference in the Medicare for All debate,\" said Robert Berenson, a fellow at the Urban Institute who studies hospital pricing. So, savings? Largely, the Lancet paper is more generous in its assumptions than other Medicare for All analysis, noted Jodi Liu, an economist at the RAND Corp., who studies single-payer plans. To the researchers’ credit, she said, they acknowledge that their findings are based on uncertain assumptions. For instance, the researchers calculate $78.2 billion in savings from providing primary care to uninsured people — $70.4 billion from avoided hospitalizations and $7.8 from avoided emergency room visits. But previous evidence suggests that logic is suspect at best. When states expanded Medicaid under the Affordable Care Act, providing new insurance to people who had previously lacked coverage, avoidable hospitalizations and emergency room visits didn’t disappear because people could suddenly use preventive care, noted Ellen Meara, a professor at the Harvard T.H. Chan School of Public Health. That evidence doesn’t appear anywhere in the Lancet paper. \"The notion that we’re going to get rid of all these avoidable visits — that’s not been borne out,\" she said. The researchers also assume that a Medicare for All system would pay hospitals at a maximum of Medicare rates. That’s tricky. In 2017, the nonpartisan Medicare Payment Advisory Commission estimated that, on average, a hospital has a -9.9% margin on a patient who is insured through Medicare. (Private pay helps make up that difference.) Some hospitals certainly would be able to swallow this cost. But others would struggle to stay afloat, said Adrianna McIntyre, a health policy researcher at Harvard University Given the political influence hospitals in particular carry in Congress — where most members are sensitive to their concerns — passing a plan offering such a low payment rate would be politically challenging. Sanders’ bill doesn’t actually specify the rates at which hospitals would be paid. #### Featured Fact-check ![](\\" ![](\\" Social Media stated on September 2, 2024 in social media posts The Hells Angels Motorcycle Club is on the way to Aurora, Colorado, to confront a Venezuelan gang. ![\\"true\\"](\\" false/33efdb6633e5e2fdc2d4e2f63383a1e0.jpg.\\") ![\\"false\\"](\\" false.jpg\\") By Loreben Tuquero • September 9, 2024 Beyond the lower payments, the researchers also suggest hospitals would spend less money on overhead, only having to navigate a single insurance plan. That change accounts for $219 billion in their estimated savings. But again, that ignores some of the reality of how hospitals work. While a single-payer system would undoubtedly cost less to administer — requiring a smaller back-end staff, for instance — it would not eliminate the need for expensive items like electronic health records, which coordinate care between hospitals. \"The assumptions are unrealistic,\" said Gerard Anderson, a health economist at Johns Hopkins University in Baltimore. \"You are never going to save that much money from the various providers.\" The cost-sharing question Medicare for All would enroll all Americans in coverage far more generous than what most experience now — eliminating virtually all cost-sharing associated with using health care. That’s a major change, researchers told us. Previous evidence suggests that such a shift would encourage consumers to use health care more than they currently do. The Lancet paper acknowledges that — but only partially. It allows that people who are uninsured or \"underinsured\" — that is, who have particularly high levels of cost-sharing now — would use more medical care under Sanders’ system than they currently do. It factors that into the price tag. But its estimate does not account for people who already have decent or adequate insurance and who would still be moving to a richer benefit, and therefore more likely to use their insurance. \"It drastically underestimates the utilization increases we would expect to see under Medicare for All,\" McIntyre said. \"People have different views on whether the increased utilization is good or bad,\" she added — it makes the program more expensive, but also means more people are getting treatment. Other estimates? Context is helpful, too. Other estimates — namely, a projection by the Urban Institute — of Medicare for All have suggested it would increase federal health spending by about $34 trillion over 10 years. But elimination of other health spending would make the overall change smaller. To implement the Sanders proposal, national health spending — public and private dollars, both — would increase by $7 trillion over a decade, Urban said. And Medicare for All would be bringing new services: more insurance for more people, and more generous coverage for those already covered. Urban’s estimate of $7 trillion more in spending over 10 years is far removed from the study’s estimate of $450 billion less annually. And, experts said, relying on the latter figure isn’t a good idea. \"I think they need more work to prove\" the savings, Meara said. \"They’re not being complete, and by not being complete, they’re not being honest.\" It’s also worth noting that the study’s lead author was also an informal unpaid adviser to the Sanders staff in drafting its 2019 version of the Medicare for All bill, according to the paper’s disclosures section. The \"lives saved\" Experts agree that expanding access to health insurance would probably reduce early mortality. But the 68,000 figure is another example of cherry-picking, Meara said. The figure is based on a 2009 paper. It doesn’t acknowledge a body of research that came after, including multiple studies that examined how expanding Medicaid affected mortality — and maybe offered less dramatic numbers. \"When they so clearly are cherry-picking, when they clearly have all the information on studies in front of them, it’s concerning,\" Meara said. \"It’s a situation where you’re going to overpromise and underdeliver.\" Our ruling Sanders said a recent study suggested Medicare for All would save $450 billion annually and saves 68,000 lives. That study does exist. And it cites some evidence. But many of its assumptions are flawed, and experts uniformly told us it overestimates the potential savings. It cherry-picks data in calculating mortality effects. This statement has some truth, but ignores context that would create a dramatically different impression. We rate it Mostly False. #### Read About Our Process The Principles of the Truth-O-Meter ### Our Sources Bernie 2020, \"How Does Bernie Pay For His Major Plans,\" Feb. 24, 2020. The Lancet, \"Improving the Prognosis of Health Care in the USA,\" Feb. 15, 2020. JAMA, \"Association of Medicaid Expansion With 1-Year Mortality Among Patients With End-Stage Renal Disease,\" Dec. 4, 2018. Medicare Payment Advisory Commission, \"2019 Report to the Congress,\" March 15, 2019. University of Michigan, \"Medicaid and Mortality: New Evidence from Linked Survey and Administrative Data,\" Aug. 17, 2019. Email interview with Gerard Anderson, professor at Johns Hopkins Bloomberg School of Public Health, Feb. 19, 2020. Email interview with Robert Berenson, fellow at Urban Institute, Feb. 19, 2020. Email interview with Jodi Liu, associate policy researcher at the Rand Corp., Feb. 19, 2020. Telephone interview with Ellen Meara, professor of health economics and policy at the Harvard T.H. Chan School of Public Health, Feb. 25, 2020. Telephone interview with Adrianna McIntyre, health policy researcher at Harvard University, Feb. 25, 2020. ## Browse the Truth-O-Meter ### More by Shefali Luthra ![](\\" ![](\\" Martha McSally stated on June 22, 2020 in a campaign ad: “Of course I will always protect those with preexisting conditions. Always.” ![\\"false\\"](\\" ![\\"false\\"](\\" By Shefali Luthra • June 25, 2020 ![](\\" ![](\\" Donald Trump stated on June 15, 2020 in remarks during a roundtable discussion: “If we stopped testing right now, we\'d have very few cases, if any.” ![\\"pants-fire\\"](\\" th.jpg\\") ![\\"pants-fire\\"](\\" pants-fire.jpg\\") By Shefali Luthra • June 17, 2020 ![](\\" ![](\\" Donald Trump stated on May 11, 2020 in comments in the Rose Garden: “Germany and the United States are the two best in deaths per 100,000 people, which, frankly, to me, that\'s perhaps the most important number there is.” ![\\"false\\"](\\" ![\\"false\\"](\\" By Shefali Luthra • May 13, 2020 ![](\\" ![](\\" Ralph Northam stated on May 1, 2020 in a news conference.: Technology coming to Virginia allows COVID-19 personal protection equipment to be “decontaminated and reused 20 times without degrading performance.” ![\\"half-true\\"](\\" th.jpg\\") ![\\"half-true\\"](\\" true.jpg\\") By Warren Fiske • May 12, 2020 ![](\\" ![](\\" Donald Trump stated on April 27, 2020 in comments made during a White House briefing: “We’ve tested more than every country combined.” ![\\"pants-fire\\"](\\" th.jpg\\") ![\\"pants-fire\\"](\\" pants-fire.jpg\\") By Shefali Luthra • April 30, 2020 ![](\\" ![](\\" Donald Trump stated on April 23, 2020 in comments made during a White House media briefing on the coronavirus: “We’re also using a sterilization process ― some great equipment that will sterilize masks up to 20 times per mask. So that’s like ordering 20 times more masks.” ![\\"half-true\\"](\\" th.jpg\\") ![\\"half-true\\"](\\" true.jpg\\") By Shefali Luthra • April 29, 2020 ![](\\" ![](\\" Barack Obama stated on April 14, 2020 in his online video endorsement of Joe Biden for president: Republicans “have shown themselves willing to cut millions off their health insurance and eliminate preexisting condition protections for millions more, even in the middle of this public health crisis.\" ![\\"true\\"](\\" ![\\"true\\"](\\" By Shefali Luthra • April 16, 2020 ![](\\" ![](\\" Bernie Sanders stated on April 8, 2020 in an op-ed published in The Guardian: “It has been estimated that only 12% of workers in businesses that are likely to stay open during this crisis are receiving paid sick leave benefits as a result of the second coronavirus relief package.\" ![\\"mostly-true\\"](\\" th.jpg\\") ![\\"mostly-true\\"](\\" mostly-true.jpg\\") By Shefali Luthra • April 13, 2020 ![](\\" ![](\\" Jesse Watters stated on March 31, 2020 in comments made during an episode of \"The Five\" on the Fox News Channel: “We were slow with the testing, but very quick with the travel ban. And that\'s been much more critical in saving lives.” ![\\"false\\"](\\" ![\\"false\\"](\\" By Shefali Luthra • April 3, 2020 ![](\\" ![](\\" Donald Trump stated on March 24, 2020 in Fox News town hall: \"We\'ve done more tests in eight days than South Korea has done in eight weeks.\" ![\\"false\\"](\\" ![\\"false\\"](\\" By Shefali Luthra • March 25, 2020 ![](\\" ![](\\" Donald Trump stated on March 18, 2020 in comments made during a White House media briefing: The coronavirus \"snuck up on us,” adding that it is “a very unforeseen thing.” ![\\"pants-fire\\"](\\" th.jpg\\") ![\\"pants-fire\\"](\\" pants-fire.jpg\\") By Shefali Luthra • March 19, 2020 ![](\\" ![](\\" Donald Trump stated on March 11, 2020 in a White House speech: The health insurance industry has “agreed to waive all co-payments for coronavirus treatments.” ![\\"false\\"](\\" ![\\"false\\"](\\" By Shefali Luthra • March 12, 2020 ![](\\" ![](\\" Bernie Sanders stated on February 25, 2020 in in remarks during the South Carolina Democratic primary debate: “(A recent study) said ‘Medicare for All’ will lower health care costs in this country by $450 billion a year and save the lives of 68,000 people who would otherwise have died.” ![\\"barely-true\\"](\\" th.jpg\\") ![\\"barely-true\\"](\\" barely-true.jpg\\") By Shefali Luthra • February 26, 2020 ![](\\" ![](\\" Pete Buttigieg stated on February 21, 2020 in a video ad released by the Pete Buttigieg for President campaign: “If you like your private plan, you can keep it.” ![\\"barely-true\\"](\\" th.jpg\\") ![\\"barely-true\\"](\\" barely-true.jpg\\") By Shefali Luthra • February 25, 2020 ![](\\" ![](\\" Joe Biden stated on February 19, 2020 in comments during the February Democratic primary debate in Las Vegas: “From the moment we passed that signature legislation, Mike (Bloomberg) called it a disgrace.” ![\\"true\\"](\\" ![\\"true\\"](\\" By Victoria Knight • February 20, 2020 ### Bernie Sanders embraces new study that lowers ‘Medicare For All’ price tag, but skepticism abounds * ![](\\" ![](\\" Instagram posts stated on September 12, 2024 in an Instagram post: A video shows a body that Israel embedded with a bomb exploding during a Palestinian funeral procession. ![\\"false\\"](\\" ![\\"false\\"](\\" By Sofia Ahmed • September 13, 2024 * ![](\\" ![](\\" Facebook posts stated on September 11, 2024 in a post: “ESPN has fired Shannon Sharpe.” ![\\"false\\"](\\" ![\\"false\\"](\\" By Gideon Hess • September 13, 2024 * ![](\\" ![](\\" Instagram posts stated on September 12, 2024 in an Instagram post: Former President Donald Trump admitted during the Sept. 10 presidential debate that he “blew up the Nord Stream pipeline.” ![\\"pants-fire\\"](\\" th.jpg\\") ![\\"pants-fire\\"](\\" pants-fire.jpg\\") By Loreben Tuquero • September 13, 2024 * ![](\\" ![](\\" Facebook posts stated on September 10, 2024 in a Facebook post: Patron, Don Julio and Pink Whitney tequila recalled because they contained fecal matter. ![\\"false\\"](\\" ![\\"false\\"](\\" By Jeff Cercone • September 13, 2024 * ![](\\" ![](\\" Elissa Slotkin stated on September 11, 2024 in a TV ad: Mike Rogers supported “laws that could eliminate IVF and birth control.” ![\\"half-true\\"](\\" th.jpg\\") ![\\"half-true\\"](\\" true.jpg\\") By Caleb McCullough • September 13, 2024 * ![](\\" ![](\\" Instagram posts stated on September 11, 2024 in an Instagram post: \"Debate moderators made the false claim to Donald Trump that there is nowhere in the United States where abortion is legal up until birth.\" ![\\"false\\"](\\" ![\\"false\\"](\\" By Jeff Cercone • September 13, 2024 * ![](\\" ![](\\" Facebook posts stated on September 12, 2024 in a Facebook post: ABC News fired presidential debate moderators David Muir and Linsey Davis. ![\\"pants-fire\\"](\\" th.jpg\\") ![\\"pants-fire\\"](\\" pants-fire.jpg\\") By Sofia Ahmed • September 13, 2024 * ![](\\" ![](\\" Yes on 4 stated on September 10, 2024 in a TV ad: Florida’s six-week abortion law has “no real exceptions. 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A recent study said Medicare for All’ will lower health care costs in this country by 450 billion a year and save the lives of 68000 people who would otherwise have died