In the most recent Democratic debate, South Bend, Indiana, Mayor Pete Buttigieg and Sen. Elizabeth Warren each made an observation, easily lost in the weeds of the health care debate.

Sen. Warren pointed out that the issue is not insurance per se, but rather the cost of health care, which, by law, makes up at least 80 percent of health insurance premiums. Americans want to be able to see their doctor, get their prescriptions and not go broke, and they don’t much care who pays the claims, as long as they get paid.

Mayor Buttigieg was also right when he said that if an approach were a good one, people would vote with their feet, and the American way is to trust them to do that. His “Medicare for all who want it” would best deliver universal coverage faster than a blunt-force transition to “Medicare for All” for two primary reasons.

First, Americans fear losing the coverage they have more than they want a better deal financially. Because of this, Sen. Warren’s proposed short-term elimination of private insurance will be a loser in Congress.

That said, Medicare is the Walmart of health care purchasing and gets by far the best volume discounts. Were Medicare offered as a choice, it will have a significant cost advantage to consumers, as much as 40 percent, over alternative plans and, indeed, eventually “all will want it.”

William Rosenberg

Mount Vernon

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