Bernie's Medicare for all bill is nonsense. If you introduce a bill that fundamentally changes nearly 1/5th of the economy and you don't have a funding mechanism, then you don't have a serious bill. It's just like the "repeal and replace" garbage we heard for years out of Republicans. Their ideas were never serious and it showed this year.
People need to get it through their thick heads, we will not have single payer in this country... ...He correctly pointed out we pay for more per-capita in this country for healthcare than any of our peer nations and do not get better results. Yes, that is absolutely true. He then put the blame for it on insurance companies and big pharma.
1. Pharmaceuticals are 10% of healthcare costs. You could give every drug away for free, and healthcare costs would still be far higher than our peer nations. That is not to say that drugs are not expensive and something needs to be done, but its not a panacea.
2. Even if you take out every dollar of profit from private insurers, every bonus they give out, all of it, you will take a family health insurance down from day 21k a year to 19k a year. Still way more than our peer nations...
You're right to point out that providers are the greatest contributor of costs, and that the Medicare for all bill as it stands is not going to happen. That said, I'm about 100% certain that the actual intent of this bill is to help publicize and normalize the idea of SP and build political momentum, not actually pass in a Republican House with a Republican Congress under a Republican President; let's keep it real.
However, you're wrong both about the impossibility of SP, and that the real remedy to costs lies in places other than SP. Further, Bernie is indeed right to blame big pharma and insurers; even though their direct culpability in terms of costs isn't as great as labour it's still quite substantial, meanwhile they have and have always been leading opponents and lobbyists against SP legislation.
The fact is that the current system is a perfect storm of toxic structuring wherein the whole is most costly than the sum of its parts.
For example, insurers not only add a great deal of bloat and inefficiency in terms of their middle man consumption of value which is essentially a pure loss, but in terms of the costly and largely useless administrative layer they impose upon hospitals; in fact, it accounts for 25% of total hospital spending alone (nevermind the administrative costs endured by other healthcare elements); a figure roughly 150% to 208% of other developed countries.
This toxic structuring is largely a result of market fragmentation.
You have administrative bloat because you have to deal with countless disparate insurance plans each with their own complications and loopholes.
You have insanely high drug and medical device/supply prices because you have a government captive to the interests of their producers while a bottomless array of health insurers each negotiate their own prices without nearly the clout and negotiating power of a singular governmental entity; meanwhile, the providers turn around and try to make up for the compromised prices by gouging people not under an insurer.
You have run away salaries and labour costs because there are no price controls on anything beyond what meager concessions insurers can negotiate (largely at the expense of the un/underinsurered who 'compensate'), and there's little incentive to not to gouge (for everything, from labour to medical supplies/drugs like Tylenols for $20) and commit to excess testing and procedures, both due to the threat of legality giving rise to so called 'defensive medicine', and because why _wouldn't_ you drill the insurer as much as you're able?
Then you've got the government paying for the lack of preventative and maintenance care people can't afford as a result of all this via emergency visits which are themselves exorbitantly expensive for all of these reasons, plus similarly inflated prices under Medicare.
And finally, you have ridiculous premiums because your insurer not only has to deal with and pay for all this cascading, cumulative bloat, but also must make a profit. It's not your friend or benefactor, it's there to make money off of you, and so it shall.
For all this expense and excess, the American system doesn't even offer consistently superior outcomes, and in fact under performs more often than not in almost everything but cancer treatment.
What addresses all of these problems effectively and simultaneously? Singlepayer or at a bare minimum, public option/multipayer.
People are coming around to SP; already a majority is in favour as is the trajectory of public opinion. It's only a matter of time; the curve of history is long but it bends towards justice.