Medicare for All is cheap---market power allows the US to negotiate lower prices.

The bottom line is, if we can afford the current system with all its waste and inefficiencies, we can afford a simpler, more efficient system: Medicare for All.

Eliminating the private insurance system would have saved $245 billion in 2019 (see Figure 5). To this needs to be added the nearly $200 billion in savings from provider administration, because under Medicare for All hospitals and physician practices will no longer need so many bill collectors. An uncounted benefit: nurses and doctors will be able to spend time providing patient care instead of negotiating with insurance companies, and Americans will live longer and healthier lives.

Unlike private insurance companies, Medicare already has the market power to negotiate realistic prices with hospitals, equipment manufacturers, and pharmaceutical companies. Instead of prices set by providers with market power, prices will be negotiated by a Medicare for All system with the market power that stems from its position of being responsible for paying for the healthcare of Americans. It can then negotiate prices in line with the real costs of providing healthcare, prices more in keeping with those paid by people outside the United States. Adopting world prices for drugs and medical devices would have saved the US over $200 billion in 2019. Eliminating the surcharge above Medicare prices collected by hospitals and drug companies would have saved another $400 billion.

Putting it all together, Medicare for All could have saved over $1 trillion in 2019, bringing percapita healthcare spending down to the level of other affluent countries. Over ten years, the gross savings would come to nearly $20 trillion (see Figure 6).