Photo by Marc Nozell

We are in the beginnings of an election year in the United States and the first primary votes to determine the Democratic nominee will be cast in the coming weeks. Healthcare costs remain a top concern for voters, and candidates have developed varying proposals to improve healthcare, reform the current system, and reduce healthcare costs in the U.S.

Independent Senator from Vermont and 2016 Democratic Presidential Candidate Bernie Sanders has long championed the ideal of single payer healthcare, often referred to as Medicare for All in the U.S. In a single payer system, the federal government fully covers every service and procedure, including dental, vision, long-term care and abortion, with no out-of-pocket charge to patients. Bernie Sanders has often claimed Medicare for All is the only way to address deeper problems in the United States healthcare system, from medical bankruptcies to high maternal mortality rates, especially among poor and minority women. Senator Sanders has proposed allowing importing medication from abroad at

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by Richard Sagall, M.D.

Insurance is really a simple concept. But few people, and even fewer politicians, seem to understand how insurance works and why so many of the promises we hear are impossible.

Here are the basic concepts of insurance:

Number 1 – You Never Win with Insurance – You always lose with insurance. Think about what happens when you have health insurance.

Outcome 1 – You get sick, perhaps really sick, and you suffer while ill. You may experience long-term or even permanent disability from your illness. Or, in the worst case, you die. Your health insurance helps with the cost, but in any case, you suffer.

Outcome 2 – You spend a lot of money on premiums getting nothing in return. It’s true that you remain physically healthy, but, due to the high cost of health insurance, you may not be so financially healthy. So, you also suffer, just in a different way.

Number 2 – What You Really Get from Insurance – Or perhaps more accurately, what you should be getting from health insurance. What you are paying for with health insurance is a sense of comfort that you won’t

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