So whether you can get health insurance now depends on your boss’s credit card?

As a physician, I first began writing about the inefficiencies and disparities I was seeing in American health care more than 30 years ago. At that time, conventional wisdom held that our health care was the “best in the world,” our outcomes were superior and every country that offered universal health care would soon collapse.

Earlier this year, amid much fanfare, the Koch-funded Mercatus Institute at George Mason University released a 24-page analysis of Medicare for all and declared that it would add $28 trillion to the federal budget during the next 10 years. This news was splashed all across conservative media outlets.

Then, just as suddenly, the discussion went radio silent.

What happened? Buried in the study was this inconvenient truth — under Medicare for all, not only would all Americans gain insurance coverage, but total health care spending would actually drop by $2 trillion over 10 years.

In other words, that $28 trillion that made such headlines? The truth is, we already are paying those costs through high premiums, co-pays, deductibles and uncovered expenses. Medicare for all simply would spend the same money more effectively.