Bernie Sanders reluctantly admitted during last week’s Democratic presidential debate that his single-payer national health insurance plan would require a tax on middle income families.

Political commentators on many of the TV networks immediately criticized his plan as being unacceptable to most Americans.

They did not say the one thing that mattered. Sanders was being honest.

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If we’re going to have true national health insurance, Medicare-for-all, we’re going to have to pay for it.

Or, we can have some sort of half-baked plan that will not be adequately funded, will fail to cover everyone and will eventually become another example of government’s failure to fulfill its promises.

The fact is most Americans are already paying a “tax” for health insurance. It’s just called something else — health insurance “premiums.”

People who get their health insurance through work pay thousands of dollars a year for that coverage. In addition, they likely pay deductibles and co-pays. They may have their paychecks reduced by thousands of dollars each year to take advantage of Health Savings Accounts, HSAs.

That’s how our nation’s discussion about health insurance continues to change over time. People talk about the millions of Americans who love their private health insurance policies, paid for by their employers.

But those policies are not what they used to be. They include HMOs, PPOs, POS plans and others. You won’t even know what your plan covers until someone in your family gets really sick.

Health care costs increase all the time. Employers keep paying more to cover their employees’ health insurance. Many businesses have dropped coverage because they can’t afford it, or they have cut employee hours to part-time to reduce insurance benefits.

As artificial intelligence continues to expand in the workplace, many jobs that currently provide health insurance benefits will begin to disappear.

Many truck drivers, for example, will be replaced by self-driving vehicles, or drones.

Yet, when Sanders or other Democratic candidates for president talk about doing away with private health insurance, most voters run away in panic.

While more than half of all Americans have told pollsters that they support Medicare-for-all, only about one in three is willing to pay higher taxes for the privilege. The number drops even lower if eliminating private health insurance is part of the bargain.

Americans want health care to be a right. They want private, employer-supplied health care to remain an option. And they don’t like paying taxes.

But they will pay higher insurance premiums and happily contribute more money to their health savings accounts. Those are health insurance taxes and fees by another name.

Remember when private insurance companies refused to insure people with pre-existing conditions? Sure, you do. That’s what private insurance companies do. They make money. And those billions of dollars in profit do nothing to improve hour health care.

They also do nothing to regulate the cost of prescription drugs. Insulin in Canada costs $30 a vial, while the same supply might cost $320 here. That’s $1,200 in Canada for a supply of insulin that would cost a diabetic $12,000 in the U.S.

We need to regulate the cost of prescription drugs. We need to regulate medical costs.

Every other industrialized country in the world does both. Would a single-payer national health care system be perfect? Hell no. Is the current system of health insurance perfect? You know it is not.

People are frightened of change.

But under the current system people can’t understand their medical bills or their insurance coverage. The current system is designed to confuse you and rip you off.

You have to demand something different. Change is going to happen. It will be a change you control, or one controlled by people most concerned about making money.

That’s sick.

Email: philkadner@gmail.com

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