At the Thursday debate, Clinton attacked Sanders' healthcare plan by repeating the big business disinformation claim that single payer healthcare will increase costs to regular Americans. Because a single payer system is funded through the government, tax revenue from some source may very well have to increase. But it's sort of like switching insurance companies in order to get lower premiums. Yes, your new insurance company will be asking you to pay them money you didn't have to pay them in the past, but you'll no longer be paying the higher premiums at your previous insurance company. Stopping the higher premiums and paying the lower premiums leaves you paying less in total.
You don't have to be a "socialist" to think this. Forbes magazine (self-described as "the capitalist tool") had a 2014 article "U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries" It tells us: "It’s fairly well accepted that the U.S. is the most expensive healthcare system in the world, but many continue to falsely assume that we pay more for healthcare because we get better health (or better health outcomes). The evidence, however, clearly doesn’t support that view." And guess what? It's those European and other single payer countries that Forbes tells us are both cheaper and better. If only Clinton or her advisors would read Forbes!
Canada is a useful example of how a single payer healthcare system can cost far LESS than the US system. You should all read the Scientific American article "We're Number Two: Canada Has as Good or Better Health Care than the U.S." Please note: this article is from 2007 - before "Obamacare" - so some details will be different today, but there is much in the US system which remains the same. At the time of that article's writing, the Canadian system showed comparable results for patients to that of the US system. There were areas where one or the other health care system did a bit better, but on the whole, they were comparable. There was one point of difference you might find especially noteworthy - Canada rated better on mortality.
The subheading of the article reads, "Despite spending half what the U.S. does on health care, Canada doesn't appear to be any worse at looking after the health of its citizens." No, that does not mean the total health spending in Canada is less because of its smaller population. The study showed, "per capita spending on health care is 89 percent higher in the U.S. than in Canada."
The Scientific American article mentions a few areas in which Canadian healthcare didn't rate as high as the US. However, Canada pays so much less per capita that it could easily pay somewhat more to make those areas as good as that in the US and still be paying well below what we pay.
Remember, Canada already has universal coverage, so their per capita cost is about what our single payer system would be when all those who currently lack coverage are added to US health care spending.
The fact is, if the US had the same health care system as Canada, our per capita spending could very well be even lower than that of Canada. Canada's population is only about 1/9 that of the US. The infrastructure for a population nine times as large would not have to need exactly nine times as many administrators, nine times as many desks, nine times as much building space, etc. Buying in larger volume would allow the US to get a lower unit-price. So, our per capita cost could be lower.
If Clinton has a proposal for a single payer healthcare system that gives the same quality of care as Sanders' at a lower per capita cost, let her present it as an alternative. However, that's not what Clinton is putting forward - and yet she spreads this fabrication that single payer systems in other countries mean greater costs.
(Other countries may have higher taxes, but they also have a stronger social safety net, paid family leave, free or lower-cost college, at least in some cases shorter workweeks and/or more vacation time, lower child care costs, are caring for more refugees, etc. And they're doing that with the disadvantage of having smaller populations to support the infrastructures for these programs. The question shouldn't be how much taxes are, but how much one pays in the combination of taxes, insurance premiums, out of pocket medical spending, tuition, child care, etc. The comfort of knowing these protections are available is also worth something.)
The other half of this disinformation is the idea that average Americans would have to pay for any additional costs from any new government programs. That need not be true. Sure, if you're a politician who accepts the current system of dumping an unfair amount of taxes on people of average incomes while letting the super-rich get special lower rates for long-term capital gains and other income sources which are received mainly by the 1%, then average Americans will pay more taxes IF spending rises. We don't have to continue this unfair tax system.
So:
1) The per capita cost of health care in Canada is FAR LESS than in the US
2) Even if it weren't, the extra expenses could be at least substantially paid by the wealthy in a fair tax system
If you care about the facts, this is the scientific knowledge.
There are some tax-related matters which should be addressed in the process of adopting a single payer health care system in the US. Currently, working people have both income and Social Security / Medicare taxes deducted from their paychecks. The Social Security / Medicare taxes are a flat rate - it’s not like a progressive income tax. (Social Security taxes are only taken out of the first about $110,000 of salary, so those with higher salaries actually pay a lower rate when comparing total yearly salary and total yearly Social Security tax.) When universal health care is enacted, there's no reason why health care shouldn't be paid for solely by a progressive income tax and the Medicare tax eliminated. That will mean wealthy people who don't work for a living (don't pay Medicare taxes) will be expected to pay toward health care like everyone else. Rather than working people paying the equivalent of income tax + Medicare taxes, while the rich only pay their current income taxes, we have to make the rich start chipping in. A properly progressive income tax would also mean the wealthy would pay their fair share in tax rates, so less of the burden would fall on average Americans.
We might want to address other matters. Employers also pay a portion of the Social Security and Medicare taxes on behalf of their employees. If the Medicare tax is eliminated, the question arises what should be done with that money which the employees earned and the boss paid to the government for the employees. There are two reasonable alternatives. The employers could be required to pay that money to the single payer health care system as an increase in their regular taxes. That would help keep down the need to tax average Americans. The other option would be to add that amount to employees' paychecks as salary. Part of that extra salary would go to income taxes. At worst, all of it would go to taxes for the health care system - but the net paycheck would be the same because this is money which never passed through the employees' hands before.
There's also the question of the health insurance premiums some employers pay toward employee group insurance plans. When that private insurance isn't needed because of single payer health care, should that just be a windfall that the boss gets to keep? While that doesn't sound entirely fair, if that were to be the case, the company would have lower expenses - which means larger profits which would be taxed (would help fund single payer health care.) However, we could try to have at least part of those premiums be added to employee salaries or to business taxes.
So, single payer can cost less simply by itself. A more just tax system could prevent average Americans from seeing increases in their taxes no matter whether government spending was increasing as a result of this part of the government or that part of the government. Together, there's no reason why most Americans couldn't see their taxes become smaller.
Forbes can tell the truth to business people. Scientific American tells the truth to people interested in scientific evidence. But establishment politicians can't or won't tell the same facts to voters. Does it really matter whether Clinton knows she's spreading disinformation, or is just too trusting of disinformation from big money lobbyists, or chooses advisors who feed her big business disinformation? Forget whether or not you think single payer healthcare should be an issue this year - can you trust the statements that come from Clinton’s mouth?