Under the Sanders proposal, for example, cost control is secured by a global budget and by imposing Medicare payment rates. Blahous, a former Medicare trustee, estimates that under the Sanders proposal, provider payments would be cut by an estimated 40 percent by usingMedicare payment rates. Using Medicare payment rates throughout the entire American health care economy would hurt patients. Already, the Centers for Medicare and Medicaid Services projects that “nearly half of hospitals, approximately two-thirds of skilled nursing facilities (SNFs), and over 8 percent of home health agencies (HHAs) would have negative total facility margins.”

The Urban Institute estimates 10-year spending of $32 trillion, only about half of which would be covered under Sanders’ funding options Mercatus Center’s Charles Blahous estimates a 10-year $32.6 trillion increase in federal spending. Even “doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan.” Economist Kenneth Thorpe of Emory University estimates $24.7 trillion in additional federal spending, and also estimates an average deficit of $1.1 trillion per year. The Center for Health and Economy estimates a 10-year net cost of up to $44 trillion, and an annual deficit of $2.1 trillion.