You still missed the point, which is that the “impact on the budget” is irrelevant as long as sufficient resources and labor are available to provide healthcare for everyone. The thing to take note of in Sen. Sanders’ proposal is that those who will see tax increases are the same people he will likely tax heavily with or without Medicare4All.

Any tax applied to the working class will only be to avoid a possible inflationary event as everyone is suddenly freed from having to pay premiums and out of pocket expenses, not to “pay for” the program costs. Such an event will be mitigated by the unemployment the plan would produce and we certainly owe those workers more than the pittance of benefits now available via the safety nets. A generous transition program for them could easily be the model for a guaranteed job program that would retrain displaced workers in the future as well, or simply offer public service employment to any worker who might prefer it.

Medicare Advantage is the most expensive of all the current choices for seniors, including purchasing insurance outright on the open market, but it is the government footing the bill so no one notices the cost. The companies offering it only began including some vision and hearing coverage, as well as expanded drug coverage, when it became obvious they might be seeing an end to their gravy train. Any senior who doesn’t plan on moving or traveling outside of the available network coverage of the insurance companies would be a fool not to take advantage of it, but that doesn’t mean that the program is more cost-effective as a model for healthcare in general. Using it as such would actually blow a hole in the economy, and quickly.