Step into a doctor’s office, one of the first questions asked is “What is your insurance?” but what if that wasn’t the case? What if, instead, the government paid for your medical expenses? That is the sweeping overhaul that Senators and presidential hopefuls Bernie Sanders and Elizabeth Warren are proposing – and it’s getting a lot of buzz.

Currently, payments for health coverage are mainly made through insurance companies, the most notable being United Health, Aetna, and Anthem. For example, if someone goes to the hospital after breaking their leg, the insurance company will pick up the bill, with the exception of an additional copay the individual pays themselves. For the majority of Americans, medical care is paid through an insurance company- either from their employer or individually.

In an ideal world, this process would be the norm, but in reality there have been many caveats with the insurance companies. Many people have accused insurance companies of excessive greed, citing skyrocketing health costs and an absence of full coverage. “Competition in the health insurance industry has only driven up costs for uninsured Americans,” said Isaac Rjavinski ’20. “The service provided by private health insurance companies is a utility, not a luxury – the wealthiest country in the world should not hedge the lives of the most vulnerable Americans on the unethical profits motives of these companies.” Many individuals see government-run single payer healthcare as an alternative to private health insurance that eliminates the effects of profit and business on the healthcare sector.

The Sanders and Warren campaigns have endorsed proposals that replace private insurance companies with a government program similar to Medicare. In this plan, the government would be the one that negotiates with medicare providers, like hospitals, to pay for people’s healthcare costs. It would essentially replace insurance companies with a government pool of people that would cover each and every individual. This would raise the portion of Americans with healthcare coverage from the current 90% to universal for all Americans. The Sanders website cites that the United States pays the most out of any developed nation for healthcare at around $10,000 per person, roughly 18% of GDP. Through measures such as negotiating with pharmaceutical companies and the consolidation of healthcare, the Sanders proposal claims that the vast majority of Americans will see a reduction of $4,400 on average in their healthcare expenses.

“The wealthiest country in the world should not hedge the lives of the most vulnerable Americans on the unethical profits motives of these companies,” said Isaac Rjavinski ’20.

However, the estimates regarding how much the program would cost the government vary from $2.76 to $3.87 trillion, which would make it the largest department in the United States government by percent of GDP. This begs the question: how would we pay for it? The Sanders campaign has argued that it would be paid through a multitude of measures, most notably a wealth tax on the top income brackets, as well as corporate taxing and closing of loopholes allowing businesses to move profits offshore. Despite this, Sanders has conceded that it would slightly increase taxes for middle class Americans, yet it would also save them a considerable amount in healthcare costs.

The positions of other moderates such as Biden, Buttigieg, and Harris vary, yet still build on the healthcare reforms in the Affordable Care Act passed by President Barack Obama in 2010. When it comes to the premise of private insurance, many moderates’ plans revolve around a public option, where people are given the choice of opting into Medicare or simply staying on their current private insurance. According to a Bronx Science student who wishes to remain anonymous, “Americans who can and want to have private healthcare… should be able to and the government should not force them into certain plans. Cheaper, public healthcare will not be of the same quality of more expensive, private healthcare,” and that, “just like we have the option to buy the more expensive, but higher quality option in a store, we should be able to do so with our health insurance.” Even so, many conservatives do not even want to go as far as this, and instead hope to undo many measures in the Affordable Care Act and switch back to a more privatized health insurance network with fewer government regulations. As a result, a wide range of opinions on the matter exist across political parties and ideological beliefs.

The role of private insurance is a hotly contentious one, with a range of potential solutions involving different amounts of government intervention in the American healthcare system. What will happen to the health care system of the United States is yet to be seen, but all we know is that any reform would have implications for every American.