Eh. Every single developed country with multi-payer also has similar health outcomes at a fraction of the cost.
Single payer isn’t really comprehensive cost control. If we used Medicare’s reimbursement rates right now to cover everyone in the US, we’d still be paying more than everyone else.
Heck, right now, the federal, state and local spending on healthcare, covering ~40% of the population, is already more per-capita than Canada’s. Or France’s. Or Germany’s. Or Japan’s. In other words, we would already be able to cover every single person in the US with the money the government currently collects if we had the cost control mechanisms, reimbursement rates and risk profiles they have.
There are two ways having a larger pool lowers costs.
The first is that it allows insurers to lower their overall risk profile, but the effect has diminishing returns and most insurers already have pools large enough for this to be a nonissue.
The second major cost savings function is around increasing the bargaining position of the insurer vs. a healthcare provider to negotiate lower rates, however you don’t actually need single payer to maximize this. France, for instance, simply negotiates one rate schedule for all payers instead of having every payer negotiate separately. Japan just centrally fixes the prices of treatments (something we used to do).
Unrelated to pool size, there is cost savings from potentially reduced billing overhead with single payer, but that can easily be wiped away if cost controls aren’t firmly stuck to.
I don’t see much in the way of cost control measures in these bills which is… troublesome. Congress has a long history of killing cost control mechanisms of Medicare (the annual “doc-fix” giveaway for instance).
Of course, I’ll still happily say I support Medicare-for-All, but really I support fixing the system and if the only way we can do it politically is to call it MFA, so be it. I just wish the bills were more than a way for politicians to raise money.