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| Bernie Sanders releases healthcare plan hours before Democratic debate | Bernie Sanders releases healthcare plan hours before Democratic debate |
| (35 minutes later) | |
| Bernie Sanders on Sunday detailed how he would expand Medicare for all Americans, releasing the first cost estimates behind his plan just minutes before he was expected to face questions from a sceptical Hillary Clinton. | |
| Related: Democratic debate: Sanders and Clinton face off in South Carolina – live updates | Related: Democratic debate: Sanders and Clinton face off in South Carolina – live updates |
| The funding model, including estimates from an independent healthcare economist from the University of Massachusetts at Amherst, relies heavily on a payroll tax to help pay for the cost of shifting from a fragmented private system to a unified public insurance umbrella. | The funding model, including estimates from an independent healthcare economist from the University of Massachusetts at Amherst, relies heavily on a payroll tax to help pay for the cost of shifting from a fragmented private system to a unified public insurance umbrella. |
| The so-called “single-payer” insurance model is employed successfully in a number of industrialised countries such as Canada, but several practical questions over how to move from the current US system had overshadowed Sander’s ambitious promises. | The so-called “single-payer” insurance model is employed successfully in a number of industrialised countries such as Canada, but several practical questions over how to move from the current US system had overshadowed Sander’s ambitious promises. |
| Clinton spent much of the week leading up to Sunday’s debate putting pressure on Sanders, attacking him for failing to provide cost estimates and claiming his plan would inevitably involve steep tax rises for many middle class families. | |
| Sanders has always argued the efficiency benefits from having a single government purchaser of healthcare would more than compensate for the extra taxes used to pay for it – estimating there would be overall savings of $6tn over the next 10 years compared to the current system. | Sanders has always argued the efficiency benefits from having a single government purchaser of healthcare would more than compensate for the extra taxes used to pay for it – estimating there would be overall savings of $6tn over the next 10 years compared to the current system. |
| But it remained unclear whether employers would necessarily pass on their savings from not having to provide medical insurance, or leave taxpayers facing a huge hike in payments to the government in the interim. | But it remained unclear whether employers would necessarily pass on their savings from not having to provide medical insurance, or leave taxpayers facing a huge hike in payments to the government in the interim. |
| However, detailed policy notes released ahead of the fourth Democratic debate in Charleston propose a potentially significant breakthrough to overcome this challenge and counter Clinton’s claim that middle class taxpayers would be worse off. | However, detailed policy notes released ahead of the fourth Democratic debate in Charleston propose a potentially significant breakthrough to overcome this challenge and counter Clinton’s claim that middle class taxpayers would be worse off. |
| Sanders proposes a 6% payroll tax levied directly on employers, which would pay for the bulk of the costs of expanding Medicare to cover all Americans. There would also be a 2.2% “healthcare premium” added to individuals’ federal tax charges, but the plan anticipates that most families would be better off as a result of reduced co-pays and other existing insurances costs. | Sanders proposes a 6% payroll tax levied directly on employers, which would pay for the bulk of the costs of expanding Medicare to cover all Americans. There would also be a 2.2% “healthcare premium” added to individuals’ federal tax charges, but the plan anticipates that most families would be better off as a result of reduced co-pays and other existing insurances costs. |
| Estimates by economist Gerald Friedman, released by the Sanders campaign, claim that the typical family earning $50,000 a year would save nearly $6,000 annually in healthcare costs overall. | Estimates by economist Gerald Friedman, released by the Sanders campaign, claim that the typical family earning $50,000 a year would save nearly $6,000 annually in healthcare costs overall. |
| Friedman estimates the average working family now pays $4,955 in premiums for private insurance and another $1,318 on deductibles for care that isn’t covered. The Sanders campaign claims that under his plan, a family of four earning $50,000 would pay just $466 a year to the Medicare-for-all program. | Friedman estimates the average working family now pays $4,955 in premiums for private insurance and another $1,318 on deductibles for care that isn’t covered. The Sanders campaign claims that under his plan, a family of four earning $50,000 would pay just $466 a year to the Medicare-for-all program. |
| “Universal healthcare is an idea that has been supported in the United States by Democratic presidents going back to Franklin Roosevelt and Harry Truman,” Sanders said. | “Universal healthcare is an idea that has been supported in the United States by Democratic presidents going back to Franklin Roosevelt and Harry Truman,” Sanders said. |
| “It is time for our country to join every other major industrialized nation on earth and guarantee healthcare to all citizens as a right, not a privilege.” | “It is time for our country to join every other major industrialized nation on earth and guarantee healthcare to all citizens as a right, not a privilege.” |
| In response, the Clinton camp issued a statement attacking the idea. | In response, the Clinton camp issued a statement attacking the idea. |
| “Senator Sanders has been changing a lot of positions in the last 24 hours because when his plans and record come under scrutiny, their very real flaws get exposed,” said spokesman Brian Fallon. | “Senator Sanders has been changing a lot of positions in the last 24 hours because when his plans and record come under scrutiny, their very real flaws get exposed,” said spokesman Brian Fallon. |
| “After digging in his heels for weeks, he backpedaled on his vote to give sweeping immunity to gun manufacturers and dealers. And after weeks of denying the legitimacy of the questions Hillary Clinton raised about flaws in the healthcare legislation he’s introduced nine times over 20 years, he proposed a new plan two hours before the debate. | “After digging in his heels for weeks, he backpedaled on his vote to give sweeping immunity to gun manufacturers and dealers. And after weeks of denying the legitimacy of the questions Hillary Clinton raised about flaws in the healthcare legislation he’s introduced nine times over 20 years, he proposed a new plan two hours before the debate. |
| Related: Hillary Clinton targets Bernie Sanders' 'flip-flop' on gun control | Related: Hillary Clinton targets Bernie Sanders' 'flip-flop' on gun control |
| “Hillary Clinton knows what it takes, and has what it takes, to protect the gains of the Affordable Care Act and secure quality, affordable healthcare for all Americans. When you’re running for president and you’re serious about getting results for the American people, details matter – and Senator Sanders is making them up as he goes along.” | “Hillary Clinton knows what it takes, and has what it takes, to protect the gains of the Affordable Care Act and secure quality, affordable healthcare for all Americans. When you’re running for president and you’re serious about getting results for the American people, details matter – and Senator Sanders is making them up as he goes along.” |
| Clinton has been stepping up her attacks on Sanders’ single-payer healthcare scheme, mindful no doubt of tightening polls in Iowa and her rival’s enduring lead in New Hampshire – although she maintains a healthy national lead. | Clinton has been stepping up her attacks on Sanders’ single-payer healthcare scheme, mindful no doubt of tightening polls in Iowa and her rival’s enduring lead in New Hampshire – although she maintains a healthy national lead. |
| She has claimed that the impact of the plan would be to return control over health insurance to the governors of individual states, and to slap an additional 9% tax on middle-class families to pay for it. | She has claimed that the impact of the plan would be to return control over health insurance to the governors of individual states, and to slap an additional 9% tax on middle-class families to pay for it. |
| The Clinton campaign surprised observers this week by unleashing Chelsea Clinton – who has previously been used in a less aggressive fashion - against the Sanders healthcare plan. She claimed the scheme would dismantle Obamacare and “strip millions and millions and millions of people of their health insurance”. | The Clinton campaign surprised observers this week by unleashing Chelsea Clinton – who has previously been used in a less aggressive fashion - against the Sanders healthcare plan. She claimed the scheme would dismantle Obamacare and “strip millions and millions and millions of people of their health insurance”. |
| Sanders lashed back by accusing Hillary Clinton of sounding like a Republican on the subject of healthcare. | Sanders lashed back by accusing Hillary Clinton of sounding like a Republican on the subject of healthcare. |