But I still haven't seen a plan that is detailed enough to inform me how, exactly, it could work or how it could pass.
Everyone, of course, who works already pays into Medicare. But as it exists now, everybody who pays in is paying to support the medical costs of those over 65. To fund a universal system is extremely costly (as seen in the failure of several well-intentioned states to institute a state-level program). I know there are plans to put a large tax burden on businesses and corporations, and that could go some way towards making it work (but until I see a CBO analysis of the precise costs, I'm not sure of the balance sheet--or whether businesses would be so opposed as to kill its passage; it might be a wash for them on providing private coverage, or not; for the generous businesses that provide high-level coverage, it would probably be a gain; for those that provide no or lesser insurance, there would be blowback). Then there is the possibility of charging premiums to younger people, or making it "progressive" based on income (something I would oppose on the grounds that it would then not be a true universal system, like Social Security). Or raising the Medicare tax on everyone. Or ...?
Then there is the question of supplementary insurance. Medicare, of course, does not cover everything, and in most countries that have a single-payer system people who can afford it also have supplementary insurance (as do most on Medicare who can afford it have here in the US). Another two-tiered system, in a way.
It's easy to say we want Medicare for All, and I'm not saying that is not the most desirable thing. But I wonder if we're being premature in making such a giant push for it all at once. Just as the Republicans promised to undo Obamacare a zillion times, and in the end couldn't do it, I don't want the Democrats to do the same thing. You don't get a zillion chances to pass these things. Each time you try and it fails, you lessen the chance that you can do it next year. That puts me sort of in the camp of those who want to see a phased in, incremental approach that locks things in over time, perhaps starting with extension to 55 and older, and a public option for the existing ACA. Together, those could be huge stepping stones to an eventual single-payer system as the two ends coalesce.
Don't make this just some sort of populist campaign promise that doesn't have the down-and-dirty details or political clout to pass. It hurts, rather than helps, the goal, in the end.
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