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Americans Don’t Really Want Medicare for All — They Want Japanese Health Care
Japan provides a model for Americans who want a system that covers everyone with no mandate and no new middle-class taxes

Bernie Sanders has made a habit of pointing out how much less other countries pay for health care. Throughout the Democratic debates, the Vermont senator repeatedly claimed that the United States is “spending twice as much per capita on health care as any other nation.”
Sanders of course doesn’t mention that his plan wouldn’t come anywhere close to cutting our health care spending in half — doing so would require bringing salaries for doctors and hospital workers down to international norms. His omission is no surprise: Too often, American politicians rely on superficial comparisons with other nations to promote their health care agendas. Moderate Democrats often claim Obamacare should resemble the Swiss health care system, though in reality Obamacare lacked all the regulations that make that system function. Conservatives frequently try to scare people by pointing to highly selective stories of wait times in Canada or Britain, while ignoring the infinite wait time caused by not being able to afford care here.
If we look honestly at all the health care systems in the world to find the one which most closely aligns with voters’ desires, we would probably end up with the Japanese model. It is not the system anyone would design from scratch. It is a relatively complex system that evolved over decades to fit the needs, changing dynamics, and political trade-offs of the country. But for that very reason, it might most closely satisfy Americans’ seemingly endlessly contradicting opinions on reform.
Japan has more than 3,000 insurance plans, yet the benefit is not nearly the costly mess it is in the United States.
The Japanese health care system is based on employer- or union-provided insurance, just like the American one. People not covered by employer insurance are covered by government plans. Seniors basically have their own special coverage. The poor and disabled have special subsidies. Cumulatively, Japan has over 3,000…