Professor Robert Field discussed the plausibility of national health insurance on Knowledge at Wharton Radio on Feb. 22.

Since U.S. Sen. Bernie Sanders announced his entry into the 2020 presidential election, his “Medicare for All” proposal has received a lot of attention. While it may seem idealistic, Field says, it isn’t impossible.

“In theory, absolutely it can work, but like everything else, the devil is in the details,” he said.

Field noted that (not withstanding inflation) over the next decade, the plan would be comparable to the cost of current U.S. health care. The difficulty, he says, lies in “allocating who pays what.”

However, he questioned what would happen if the Sanders plan were able to remove co-pays and deductibles.

“There is this golden window between not discouraging people from getting necessary care and not encouraging them to get unnecessary care,” he said.

Field believes that there are many other “middle-of-the-road measures.”

“The biggest potential benefit with a single-payer system is no billing,” said Field. “If we did have a ‘Medicare for All’ system, or one set of payments from one payer, it would be very difficult then for doctors and hospitals to opt out. You would be guaranteed that you’d have every provider in the network, but Medicare would then make decisions not just about payment, but also about coverage and new technologies.”

According to one study, as of 2016, the U.S. health care and related industries had 22 million jobs and a projection of another 11.6 million workers needed between 2016 and 2026. That is why politically speaking, Field believes that the private insurance industry “would be a formidable force to fight against,” raising the specter of losing “thousands of jobs and economic engines.”