Health insurance premiums are a private tax; Medicare for All would lower workers' total burden and should be Democrats' top priority
Source: Tim Higginbotham. "End the Private Health Insurance Tax: Pass Medicare for All." November 9, 2026. jacobin.com
The Gist
The author argues that what workers pay for health insurance out of their paychecks is basically a tax that goes to private companies, and a pricey one. Using his own pay stub, he claims Medicare for All would cost him far less than he pays now, so Democrats should make it their first priority.
Conclusion
Democrats should make Medicare for All their first priority, because replacing employer-based private insurance premiums with a single-payer system would lower workers' overall financial burden, free up wages, and eliminate waste.
Premises
- Health insurance premiums (employer and employee contributions) are compulsory, unavoidable deductions from compensation, so they function as a tax paid to private insurers rather than to the government.
- The U.S. spends roughly 18 percent of GDP on health care, about double peer nations with universal systems, with the excess going to insurer profit and administrative waste.
- Rising premiums and growing deductibles suppress wages and tie workers to their jobs, because employers weigh insurance costs against wages.
- Under Sanders's Medicare for All proposal, the author's combined payroll and income tax cost would be about $354 per paycheck, versus $1,267 in current premiums, a savings of roughly $23,700 per year, and out-of-pocket costs would disappear.
- Health insurance exists to minimize risk, costs, and catastrophes, which can only be accomplished by a single government payer.
- Medicare for All would save up to a trillion dollars a year in overall spending, and the policy remains popular following Democratic midterm wins.
Assumptions
- The author's personal pay stub (a unionized municipal worker with an unusually expensive family plan) is representative of typical workers.
- Calling premiums a 'tax' is a legitimate classification that supports the policy conclusion rather than merely a rhetorical reframing.
- Employers would pass premium savings on to workers as wages and benefits rather than keeping them.
- The Sanders financing proposal would raise enough revenue at the stated rates, and the projected savings in national spending would actually materialize.
- Only a single government payer can achieve the goals of health insurance; alternative reforms (public option, regulated multi-payer) would not.
- Electoral popularity and recent Democratic wins indicate a mandate for Medicare for All and political feasibility.