Interactive estimate · 2024 U.S. health spending
The U.S. spent $5.28 trillion on health care in 2024. Each colored block below is one way a single-payer system could cut that bill. Click a block to see the assumptions behind it and pick how optimistic to be.
Gray is spending that continues under either system. Colored blocks on the top bar are savings; the purple block on the bottom bar is new spending on care people skip today.
Part 2 · Financing
The same health care has to be paid for by someone. Today the bill is split among the federal government, states, households, employers and charities. Under Medicare for All most of it moves onto federal taxes. The total here follows your choices above, so cheaper assumptions mean smaller tax increases.
Today's split is from the 2024 National Health Expenditure accounts, by who ultimately provides the money. New taxes are assigned to whoever pays them (a payroll tax split between employers and workers, an income tax to households). Taxes on higher wages count toward households.
Today's federal share already includes ACA premium credits. The biggest hidden subsidy is the tax exclusion for employer health plans: about $299B in lost income and payroll tax in 2022. Under single payer, employer premiums end, so the exclusion ends with them. Whatever employers pay out as higher wages becomes taxable, which is the "employer savings" choice above.
The Veterans Health Administration spent about $119B in fiscal 2025, already inside both the federal share and total spending. Recent Medicare for All bills keep the VA separate. Folding it in would move the same dollars into the new program rather than change the totals: VA hospitals would become providers paid like everyone else, and veterans could use any doctor.
Single-payer bills cover medically necessary care. Cosmetic work stays out of pocket, and services like chiropractic are covered only as far as the plan decides (traditional Medicare covers spinal manipulation only). Whether the wealthy can buy faster or extra care is a real fork: Canada largely bars private insurance for covered services, while Australia and the UK allow a private tier alongside the public one. Whether employers would pay for top-ups depends mostly on whether they stay tax-free.
Charging people who visit for every cough is a copay question. Small, income-scaled copays cut low-value visits and raise some money, but they also deter needed care, which is why the Sanders bill has none. The "extra and elective care" choice lets you add them.
Levels marked "illustrative" are round-number steps between published estimates, not figures from a study. Tax rates use CRFB's rule of thumb (a 32% payroll tax or 25% income surtax raises about $3T a year) and ignore how people and employers change behavior when taxes rise. For comparison, CBO found federal health spending would rise $1.5–3.0 trillion in 2030 under its single-payer options.