Action Alert: Tell Sanders to Reject Cost-Sharing (Co-pays)

August 30, 2017

Dear single-payer activist:

Senator Bernie Sanders plans to introduce a single-payer bill in the U.S. Senate shortly after Labor Day. We applaud Sen. Sanders’ longstanding support for improved Medicare for all, and the work he has done to insert single payer into the national health care debate. Unfortunately, we have learned that Sen. Sanders has not ruled out copays in his bill from patients with incomes higher than 200 percent of the poverty level.

Sen. Sanders seems willing to consider these cost-sharing measures in order to enlist additional Senate co-sponsors. However, copays are medically unwise and would undermine popular support for the bill since millions of unionized workers with hard fought, high-quality health plans would see their coverage deteriorate.

Copays burden the sick, shift care from poorer to wealthier patients, and discourage patients from seeking needed medical services. Research shows that patient cost-sharing actually raises administrative costs; experience in other nations prove that they are not needed for cost control. For more details and a review of the medical evidence on the harms of copays, please read this letter to Sen. Sanders from several PNHP leaders.

ACTION ALERT: We urge you to call Sen. Sanders’ office at (202) 224-5141 or send him an online comment at:

Tell Sen. Sanders:

  • Do NOT include copays in your single-payer bill!
  • Copays do not reduce administrative costs.
  • Copays discourage patients from seeking medically-necessary care.

Under a well-designed single-payer system, all Americans would see their coverage improve, the vast majority would see their overall costs decrease, and providers would operate in a much less bureaucratic environment. Copays would jeopardize progress on all of these fronts, which is why we need you to speak out today!


Carol A. Paris, M.D.

3 thoughts on “Action Alert: Tell Sanders to Reject Cost-Sharing (Co-pays)

  1. They have copays for GP care in New Zealand and they don’t work – mainly because they discourage patients from seeking preventive care early in the course of their illness. They wait to get care until their illness is much more advanced and much more expensive to treat. This is why copays are never cost effective.

    Please contact Sanders. He needs to hear from you.


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