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The Difference Between a ‘Public Option’ and ‘Medicare for All’? Let’s Define Our Terms

A glossary for the emerging Democratic health care debate.

By Margot Sanger-Katz

Democrats, the many running for president as well as energized members of Congress, are talking big about health care again. Among other things, that means brace yourself for some jargon.

Here’s your neighborhood health care nerd to help define some terms.

Various proposals are floating around, each of which would change the health care system in distinct ways. Some, like one from Senator Bernie Sanders, would do away with all private health insurance. Some would make small expansions in existing public programs. Some would try to cover all Americans through a mix of different insurance types.

It can be mystifying when people call all of these ideas “Medicare for all,” as some in the debate have been doing.

A glossary of terms could make the debate less confusing. Let’s start with the basics.

What is Medicare?

Medicare is a 54-year-old program that provides health insurance for Americans 65 and older, and for a few other groups of people with particular diseases or disabilities.

Traditional Medicare pays doctors and hospitals according to set prices determined by the government, and most medical providers in the United States accept it. It’s also possible to enroll in private Medicare plans that can offer additional benefits, though with a more limited set of health providers.

Private plans handle Medicare drug coverage, and you can choose among options. You pay premiums each year, and you pay deductibles and co-payments when you use medical services.

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