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Data: The Urban Institute; Note: 2020 estimates assumes all reforms fully phased in and in equilibrium, "Household spending" is for those 64 and under; Chart: Andrew Witherspoon/Axios

Democrats aren't debating small differences in health policy — a public option would be radically different than a shift to a single payer system, and a new analysis by the Urban Institute and the Commonwealth Fund illustrates just how big those differences are.

By the numbers: A public option — even a robust one — would cost the federal government an additional $1.5 trillion over 10 years. Full-blown single payer would result in a federal spending increase of $34 trillion.

Yes, but: More federal spending doesn't necessarily mean the health care system as a whole is getting more expensive.

Details: The analysis doesn't look at any specific piece of legislation or any particular Democratic candidate's plan, but it covers the spectrum of what's been proposed.

  • National cost savings generally come at the expense of providers, as their payment rates would be regulated under expanded government coverage.

Go deeper

Ben Geman, author of Generate
Sep 30, 2020 - Energy & Environment

Climate's surprise appearance in the debate

Illustration: Annelise Capossela/Axios

The debate was a mess as moderator Chris Wallace struggled with President Trump's interruptions. But let's analyze the climate parts anyway without normalizing the whole thing.

Why it matters: The contest provided a collision over the topic between Trump and Joe Biden, and underscored the two candidates' immense differences.

2 hours ago - Health

Axios AM Deep Dive: Covid forever

Illustration: Aïda Amer/Axios

It was 563 days ago that the WHO declared Covid-19 a pandemic. This Axios AM Deep Dive, led by healthcare reporter Caitlin Owens, looks at our Covid future.

Federal judge blocks vaccine mandate for NYC teachers

Students are dismissed from the first day of school at PS 133 in Brooklyn on Sept. 13. Photo: Michael Nagle/Xinhua via Getty Images

A federal appeals court judge on Friday temporarily blocked New York City schools from enforcing a vaccine mandate for school employees, days before it was set to take effect, AP reports.

Driving the news: The vaccine mandate was set to begin on Monday, prompting concerns over staffing shortages in schools across the nation's largest school system.