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Vermont Sen. Bernie Sanders introduced his bold, new “Medicare for all” health care plan on Wednesday with the support of many of his Democratic colleagues in the Senate.

The single-payer, universal health care proposal would give all Americans a “Universal Medicare card” to cover a whole host of health care services, from hospital stays and doctor visits to substance abuse treatment, dental, vision and even abortions, CNN reports.

Sanders outlines the “Medicare for All” plan on his website, which declares “Americans need a health care system that works for patients and providers. …

“We need a health care system that significantly reduces overhead, administrative costs and complexity.”

The plan is expected to cost about $1.38 trillion per year, paid for by tax hikes on employers, the middle class, and the wealthy. Estimates of Sanders’ previous single-payer proposals by the Urban Institute estimated the changes could cost as much as $32 trillion over the course of a decade, Reason reports.

The expense, according to a much younger Sanders, would bankrupt the nation.

In a YouTube video of a younger U.S. Rep. Sanders from 1987, he described what he envisioned would happen if the government gave everyone a Medicaid card. Medicaid, of course, is the much less costly cousin of Medicare.

“You want to guarantee that all people have access to heath care as they do in Canada,” he said at the time. “But I think what we understand is that unless we change the funding system and the control mechanism in this country to do that, for example if we expanded Medicaid to everybody, give everybody a Medicaid card, we would be spending such an astronomical sum of money that we would bankrupt the nation.”

Reason weighed in on Sanders’ proposal, and the 1987 clip, in an editorial Thursday.

“The most striking thing about the legislation Sanders introduced yesterday … is that it effectively wishes those questions away. It promises huge overall savings along with coverage that would be far more expansive, and far more expensive, than Medicaid for all, with no clear way to pay for it, and no specific strategy for driving costs or spending down,” according to the Libertarian news site.

“In 30 years of political advocacy, Sanders has not solved any of the fundamental problems with single payer. He has merely opted to pretend they do not exist.”

And aside from the finances, there’s also huge potential problems with actual medical services under the single-payer system, as Canadian doctor Danielle Martin explained to Sanders on his own radio show, The Bernie Sanders Show.

Martin told Sanders that while patients in Canada are generally well served by the system in emergency situations, dealing with routine medical treatments can be a nightmare.

“Canadians do not wait for urgent or emergent issues, so if people get seriously sick in Canada and have a heart attack or cancer diagnosis … our outcomes are excellent for those serious conditions,” she said. “Having said that, we do have a problem with wait times for what we call elective, or non-urgent procedures. … So if I have a patient with headaches and want the opinion of an neurologist about the management of their migraines, for example … they might wait several months to see a neurologist for a non-urgent problem like that, or non-urgent surgeries. The classic example is a hip or knee replacement. …

“It depends on where you are in the country, sometimes it’s a few months, sometimes it’s a year. Sometimes, in some places, it’s been even longer than that that people wait for a hip or a knee replacement,” Martin said. “And I think that’s totally unacceptable.”

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