Charlie Munger Said Single-Payer Is the Fix America Needs. ‘Having a Basic Level of Care for Everybody’ Should Be a Right, Even With No Insurance
By Jeannine Mancini
November 17, 2025
Charlie Munger looked at the American healthcare system and gave the kind of diagnosis that does not come with a gentle bedside manner.
The longtime Berkshire Hathaway vice chairman, Republican and Warren Buffett’s closest business partner thought the cure was simple, politically explosive, and inevitable.
In Munger’s view, the U.S. needed single-payer healthcare, and younger generations would live long enough to see it.
He laid out his case in a 2017 interview with Yahoo Finance’s Andy Serwer, six years before he died. In the chat just after Berkshire’s annual meeting, Munger made it clear he did not fit neatly into his party’s talking points.
“I’m not a normal Republican,” he said, adding that there was “a lot wrong” with the way Americans pay for care.
Munger didn’t dispute that his country delivered world-class treatment at the top. If someone had a rare cancer or landed in an intensive care unit, he believed the U.S. could be the best place to be.
What bothered him was everything wrapped around that care. He described the structure as a Rube Goldberg creation that “arose by accident” and complained about “massive amounts of excess cost” baked into the system.
When Serwer pressed him on what would actually fix the U.S. system, Munger didn’t drift into vague reform talk. “Having a basic level of care for everybody with no insurance aspect as a right I think is a good idea,” he said.
That’s the core of what single-payer healthcare means in practice. Instead of a patchwork of private insurers, employer plans, and government programs, one central payer, usually the federal government, picks up the tab for covered medical care.
Everyone is in the same core system from the start. Doctors and hospitals can still be public or private, and wealthier patients can still pay for faster or more luxurious options. The model looks a lot like Canada’s structure, or like Medicare expanded across the entire population instead of just older adults.
Munger thought that mix struck the right balance. He said a “benign despot” would design a single-payer system with the option to opt out into private care that is “a little faster or a little fancier,” similar to Europe and Canada.
When Serwer asked directly whether single-payer really was the answer, Munger did not hedge. “Yes,” he said. On the follow-up about a high-end opt-out, he answered the same way. Then he made a prediction: “I think you young people will live to see a healthcare system that looks a lot like Canada’s with a better private opt out system. I won’t.”
Munger did not soften his stance a year later. In a 2018 interview with CNBC, he called the U.S. system “shot through with rampant waste” and that some of what he saw as a hospital trustee was “deeply immoral.”
“A lot of the medical care we do deliver is wrong” and “so expensive and wrong,” he argued, and he accused parts of the industry of artificially prolonging death to make more money. This was not just a budgeting issue for him. It had crossed into an ethical one.
Munger also tied healthcare costs directly to the broader economy. Buffett had famously warned that rising medical expenses were a “tapeworm” on American business. He agreed and pushed the point further, arguing that U.S. manufacturers carry a “huge competitive disadvantage” compared with companies in Europe, where governments…
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