The Mercatus Center released a report that estimated that the Sanders single payer plan would cost 32 trillion over ten years. This was close to an earlier estimate done by the Urban Institute. There are important differences between the two studies but the bottom lines are similar. The Sanders plan would mean a very large increase in federal health care spending. In this brief, we compare the two approaches and show that there are an array of alternative proposals that could achieve most of the same objectives at a lower federal budget cost.