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Senator Sanders is letting his opponents portray his Medicare for All plan as an unaffordable extravaganza that will eliminate millions of Americans' beloved health plans. If he could think and talk like an economist, he'd win the Democratic nomination hands down.
If only Senator Sanders could think and talk like an economist. He'd win the Democratic nomination hands down. As it is, he's letting his opponents portray his Medicare for All plan as Fidel's dying wish — an unaffordable extravaganza that will eliminate millions of Americans' beloved health plans.
Let me tell the Senator how this economist (moi) would respond to his opponents' objections to Medicare for All.
Pete's Objection:
Your plan is crazy expensive. It adds $32 trillion to federal spending over the next decade.
Answer:
Pete, You are terrific with languages, but arithmetic, not so much.
Our country pays 18 percent of GDP on third-rate healthcare, which leaves 85 million people uninsured or underinsured.
Who's paying this bill?
Is it Uncle Sam? No. Uncle Sam is taxing us to cover what he pays.
It is our employer? No, our employers are lowering our pay checks to cover what they pay.
Is it we, the people? Bingo, Pete! It's we the people. We're paying 18 cents on the dollar of our incomes. Whether it's out of our left pocket or out of our right pocket, whether it's called taxes, employer contributions, employee contributions, deductibles, co-payments, co-insurance, or out-of-pocket expenses, IT DOESN'T MATTER.
What matters, Pete, is the 18 cents on the dollar, which is heading to 22 cent on the dollar by 2050.
The question, Pete, is the cents-per-dollar cost under Medicare for All. The $32 trillion dollar 10-year costs you keep citing counts larger payments out of the left pocket. It ignores the smaller payments out of our right pocket. Yes, the government will pay more of the bill, indeed it will pay all of the bill. But we and our employers will pay less, in fact, none of the bill.
So, Pete, let's put your Harvard and Oxford educations to work. From what I've told you, you now realize that what matters is total healthcare spending as a share of GDP. My plan will, initially, keep that cost right where it is — at 18 cents on the dollar. This means that the extra trillions coming out of our left pocket will be exactly offset by fewer trillions coming out of our right pocket.
Don't believe me, Pete. Read the Rand study. It's written in one of your eight languages — English.
But here's the really big thing you're missing, Pete. There is no reason we need to spend 18 percent of GDP providing excellent healthcare to the entire population. Through time, I'm going to lower this share to 15 percent of GDP. That will still be higher than the healthcare shares of GDP in Switzerland, Sweden, France, Germany, Holland, Denmark, and Norway — all countries with far better healthcare than ours as judged by mortality and morbidity rates.
So, Pete. If, over time, we cover everyone, but lower healthcare spending from 18 percent to 15 percent of GDP, how much less will we be spending mid-century? I'll give you a relevant fact. Under our current healthcare system, we're heading to total healthcare costs of 22 cents on the dollar by 2050. Now, let me subtract the 15 cents from the 22 cents for you, Pete. That's a 7 percent of GDP saving, which is absolutely massive.
In short, Pete. My plan is fiscally conservative and affordable. Your plan — keep the system as is and give people a Medicare option most won't be able to afford — is far more expensive. It will cost at least 22 cents on the dollar in 2050.
Amy's Objection:
Your plan is nuts. Why do you want to kick 149 million people off of their health plan? And, by the way, I've won in red counties in Minnesota.
Answer:
Amy, you are a terrific Senator. But you are concerned about something no one else really cares about. People care about their doctors and their hospitals. Under Medicare for All, we'll all get to see our same doctors and we'll all get to go to our same hospitals. The only difference is that the government will pay those same doctors and those same hospitals. None of us will be paying any money to our doctors and hospitals either directly or indirectly, through our employers or through private health insurance plans.
Amy, you are objecting to who hands the payment to our same doctors and same hospitals. This is, pardon my Norwegian, dum. Ask anyone in the red counties who voted for you if they care who hands their same doctors and their same hospitals the money for taking care of them. At the same time, ask them if they really care who brings them their mail — whether its mailman, Joe, or mailman, Frank, or mailman, Jane, none of whom they meet because the mail comes when they're at work or otherwise away.
Joe's Objection:
Your plan is nuts. Why do you want to kick 149 million people off of their health plan? And I'm responsible for everything my friend, Barack, accomplished.
Answer:
You're missing something Joe. I can't shut down private insurance companies. That's unconstitutional. So if 149 million Americans want to pay an exorbitant amount for what, under Medicare for All, they can receive for free, they are free to do so. But they won't.
Joe, We're both old enough to remember those awful years before Medicare was initiated in 1965 when so many people 65 and older couldn't get any health insurance because of their preexisting conditions. When President Johnson introduced Medicare, he didn't ban private insurance. It naturally disappeared. No one wanted to pay for something they could get for free.
Yes, Medicare doesn't cover everything, which is why older people need to pay so much for supplemental polices and face such high out-of-pocket expenses. Medicare for All will change all that. It's going to cover 100 percent of everyone's healthcare costs.
To repeat, I'm not kicking anyone off of anything. People can stick with their plans. But, you, Amy, Pete, Joe, and Mike know that people will voluntarily join Medicare for All. So, please, stop using this "kicking off" language.
Mike's Objection:
You met communists years ago. You are a communist. Need proof? You support Medicare for All.
Answer:
Our president has met the worst communist in the world — Kim Jong-Un. Our President sends him love letters. He's passionately in love with Kim Jong-Un. Is our President a communist? Maybe so.
Anyway, Mike, why not spend your billions on ads calling President Trump a communist? I don't really care what you call me. Calling people terrible names is what we're trying to end. If you need to call me a communist, see how many votes that gets you. I've been calling myself a Democratic Socialist. But, as I just made clear to Pete, I'm also a fiscally conservative Republican. Indeed, everything I've proposed will be paid for. I'm going to work to save the next generation, not burden them with an even larger federal debt to pay off. Please run some ads calling me a fiscally conservative Republican.
