It’s been a few weeks since Senator Elizabeth Warren released her plan to pay for Medicare for All. I confess, I had hope. Senator Warren knows a boatload more than I do about economics and the mechanisms that would have to be in place to pay for a multi-trillion dollar government program. Now, it appears that in the process of laying out her plan and seeing her own plan laid bare, she has unconvinced herself.
To be fair, most candidates don’t bother to flesh out the details of their policy proposals, especially before the general election. The details give away the game. It’s one thing for voters to throw enthusiasm behind something they’re going to get with a particular candidate. But when that candidate says, “Oh, yeah, it’s going to cost over $30 trillion over 10 years, and we’re not raising taxes on the middle class at all!” Even the most enthusiastic voter is going to have more questions than they had before.
There are two main payment mechanisms that Warren plans to employ.
1. Make it cost less: redirecting money that goes to the states; controlling price and payment reductions for doctors and hospitals; administrative cuts; prescription drug cost reductions and greater use of generics; and a projected rein on healthcare cost growth due to the new single payer system disallowing the competition that exists now.
2. Find the money to pay for it: redirecting employer healthcare costs to the government; the wealth tax; increasing the corporate tax rate; closing tax loopholes; taxing the increased income from no longer paying plan premiums and deductibles; taxing banks and stock transactions; cutting the Department of Defense’s budget; and increasing taxes by fixing immigration (legal residents pay taxes).
There are a lot of good ideas here, but a few are a little suspect, such as the immigration bill that has been stagnating in Congress since 2013.
Still, it’s not whether the numbers add up that bothers me. It’s the likelihood that they can pass Congress in this climate. I’m fairly sure the wealth tax would be a heavy lift, and getting corporations to redirect their healthcare contributions will meet with heavy pushback.
If Senator Warren were to win the presidency, the best case scenario would be that her new administration would have two years of single-party control. Priorities for those years aren’t just healthcare and the taxes that would pay for it. A lot of time would also need to be spent fixing what the current administration has broken. Just to put it into perspective, during the 115th Congress (2017-2018), when the GOP held both houses of Congress and the presidency, 14 pieces of legislation were enacted into public law. This year, there have been four. I have yet to hear a plan for how to achieve the elements necessary to fund Medicare for All.
In the time since Senator Warren released her plan to pay for Medicare for All, she has quietly and subtly shifted her message. Now she is backing a somewhat stepped program – a public option where the uninsured could buy into Medicare for a couple of years, and once people see the benefits, they will rally behind it and she can pass Medicare for All. This means that public opinion would have to be overwhelmingly positive for there to even be a chance of it passing into law.
Senator Warren is an intelligent, experienced, and savvy woman. I suspect that as she considers the Sisyphean task in front of her, she sees what I and so many others see – a next-to-impossible road ahead.
And like me, she is unconvinced.