After months of dodging questions about her Medicare for All plan, Warren has finally gone all-in with a figure for what her plan will cost and a pipe dream of how she’ll pay for it without raising taxes on the middle class.
Warren estimates her Medicare for All plan will cost $52 trillion over ten years. To put this number in perspective, the CBO projected earlier this year that the United States budget will be $57.8 trillion over the next ten years. Her plan literally costs 90 percent of the current federal budget, yet she thinks she can pay for it without taxing the middle class. To prove that her plan works and will save you money, she put a Medicare for All calculator on her campaign website for everyone to use.
Out of curiosity, I tested Warren’s calculator, trying various scenarios to see what it told me. It didn’t take long to figure out that this calculator isn’t much of a calculator at all. Whatever number you say you spend per year is what you save! It’s so easy that even Common Core students could figure it out! You can put $52 trillion as the amount you spend per year on health care, and the calculator will “calculate” that you would save $52 trillion under her plan. Amazing! According to Warren, “That’s because you won’t have to pay for premiums or copays or any of the other ways health insurance companies stick you with the bill. What’s more, Elizabeth’s plan for Medicare for All doesn’t raise middle-class taxes by one penny.”
Ignoring the extreme example I used above, to take this calculator at face value, you have to assume that the various ways Warren plans to finance her plan will all be passed—which anyone can tell you won’t happen.
Warren may pride herself on coming up with an answer to how much her plan would cost and how it would be paid for, but in reality, she’s still selling a pie-in-the-sky dream that would require all of her ideas to pay for it to work out perfectly without any negative side effects. Are we really expected to believe that taxing the wealthy won’t have a negative impact on Wall Street and economic growth?
Let’s keep in mind that Medicare for All isn’t the only expensive proposal Warren is campaigning on; she’s also calling for universal childcare, canceling student loan debt and universal free college, and some version of the Green New Deal, which is estimated to cost as much as $93 trillion over ten years. Where is all this money going to come from?
Even Vox co-founder Ezra Klein points out that Warren’s belief that much of the costs can be covered by various savings is based on highly optimistic or likely incorrect assumptions. “There are places where I find Warren’s math or ideas a bit optimistic,” he wrote. “I’m skeptical that payment reforms will save trillions.” He also noted that her plan doesn’t account for a problem with supply: “Warren promises repeatedly that you’ll be able to see the doctor and go to the hospital of your choice, but if your doctor is overwhelmed by patients or your hospital can’t schedule your surgery for six weeks, it’s not going to feel that way.” Funny, where have we seen that before?
It’s highly unlikely that the circumstances Warren has laid out by which she thinks her Medicare for All can be financed will work as she plans. By comparison, Obamacare was far less ambitious and many of the assumptions made by the Obama administration didn’t pan out. For example, in order to work, Obamacare needed the young and healthy to subsidize the old and sick. But, the young and healthy preferred not to get coverage, opting to pay the fine instead. Many Americans lost their jobs or saw a reduction in hours in order to avoid mandatory coverage regulations. In the Obama economy, these people were more likely to go on government assistance than find a new job. Despite promises of affordable health, most people saw premiums and deductibles skyrocket—mostly hurting the middle class. Obamacare didn’t work as promised, yet Warren puts up a bogus calculator on her website and claims she can pay for her plan without taxing the middle class? Not a chance.
But don’t just take my word for it. “The mathematical gymnastics in this plan are all geared towards hiding a simple truth from voters: it’s impossible to pay for Medicare for All without middle-class tax increases,” Joe Biden’s campaign says. And they’re correct. Part of Warren’s plan to help finance her plan is to have employers pay 98 percent of what they would otherwise spend on health plans for their employees—approximately $8.8 trillion. Elizabeth Warren calls this a “Medicare contribution.” So, while you wouldn’t get health coverage from your employer anymore, they would still have to pay pretty much exactly what they were paying before. Employers aren’t able to save any money to put back in your paycheck. What they contributed to your health plan they’ll still have to pay as… a payroll tax.
But, there’s a huge problem with her calculation.
Currently, not all employers that do offer health insurance coverage fully cover health insurance. According to a 2016 survey by the Kaiser Family Foundation, the annual average employer contribution to health insurance was 82 percent for single plans and 71 percent for family plans. When employers contribute different amounts, how do you determine what every employer’s “Medicare contribution” under the Warren plan is? Will they have to pay 98 percent of what they currently contribute or 98 percent of the entire plan per employee? If it’s the latter, employers are going to get crushed by their “Medicare contributions.” If it’s the former, what’s stopping employers from reducing their benefits to a partial contribution in order to lower their burden under her plan? This would create a significant shortfall in her calculations.
Her calculator also comes with other side-effects. As many as two million health industry jobs would become unnecessary once the government steps in to run the show, according to a University of Massachusetts economist. For Warren, that’s just part of the cost of the plan. There was no option in Warren’s calculator to account for whether you’d lose your job because of her plan, and her plan offered no solution to address those job losses.
Further, if we choose to pretend that Warren’s plan could be paid for, why would we want such a system anyway? The closest thing we currently have to Medicare for All is the VA system. The Heritage Foundation pointed out a year ago that this is hardly what we should want. “The Veterans Administration (VA) operates America’s premiere home-grown ‘single payer’ health system. In 2014, CNN reported that veterans would ‘languish and die’ because of the program’s bureaucratically manipulated ‘waiting lists.’”
The VA system’s poor record of delivering quality care became a huge Obama administration scandal after it was revealed that 307,000 veterans died waiting for medical treatment in the VA health care system. If the government can’t get it right on a smaller scale, what reason do we have to believe that it will work scaled-up to include the entire country? In fact, nationwide single-payer health care systems elsewhere in the world haven’t exactly lived up to the hype either.
According to the Heritage Foundation, in Britain’s National Health Service (NHS), often seen as a model for single-payer healthcare, “long patient waits for care have been a recurrent feature of the system. In December 2017, almost one-third of NHS regional directors reported that they were unable to deliver ‘comprehensive care.’” In January 2018, the NHS “canceled more than 50,000 ‘non-urgent’ surgeries, as British doctors charged that their patients were being subjected to ‘third world’ conditions. Historically, British survival rates for ‘urgent’ medical conditions such as lung, colon and prostate cancer fall well short of America’s performance.” While Brits spend less than Americans on health care, they also get much less. “British patients have less access to advanced diagnostic technologies, such as MRIs and CT scanners, and on a per capita basis, they have fewer doctors and nurses than almost every other Western industrialized country. British doctors and nurses are also paid far less than their American counterparts.”
That’s what Warren wants for everyone.
Are we really expected to believe that Medicare for All can be a success when other countries can’t make it work and Obamacare failed so miserably to achieve affordable healthcare? It won’t work.
Matt Margolis is the author of Trumping Obama: How President Trump Saved Us From Barack Obama’s Legacy and the bestselling book The Worst President in History: The Legacy of Barack Obama. You can follow Matt on Twitter @MattMargolis