I am solidly a Bernie supporter, but would vote for Sen. Warren should she win the nomination. However, I do have some reservations about her so boldly declaring herself a “capitalist to her bones” and her gleeful support of the neoliberal Clinton in ‘16. I worry that we will see a “market based” approach to funding healthcare under a President Warren that would look something like our present Medicare Advantage that offers far less control and savings. Insurance is a non-productive cost added to one of the most expensive items in our economy, and it is dragging down America for the sake of outlandish profits. Replacing such a massive nonessential and costly system isn’t “socialist”, it is proof of the failure of unregulated neoliberal market capitalism that kills people by political choice for the sake of profits.
Obamacare actually increased our healthcare cost by making it a “regulated utility” with little cost oversight and a profit margin guarantee. What many are missing is the cost control already available to the government that is working very well. The various government entities now provide over half of all healthcare payments via Medicare, Medicaid, VA, and premium support for government workers. Those programs also remove the most costly demographics from the insurance rolls, making everyone’s cost go down. Just moving Medicare recipients back onto the insurance rolls would bankrupt the insurance industry and place even basic healthcare out of the reach of all but the wealthiest Americans.
They are not popular with healthcare providers because they pay considerably less. but they should also not be expected to foot the bill for administration costs already built into their systems but drive up cost to insured patients. The difference between Medicare payments and what insurance pays is a good indicator of the savings available with a single-payer system where administration only involves satisfying one system, not the multiple rules and plans of multiple companies that profit from not paying for services rendered to patients. I’ve had doctors tell me that as much as one-third of their time, in addition to vast office staffing requirements, is dedicated to arguing for procedures or meds needed by patients, or simply to get paid for what they have done.
The fact that single-payer will save considerable expense is well known and I consider it a disqualifier for any Democrat who even asks such a “gotcha” question. The honest answer would be that single-payer is more likely to require a tax “CUT” for the middle class than an increase, even with no premiums or out of pocket expenses for anyone. This is because moving to a single-payer system will be extremely deflationary and will not only take $10 trillion out of the economy over the first decade, but will also cause as many as a million workers now servicing the insurance industry, either directly or for providers, to be unemployed.
Leaving them to fend for themselves with the meager support offered by their states would be more like something Trump might do. We will owe them income support and retraining, or early retirement with full pay and benefits for those close to retirement age. Absorbing a million more workers over ten years will require a robust economy that isn’t enabled by higher taxation on the middle class. The spending doesn’t matter as long as there are resources and available staffing to accomplish the goal the spending is deployed to accomplish.
Worrying about deficits in the middle of the massive reshuffling of the percentage of our economy healthcare represents would be a fool’s errand and could cause the demise of the program as Republicans will surely jump all over any slowdown/recession. Inflation is caused by too few resources being chased/bid for by too many dollars, so assuring we have available resources to provide healthcare to everyone is far more important than the dollars created by Congress. We have been starving our economy of spending to service a mostly meaningless accounting number since the ’80s anyway. It’s long past time we use the budget to manage the economy.
I know Bernie knows this because I know his econ advisor. It should be noted that whenever Bernie is asked “How will you pay for it?” in connection with any of his programs he always falls back to a list of targets for taxation that he would tax heavily with or without the programs simply because they make more money than is good for our economy or democratic system. He, unlike Warren, doesn’t like to get too deep into the weeds in a campaign and isn’t going to be baited into details that aren’t necessary, and maybe counterproductive to, gaining support and votes. Few things make the average voter’s eyes glaze over more than details of macroeconomics.
