Medicare for all: too expensive?

In a word, not even close.

Let’s check this out, using some of the same figures that have been bouncing around lately.  Bernie Sanders’ Medicare for All (MFA) proposal, reported CNN in 2017, would cost $1.3 trillion per year.

Wow, that’s a lot! Isn’t it? Let’s break it down.  There are approximately 157,288,000 Americans in the work force in 2019. $1.3 trillion, then, comes to roughly $8,900 per taxpayer, assuming that the entire cost of MFA will be borne by working people paying taxes.

About 55.4% of employed Americans are covered by health insurance provided by their employers, which accounts for 8.5% of wages for these people. The national average annual income, excluding benefits,is $46,800.  That’s a cost to the employer of $4,212 per year per employee.

If you’re a working American that’s a part of your compensation that you don’t normally see, but you can bet your employer does.

So, let’s get back to the cost of MFA, $8,900. If the money your employer pays for your health insurance were simply shifted to financing MFA, it would cover almost half of the cost.

So, what about the rest of it?  Well, the rest of it can be covered by the 44.6% of working people whose employers do not pay for their health insurance, and who therefore must pay for their own insurance, and you can bet that they pay a hell of a lot more for the same coverage than do employers.  The average cost of all private health insurance in 2019 is about $7,000.  Even accounting for the free spirits who would rather risk going broke than buy insurance, it’s more than enough to offset the remaining cost of MFA in increased taxes.

Of course, the entire cost could be offset by simply rescinding the recent Republican tax cuts, which benefit primarily the ultra rich, amounting to $2.3 trillion. But that’s off the table.

Or is it?

 

Politics as usual?

With Trump in the presidency and Republicans in control of both houses of Congress, liberals, or progressives, if you prefer, are apparently in a rout. We’re certainly behaving that way, with Democrats quibbling over the direction the party has to take in order to win everything back by the next election, temporary Democrats back in their old roles as independents or third party provocateurs, and the legions of newly, if vaguely, defined remnant left posting stern lectures on social media.

The gist of these last is that Democrats have lost control because they have drifted too far from their principles, and what is needed is retrenchment, a purge of whatever the self-appointed Guardians of the Left consider apostasy. They point to the Tea Party as a Republican movement back to the fundamentalist right, and see this purge as the reason for the party’s success in last year’s election. It worked for them, they say, so we should do the same.  Yet how many of us engaged in this lofty debate have actually read the 2016 Democratic Party Platform?  Certainly not those people claiming that there’s no difference between the two parties, the two candidates.

But is it even true that Republicans prevailed because of a purification of ideology? The truth is that most people couldn’t care less about ideology, or if they do, they fear it.  They are political pragmatists, and this explains the otherwise incomprehensible shift of many voters from Obama to Trump.

Today’s Republican party is actually a loose coalition of theocrats, libertarians, corporatists, and outright fascists. These groups have very little in common except a fear and hatred of the left, yet they voted, all of them holding their noses, for Donald Trump, a man who not only lacks a coherent ideology, but very likely doesn’t even know what the word means. A demand for ideological purity by any one of these constituencies would have resulted in a rout of Republicans instead of Democrats.

Yet, we hear from the Sanders wing of the Democratic party that that is exactly what we must do in order to win in the future, that what we need is to purge all that is not leftist dogma. Throw out the doubters, the apostates, go with an unabashedly socialist program, and “the People” will rally round.

It is not at all clear why “the People,” who went in unexpected numbers for the Republican party, would suddenly decide socialism was a great idea. Fear of socialism, or what they thought was socialism, was pretty much the glue that held the right-wing coalition together long enough to vote. We love to cite the fact that Clinton got over 3 million more votes than Trump to show the bankruptcy of the system, but neglect the obvious conclusion that the Democratic coalition, yes, the current Democratic coalition so abused by leftist purists, was sufficient to beat Trump if the vote had not had to be filtered through the electoral college.

If the United States were a parliamentarian democracy, like the vast majority of European nations, retrenchment would make sense; go with a pure (and therefore exclusionary) message, get as many votes as you can, then join a coalition to have a share of the governing system. But we’re not. Like it or not, the US is a kind of hybrid beast, a republic in which the executive and legislative branches are elected separately.  The only possible result of a less than plurality vote is a loss, and therefore coalitions must be made before the elections, not after.  If we want to prevail in the next elections, we have to find ways to draw in as many of the electorate as possible, not ways to exclude as many as possible.  And we have to find a common denominator for decent people to rally around, a glue.  Donald Trump is doing his level best to give us that.  Not only are his actions so far unacceptable to most Americans, but he’s exposing Republican cadres as spineless sycophants.  Let’s not sacrifice this gift on the altar of ideological fundamentalism.