Paul Waldman eviscerates the WSJ's "$15 Trillion Single Payer Plan" story so I don't have to.
I want to get a couple of things straight right off the bat:
- Yes, I wholeheartedly support single-payer healthcare...and in fact, the longer I track the ACA and the more I learn about the healthcare/health insurance system in America as a whole, the more certain I am that moving to single payer would make far more sense than the crazy-complex system we have today.
- I agree with Bernie Sanders on most other issues as well, but I'm still leaning towards Hillary Clinton at the moment (and I'd be perfectly fine with Joe Biden if he were to jump in as well).
- Even so, I still believe that the ACA is a massive improvement over the previous system, and I find it unlikely that single payer would be likely to happen at the national level for at least a decade or more even if Sanders were to win and the Democrats were to retake both the Senate (likely) and the House (extremely unlikely).
With all that out of the way, Tuesday's Wall Street Journal published an absolutely absurd story which tries to make it sound as though a) Bernie Sanders has proposed a specific, detailed Single Payer universal healthcare plan which b) would cost $15 trillion over the next decade c) on top of existing healthcare spending.
Spoiler: A, B and C are all utter nonsense.
Normally I would write a full teardown of this silliness, but the Washington Post's Paul Waldman has spared me the trouble:
While Sanders does want to spend significant amounts of money, almost all of it is on things we’re already paying for; he just wants to change how we pay for them. In some ways it’s by spreading out a cost currently borne by a limited number of people to all taxpayers. His plan for free public college would do this: right now, it’s paid for by students and their families, while under Sanders’ plan we’d all pay for it in the same way we all pay for parks or the military or food safety.
But the bulk of what Sanders wants to do is in the first category: to have us pay through taxes for things we’re already paying for in other ways. Depending on your perspective on government, you may think that’s a bad idea. But we shouldn’t treat his proposals as though they’re going to cost us $18 trillion on top of what we’re already paying.
And there’s another problem with that scary $18 trillion figure, which is what the Journal says is the 10-year cost of Sanders’ ideas: fully $15 trillion of it comes not from an analysis of anything Sanders has proposed, but from the fact that Sanders has said he’d like to see a single-payer health insurance system, and there’s a single-payer plan in Congress that has been estimated to cost $15 trillion. Sanders hasn’t actually released any health care plan, so we have no idea what his might cost.
But health care is nevertheless a good place to examine why these big numbers can be so misleading. At the moment, total health care spending in the United States runs over $3 trillion a year; according to the Centers for Medicare and Medicaid Services, over the next decade (from 2015-2024), America will spend a total of $42 trillion on health care. This is money that you and I and everyone else spends. We spend it in a variety of ways: through our health-insurance premiums, through the reduced salaries we get if our employers pick up part or all of the cost of those premiums, through our co-pays and deductibles, and through our taxes that fund Medicare, Medicaid, ACA subsidies, and the VA health care system. We’re already paying about $10,000 a year per capita for health care.
Read the whole thing. The Wall St. Journal should be ashamed of themselves for posting such drivel.
As Waldman notes, even IF the plan that Sanders were to propose (assuming he received the nomination and won the Presidency) were to cost $1.5 trillion per year, it would be in place of the gobs of money currently being spent on Medicare, Medicaid, federal ACA tax credits, federal ACA cost-sharing reductions, the VA, the individual private insurance market and the small group and large group employer-sponsored insurance market.
Is it conceivable that such a plan would end up costing more than the current system? Perhaps; anything's possible...but it's highly unlikely to do so. The likely worst-case scenario would be that we would end up breaking even...except with everyone covered, even the 30 million or so who haven't been covered by the ACA's more incremental/compartmentalized approach.
Again, I'm not badmouthing the ACA here: I (obviously) feel that it's working for the most part. I think it's an important step forward, but one which I hope will eventually evolve into single payer.
In the meantime, the Wall Street Journal serves no useful purpose with their article.
UPDATE: Kevin Drum of Mother Jones did his own, shorter takedown of the WSJ piece.