NPI's Cascadia Advocate

Offering commentary and analysis from Washington, Oregon, and Idaho, The Cascadia Advocate is the Northwest Progressive Institute's unconventional perspective on world, national, and local politics.

Friday, November 1st, 2019

Senator Elizabeth Warren takes on critics, releases plan to finance Medicare For All

Mass­a­chu­setts Sen­a­tor Eliz­a­beth War­ren has pro­posed over $20 tril­lion in pub­lic invest­ment to fund her auda­cious health­care plan, known as Medicare For All.

On Fri­day the War­ren cam­paign released a detailed plan argu­ing for a num­ber of new tax­es on cor­po­ra­tions and the wealth­i­est Amer­i­cans, along with off­sets and oth­er rev­enue-increas­ing mea­sures, to pro­vide health­care to all.

Senator Elizabeth Warren at Netroots Nation 2019

Sen­a­tor Eliz­a­beth War­ren par­tic­i­pates in the Net­roots Nation 2019 pres­i­den­tial forum (Pho­to: Andrew Villeneuve/Northwest Pro­gres­sive Insti­tute)

In an email to sup­port­ers, War­ren linked her Medicare For All pro­pos­al to her decades of work research­ing bank­rupt­cy. The num­ber one rea­son that Amer­i­cans go bank­rupt is the cost of health care, and three out of four fam­i­lies who declare bank­rupt­cy over health issues had insur­ance which failed to cov­er their needs.

Under the cur­rent sys­tem, eighty-sev­en mil­lion Amer­i­cans are unin­sured or “under­in­sured,” while tens of mil­lions more avoid pick­ing up pre­scrip­tions, miss crit­i­cal appoint­ments or skip rec­om­mend­ed tests. Even for those who have ade­quate insur­ance, the aver­age fam­i­ly of four pays over $12,000 a year in pre­mi­ums and out-of-pock­et costs, a num­ber that ris­es every year.

War­ren argued that a humane health­care sys­tem should have “two absolute non-nego­tiables”: no Amer­i­can should ever die or go bank­rupt because of health­care costs; and every Amer­i­can should be able to see the doc­tors they need and get treat­ment, “with­out hav­ing to fig­ure out who is in-net­work. No for-prof­it insur­ance com­pa­ny should be able to stop anyone…from get­ting the treat­ment they need.”

Warren’s new pro­pos­als not only seek to address the huge cost of health­care for ordi­nary Amer­i­cans, but also answer the ques­tion that dogged her in the last Demo­c­ra­t­ic pres­i­den­tial pri­ma­ry debate – name­ly, whether she would increase tax­es on mid­dle income fam­i­lies – with a resound­ing “no.”

Under Warren’s plan, com­pa­nies would pay in tax­es what they pre­vi­ous­ly paid for pri­vate employ­ee insur­ance, which would raise around $8.8 tril­lion over the decade. An assort­ment of new tax­es on wealth, invest­ments and finan­cial trans­ac­tions (that would fall on the wealth­i­est Amer­i­cans) would raise $4 tril­lion more. A slimmed down defense bud­get could also yield mon­ey for the plan.

The increase in rev­enue would pro­vide for an enor­mous over­haul of the U.S. health­care sys­tem. If Con­gress cre­at­ed a com­pre­hen­sive sin­gle pay­er plan for all Amer­i­cans, employ­er-spon­sored insur­ance would become irrel­e­vant, free­ing mil­lions of employ­ees of the fear of los­ing health cov­er­age if they leave their job.

What’s more, the thou­sands of dol­lars spent per fam­i­ly on copays, deductibles, out-of-pock­et costs and pre­mi­ums would be elim­i­nat­ed. Per­haps most impor­tant­ly of all, the mil­lions of Amer­i­cans cur­rent­ly unin­sured would have full cov­er­age.

Senator Elizabeth Warren speaking in Seattle

Sen­a­tor Eliz­a­beth War­ren address­es a huge crowd in Seat­tle with the icon­ic Space Nee­dle in the back­ground (Pho­to: Bob­by Aiyer/Northwest Pro­gres­sive Insti­tute)

Warren’s main Demo­c­ra­t­ic rival quick­ly crit­i­cized her pro­pos­als.

The cam­paign of Joe Biden – who favors expand­ing the Patient Pro­tec­tion Act — said the plan was “unre­al­is­tic” and argued that “It’s impos­si­ble to pay for Medicare for All with­out mid­dle-class tax increas­es.”

In recent Demo­c­ra­t­ic pri­ma­ry debates, the argu­ment over the costs of Medicare for All have usu­al­ly been framed in one of two ways: Biden and oth­er neolib­er­al can­di­dates argue that Medicare for All would increase tax­es – par­tic­u­lar­ly empha­siz­ing the poten­tial bur­den on the mid­dle class – while War­ren and her pro­gres­sive col­leagues have argued that over­all costs for health­care (inclu­sive of insur­ance pay­ments and tax­es) will be dra­mat­i­cal­ly reduced for the aver­age fam­i­ly.

In her recent announce­ment, War­ren pre­empt­ed crit­i­cisms over tax­es by point­ing out that the sav­ings her plan would offer ordi­nary Amer­i­cans would be larg­er than the wealth­i­est saved through Trump’s gigan­tic 2017 tax scam.

The finan­cial ben­e­fits of a Medicare for All sys­tem would like­ly be expan­sive.

Under the cur­rent sys­tem, health care providers (par­tic­u­lar­ly phar­ma­ceu­ti­cal com­pa­nies) reg­u­lar­ly gouge prices on essen­tial prod­ucts and ser­vices – remem­ber the antics of “Phar­ma Bro” Mar­tin Shkre­li – with patients vir­tu­al­ly pow­er­less to resist. Sen­a­tor War­ren plans to put the weight of the fed­er­al gov­ern­ment behind an aggres­sive nego­ti­a­tion sys­tem, which could pres­sure health­care providers to reduce prices for pre­scrip­tion drugs by as much as 70%.

Most coun­tries in the indus­tri­al­ized world have some ver­sion of uni­ver­sal health­care, and few politi­cians in those coun­tries would argue for an Amer­i­can-style mar­ket-based sys­tem. In the Unit­ed King­dom, for exam­ple, the right wing pop­u­lar­ized Brex­it by promis­ing £350 mil­lion ($453 mil­lion) a week for the Nation­al Health Ser­vice – Britain’s pub­licly-run health care sys­tem.

Medicare For All can’t and won’t be deliv­ered overnight, but sup­port is build­ing for the idea of expand­ing Medicare to cov­er all Amer­i­cans.

Eliz­a­beth War­ren evi­dent­ly fig­ured the time was ripe to address the tired old “How will you pay for that?” ques­tion, which jour­nal­ists always seem to ask Demo­c­ra­t­ic can­di­dates, but rarely ask Repub­li­can can­di­dates.

The cam­paign also released an expert let­ter on cost esti­mate of Medicare for All, an expert let­ter on financ­ing Medicare for All, and a cal­cu­la­tor in addi­tion to the plan itself. All these mate­ri­als are avail­able to the pub­lic and the press.

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