Monday, November 4, 2019

Bernie vs Warren on Medicare for All

Sanders projects his plan would cost $30T over 10 years.  The cost would be paid by a new middle class tax of 4% on income over $29,000.  The first $29,000 is exempt.  So, if you make $58,000, your tax increase is 2%.  Since copays, deductibles, etc, are eliminated, Bernie says nearly all middle class would pay less (and lower incomes nothing) than they pay now for healthcare in total, and that is the point.  Plus eliminating the bankruptcies, covering everyone, no worries about losing health insurance.

Warren projects her plan would cost $20T over 10 years.  The cost would be mostly paid by per-employee tax on employers, the same ones who are now obligated under ACA to provide insurance.  They would pay on average 98% of what they are now paying on mandatory health insurance so their costs go down slightly and with less bureaucracy.  Then there are some additional taxes on billionaires, etc, to pay the rest, since not all employers pay now.  Her claim is that middle class would not pay anything.

Most of those I follow say Bernie's plan is far superior, and including the funding method.  Making employers continue to pay like they do now is essentially regressive, because employers of lower income people would have to pay the same as employers of higher income people.  There's no income proportionality or progressivity here.  Plus many employers are currently exempted, and they would not pay at all.  And employers would do everything to squeeze out of it, including more contract jobs.

Bernie says the result of Warren's plan would be job losses.  I can also imagine lower quality jobs (fewer direct employees, etc) to weasel out of the new "employer contributions."  So while middle class wouldn't pay any more taxes, they would pay in other and worse ways.  And workplace segmentation (good jobs and bad jobs) continues--employers would have a strong and continuing incentive to replace good jobs with bad ones.  The whole Heathinsurance scam that started in WWII continues, simply replacing private insurance companies with government insurance that the better class of employers must pay for or squeeze out of.

Other issues I see:  If it is possible to raise tax on Billionaires, as Warren's plan includes, those taxes could be used for something other than heathcare as well.  (IIRC, Bernie uses that tax to eliminate student debt instead.)

Bernie's plan fits the model of our other most successful programs: Social Security and Medicare.  Since the middle class has paid, they will continue to demand to get the benefits with full moral authority.  When you get something "free," that can more easily be taken away, and whoever is actually doing the paying (without getting any benefits) will find some way to squeeze out of it or get the whole thing stopped.

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