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The magnificent twelve!

How Are You Going To Pay For It? Health Care Edition

The Republicans and the “liberal” mainstream media routinely ask Democratic candidates how are they going to pay for their progressive reforms. If a Republican wants to go to war or cut taxes for the rich, no one asks any questions. But if a Democrat proposes universal pre-kindergarten or expanded health care coverage, then suddenly those same Republicans and reporters want to know how they will pay for it.

When a Republican asks me that question, I ask them how much have we spent on tax cuts for the rich since 1981? How did you pay for that? Or in the alternative, I will contend that the progressive reform in question will pay for itself. Problem solved. (In light of their history of blowing up the deficit since 1981, Republicans have no standing to ask that question. None.)

On the other hand, if a fellow Democrat asks that question, then I think we Democrats must come up with a legitimate response. (Sometimes I wish we wouldn’t ask that question. There is no point in allowing the media and the GOP to hold our candidates to a higher standard than the one they typically apply to the Republicans.)

Recently, Senator Elizabeth Warren — the new Democratic front runner — has been repeatedly pressed on how she would pay for her Medicare For All plan. In the debate on October 15, Warren answered that question as follows: “I will not sign a bill into law that does not lower costs for middle-class families.”

Kerry Eleved of the DailyKos blog liked Warren’s answer and summed up the Massachusetts Senator’s platform as follows: “But the bottom line is that, regardless of Warren’s answer on any single question, she has repeatedly made where she stands perfectly clear — she’s on the side of struggling workers, both low-income and middle-class. In fact, Warren regularly offers among the clearest of responses on discussions concerning the economy, income inequality, solvency, and the power that major banks and corporations wield in America.”

Nevertheless, some of Warren’s Democratic rivals and the press still accused Warren of dodging the question. The factual premise of the question is a study from the Koch funded Mercatus Institute which contended that the ten year cost of Medicare For All is $32 trillion. Republicans like Don Bacon have falsely charged that this study indicates that Warren’s plan will cost American taxpayers an additional $32 trillion over the next decade and increase taxes on the middle class.

What Bacon and his fellow Republicans don’t tell you is that the cost of maintaining the health care status quo over the next 10 years is $50 trillion. The unspoken and dishonest assumption behind the GOP’s attack is that somehow we will be paying twice for health care in the next 10 years. Or in the alternative, the GOP makes the assumption that our health care will be free for the next 10 years.

Somebody needs to ask Trump and the GOP how they plan to come up with the $50 trillion necessary to finance the status quo. The U.S. has far and away the most expensive health care system in the industrialized world and it simply isn’t sustainable. We pay a lot more than other First World countries and get a vastly inferior outcome.

I personally favor a Medicare buy in for all plan. In my opinion a Medicare buy in for all plan is both good policy and good politics. Only the die hard Trump base opposes this plan. I do believe Medicare For All is good policy but it is a tough sell to convince 160 million Americans to swap out their employer based plan for a Medicare type plan. Our mediocre health care system has made our citizens risk averse and fearful of significant changes.

The good thing about the Medicare buy in for all system is that it gives consumers and businesses a choice. If you like your plan, you can keep it. However, if you can get a better deal with the public option plan, you can buy into the public option. This fact will help blunt the inevitable Republican lies that consumers will lose their doctor and insurance plan.

Going forward in 2020, we Democrats need to emphasize what we all agree on — universal health coverage for the American people. We need to focus on what unites us. It doesn’t help us to engage in a circular firing squad and do the Republicans’ work for them.

At the same time, the Democrats need to focus on how we differ from the GOP on health care. The Republicans simply don’t believe in universal coverage and consumer protections. Conservatives don’t believe it is a legitimate function of government to spend money on health care for the sick, the poor and the elderly. They just don’t believe in it.

We need to constantly emphasize the huge difference between our party and the GOP on health care. We need to say it again and again and again that the Republicans in Congress voted over sixty times during the Obama era to take away insurance from 20 million Americans and end pre-existing condition protections. Similarly, we need to remind the voters that Trump and the Republicans tried to do the same thing all over again when they controlled all of the branches in 2017.

We Democrats made this huge contrast on health care our central message in mid-term elections. We won big in 2018. Now let’s do it again in 2020!

I’m a trial lawyer, a Democratic activist and a sports fan.

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