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Tipsheet

Bernie on Single-Payer: Hey, People Lose Their Plans All the Time -- And Yes, I'll Raise Your Taxes

Sen. Bernie Sanders' Monday town hall-style meeting on Fox News scored big in the ratings, pulling in the most eyeballs of any candidate forum this cycle, on any network.  No wonder other 2020 Democrats are already lining up to appear on Fox, including another confirmed special. One of the most important exchanges of the evening came when Bernie was pressed on his fantastical and exceptionally costly single-payer scheme, which would dismantle and rebuild the entire US healthcare system.  Many in the media giddily shared a "viral" moment in which the heavily pro-Sanders crowd cheered the prospect of giving up their current coverage for a government plan.  Perhaps they were too excited or distracted to consider the consequences of Sanders' simultaneously candid and evasive answers.  

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On one hand, he conceded that people would be forced to pay more in taxes under his policy.  On the other hand, he downplayed and dodged on the issue of just how much more all Americans would have to fork over to Washington in exchange for a government-run program -- which would inevitably feature longer wait times, inferior outcomes, and bureaucrat-enforced rationing.  We've run through some of the staggering numbers before, but here's another look at Bernie's rhetorical sleight-of-hand to avoid digging in on the details and hard realities of his proposal:


Hemingway runs through a series of giant unanswered, leftover questions from Sanders' 2016 single-payer push, including scant details on pay-fors, and major concerns about the access-related impacts of deep cuts to doctors and hospital reimbursement payments.  He mines a quote from a Sanders-aligned economist who served up an incredible comment to the New York Times back in 2016, frankly admitting that the specifics of how single-payer would play out in the real world remain...fluid: "The pleasure of being an academic is I can just spell things out and leave the details to others. The details very quickly get very messy."  Indeed.  Hemingway then underscores how Bernie has no realistic plan to fund the 32- to 38-trillion dollar program over ten years, in perpetuity:

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His recently proposed “Medicare for all” legislation doesn’t much improve on prior attempts to flesh out how health care will be administered in a cost-effective manner, even as it’s full of tax hike proposals such as 70 percent marginal tax rates on income over $10 million, 77 percent estate taxes on the rich, and taxes on big banks. Even the liberal outlet Vox once again admits the “plan has lots of details about what single-payer would cover. It has less information on how to pay for it.” Sanders can try to soak the rich all he wants, but it doesn’t mean much when credible estimates suggest “doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan.”...In a lot of polls, Sanders is the frontrunner for the Democratic nomination. He cannot be allowed to offer a radical plan he freely admits will cause 180 million Americans to lose their existing health care coverage and not bother explaining how it works.

During the Fox town hall, Sanders also glided past the issue of 180 million people losing their private coverage under "Medicare For All," (Medicare as it exists is going insolvent, and would be eliminated under his bill), noting that some people end up shifting coverage in the churn of work and life events. That is true to some extent, but why should the "solution" be to uproot 180 million people from their existing arrangements (with which the vast majority are satisfied), and push them all into a no-competition, government-run plan that even its leading advocate cannot adequately describe, let alone pay for?  Sanders also wormed his way out of a challenge regarding his home state's failed single-payer experiment, in which a liberal governor was forced to abandon the long-anticipated project.  Bernie chalked this up to 'internal politics' in Vermont, knocking the previous governor for mishandling the situation. But the Boston Globe reported on the real reason behind the proposal's collapse -- stark fiscal realities:

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When Vermont four years ago enacted a landmark bill to establish the nation’s first single-payer health care system, they saw their long-sought dream about to be fulfilled. But reality hit last month. Governor Peter Shumlin released a financial report that showed the cost of the program would nearly double the size of the state’s budget in the first year alone and require large tax increases for residents and businesses. Shumlin, a Democrat and long-time single-payer advocate, said he would not seek funding for the law, effectively tabling the program called Green Mountain Care...Vermont took Obamacare a step further. In 2011, Shumlin proudly signed a bill to establish a publicly financed, single-payer system. The law required Shumlin to submit a detailed financial plan by 2013. Shumlin missed the deadline, raising fears among supporters and critics alike that single-payer health care would cost much more than anticipated.

Those fears were realized on Dec. 17, when Shumlin, two years late and just a month from narrowly winning reelection, released the financial analysis. The numbers were stunning. To implement single-payer, the analysis showed, it would cost $4.3 billion in 2017, with Vermont taxpayers picking up $2.6 billion and the federal government covering the rest. To put the figures into perspective, Vermont’s entire fiscal 2015 budget, including both state and federal funds, is about $4.9 billion. Shumlin’s office estimated the state would need to impose new personal income taxes of up to 9.5 percent, on top of current rates that range from 3.55 to 8.95 percent. Businesses would be hit with an 11.5 percent payroll tax, on top of 7.65 percent payroll taxes employer pay for Social Security and Medicare. And even those tax increases might not have been enough.

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These are the facts that Sanders ignored entirely in hinting that his state's failure to follow its healthcare dreams was attributable to some personality squabbles. It was all about money.  In other portions of the televised forum, Bernie squirmed on Ilhan Omar (it's clear that the left-wing base absolutely loves the anti-Semite from Minnesota), and made himself look silly on the taxes he pays.  Among his worst answers, though, was his full embrace of legalized late-term abortion, up through the moment of birth.  This has become the standard, appalling, radical Democratic line.  Apparently, all sorts of government-guaranteed benefits are "human rights" in Sanders' mind, but the right of viable human lives not to be snuffed out doesn't make the cut.  I'll leave you with Jonah Goldberg asking why the relative rarity of an act of barbarity is at all relevant to public policy:


Will a single Democrat running for president stop short of endorsing abortion-on-demand for all nine months of pregnancy?

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