More than 100 House Democrats -- nearly half of the new majority -- have signed on to a new single-payer healthcare bill that supporters describe as "battle ready." If by "battle ready," they mean, "extremely controversial, deeply politically risky, and totally bereft of any acknowledgement of the proposal's eye-poppingly exorbitant costs," they're undoubtedly correct. Politico's story on the legislation is full of extraordinary tidbits and quotes. Here are some of the most important facts we've learned:
(1) The bill "doesn’t include a price tag or specific proposals for financing the new system, which analysts estimate would cost tens of trillions of dollars over a decade." The lead sponsor of the bill says her crew will release a list of "suggested funding mechanisms" at some point in the future. One of these mechanisms, we're told, is "a tax on high earners." If you've been following this debate, you're well aware that targeted taxes on 'the rich' would be woefully insufficient in raising even a fraction of the expected cost. Enormous tax hikes on all Americans would be necessary. This math is not seriously disputed.
And given the comprehensiveness of the proposed 'benefits' in this bill (it goes even farther than Bernie Sanders' Senate version), some experts are already estimating that its price tag (which, again, is missing entirely from the legislation) could be on the order of $40 trillion over its first ten years. This would require roughly doubling the entire federal budget, which already runs a significant annual deficit. It's possible that they believe this plan to be "battle ready" because it hides the ball on cost, allowing proponents to mumble about hazy "investments" instead of confronting real numbers.
(2) Via NBC News, "The legislation's most contentious provision would end private health insurance and replace it with a government system." Yes, virtually all private coverage would be outlawed, forcing every single American into an innovation-crushing, government-run system. Approximately 177 million Americans currently receive private health insurance, either through their employers, or directly from insurers. The vast majority of these people are satisfied with their coverage, according to Gallup. All of these people would be uprooted from their existing plans and funneled into the federal bureaucracy. On the matter of ripping people away from their existing status quo, this proposal gets worse -- both practically and politically:
2. It would sunset Medicare and Medicaid, which are both popular, while (ironically) maintaining the two worst govt health care systems in existence today: the Veterans Affairs health system and the Indian Health Services.
— Pradheep J. Shanker, M.D., M.S. (@Neoavatara) February 26, 2019
For years, Democrats have attacked Republicans for "ending Medicare as we know it," often resorting to demagoguery and falsehoods. This scheme would literally end Medicare, creating a brand new, massive entitlement that seniors and Medicaid recipients would have no choice but to join. Please recall that Medicare is already becoming fiscally insolvent at an alarming rate, and that Medicaid is already terribly strained under the weight of its current recipient pool (expanded under Obamacare). Only recipients of the deeply broken VA and Native American health services would be able to keep their plans. In addition to Medicaid, both of these federally-facilitated programs have faced serious crises on access to care and wait times. And again, we have no idea how Democrats would pay for any of this -- and neither do they.
(3) Given the party's grim march toward abortion extremism, it should come as little surprise that this single-payer regime would require taxpayer funding of abortion. One of the few bipartisan truces on this divisive issue at the federal level has been the Hyde Amendment, under which public dollars do not flow to abortions. This would upend that precedent, mandating (unpopular) public funding of abortion.
(4) Minor detail:
For the first five years, at least 1 percent of that massive budget would go toward programs helping millions of health care workers displaced by the creation of a single government-run system, including “wage replacement” and retirement benefits in addition to job training. Jayapal estimated that 1 million to 2 million people in the private heath insurance industry could lose jobs.
(5) Finally, there's this important point:
Isn't it weird that all the Dems who want Medicare for All want to overturn Obamacare and no one asks them about that? That's the last Democratic president's signature achievement and it's no big whoop that the next class wants to get rid of it?
— Karol Markowicz (@karol) February 27, 2019
Last time Democrats had full control of government, they jammed through an unpopular program, promising the moon and the stars. All benefits, no drawbacks. This fiction came crashing down as five million people lost their plans, in violation of a core pledge, the federal website faltered, premiums continued to rapidly increase, and insurers fled the marketplace. Obamacare only became quasi-acceptable to many voters when fears over the wages of repeal torpedoed the GOP's replacement efforts. Both of these lessons -- Democrats' Obamacare mess, and Republicans' repeal fiasco -- offer object lessons in the profound political risks single-payer advocates are taking here.
Now the party that took a giant bite at the healthcare reform apple just a few years ago (implementation started in 2013) wants to throw out their entire new law and replace it with a government supremacist scheme. This is an admission of failure. This bill's lead sponsor calls the current state of American healthcare "absolutely atrocious." Most Americans simply do not agree with that assessment, even as they want lower costs. But Democrats remade our system, on a party-line vote, during the last presidency. Now they want a do-over, with much farther-reaching consequences, for far more people. Why should anyone trust them to do this? I'll leave you with healthcare policy expert Philip Klein's tough assessment of this reckless legislation:
New post: "House Democrats decide that the Bernie Sanders plan to socialize healthcare didn't go far enough" https://t.co/oIDePAN70f
— Philip Klein (@philipaklein) February 27, 2019