Medicare for All: Warren's Chicanery

Presidential candidate Elizabeth Warren was sharply criticized by other Democrats for not saying how much taxes would increase to pay for her Medicare for All plan. She finally gave a response (link). It includes plenty of chicanery.

The Associated Press, NY Times, and Los Angeles Times all report her Medicare for All would cost $20.5 trillion more for a decade. Of course, that's her number, and politicians excel in lowballing costs and slight of hand (Blahous). For example, private insurance plans reimburse providers far higher than Medicare does, but Warren assumes they will be reimbursed only 110% of Medicare rates. She says nothing about resulting healthcare facilities closing or job losses.

The first version of the AP article (since updated) gave revenue numbers that summed to $20.5 trillion to pay for it.  However, since Warren has already tagged some of the revenues to pay for climate change, student debt relief, bigger Social Security benefits, etc., the numbers cannot sum to all of the additional government spending she wants.

The $6.1 trillion "savings" she subtracted in arriving at $20.5 trillion is phony. She assumed it's redirected to the federal government from what state and local governments now spend on Medicaid, the Children’s Health Insurance Program, and employer contributions. Huh? The federal government will take the money, and the beneficiaries will get equal or better under Medicare for All. That's not savings; it's slight of hand, evoking revenue and obliterating transfer of cost. Blahous also noticed it. Donald Berwick, whose article I addressed here, fabricated this slight of hand for Liz (link).

Also, $1.4 trillion of it made no sense. The alleged source is more tax revenue from people not having to pay "private health insurance's premiums, deductibles and co-pays."  Sorry, Liz, and contra Blahous, not having to pay those things will not result in higher taxable income and taxes for the vast majority of people. They don't itemize and take medical deductions for income taxes, and health insurance premiums paid by employees are not deductible anyway.

By the way, isn't it amazing that eliminating co-pays and deductibles and handing out new "free insurance" cards to millions of Americans will not increase demand? Yet Liz says nothing about rising demand increasing healthcare costs.

Liz assumes the federal government will extract $8.8 trillion from employers via taxes what they would otherwise spend on private insurance for their employees. Bernie Sanders assumes only $3.9 trillion. She assumes the employers will pay 98% of what they were paying versus Sanders' 75%, but that falls far short of explaining $8.8 trillion versus $3.9 trillion.  Does she assume extracting taxes from state and local governments, public school systems, and non-profits, all of whom are employers that pay zero taxes? Not surprisingly, Liz makes an exception for unions. To the supporters go the spoils.

Liz would restore the corporate income tax rate to 35%. In her fantasy world this will not retard economic growth.

From the AP article: "We can generate almost half of what we need to cover Medicare for All just by asking employers to pay slightly less than what they are projected to pay today, and through existing taxes," Warren wrote in a 20-page online post detailing her program.

Show a little honesty, Liz. You will not ask them. You want the government to coerce them. Is that Liz's newspeak -- asking includes coercing?

I have two more questions for Liz, like ones I had for Bernie Sanders (link):

Q1: Many employers that are nonprofits, state and local governments, and public school systems provide health insurance for their employees. Does Liz advocate the same healthcare tax on them that she does on private employers and eliminating the health insurance such employers provide for their employees? Why should these employees have anything better than private sector employees?

Q2: Would the current healthcare plan for federal employees and retirees (Federal Employees Health Benefits Program) be eliminated? I much doubt it. Special and superior privileges for government employees is the usual for authoritarians like Liz. But if not, why not? Why should federal employees have anything better than private sector employees?

Medicare for All: Profligate Sanders

This article at The Hill reports on an interview of Bernie Sanders by CNBC’s John Harwood. Harwood asks Sanders about how to pay for his Medicare for All plan. Sanders responds: "You're asking me to come up with an exact detailed plan of how every American — how much you're going to pay more in taxes, how much I'm going to pay. I don't think I have to do that right now."

No, evader Sanders. The article makes it very clear that Harwood asked about aggregate additional government spending and taxes for Medicare for All. This Sanders web-page calls for additional revenues that total about $16 trillion over 10 years. However, $4.2 trillion of that is from assuming employers will pay more taxes because they won’t be deducting the cost of health insurance for their employees. Does Sanders intend that the $3.9 trillion premium/tax Sanders wants to impose on them be, unlike wages or health insurance premiums now or FICA taxes (paid to Social Security and Medicare), will not be a tax-deductible expense? It also totally ignores that employers could easily spend the “savings” on other things like hiring more employees, buying supplies, buying new equipment, etc. Thus at least $4.2 trillion of Sanders’ alleged $16 trillion is highly spurious. So Sanders’ plan is for the government to spend $34-36 trillion more on healthcare, as estimated by the left-leaning Urban Institute, and only collect $12 trillion in taxes.

The $34-36 trillion does not even include all other government spending BS wants – for climate change, infrastructure, student debt relief, more subsidies, bigger Social Security benefits, etc.

Of course, this is no problem for BS. Despite the lip service he gives to government deficits and debt – when it is convenient to criticize his political opponents – he doesn’t care an iota about government deficits or debt. He regards any government spending he approves of as a heavenly gift, and in Sanders’ newspeak justice includes extortion.

Medicare for All: Chicanery from The Guardian

An op-ed at The Guardian by Emmanuel Saez and Gabriel Zucman exemplifies chicanery about Medicare for All. No M4A proposal to my knowledge has stipulated that employers take what they now pay for healthcare coverage for their employees and use it to raise wages for their employees. Indeed, this page from a Bernie Sanders website belies it: “employers will be required to pay either 75 percent of what they are currently paying for health care costs for each of their employees who enroll in Medicare for All, or a 7.5 percent payroll tax, whichever is higher.” The same page also stipulates a new 4% premium/tax paid by the employee.

Yet Saez and Zucman write: “Take again the case of a secretary earning $50,000 in wage and currently contributing $15,000 through her employer to an insurance company. With universal health insurance, her wage would rise to $65,000 – her full labor compensation. With an income tax of 6% – which, if applied to a base large enough, would be enough to fund universal health insurance – she would have to pay about $4,000 more in tax. But the net gain would be enormous: $11,000. Instead of taking home $50,000, the secretary would take home $61,000.”

Firstly, if indeed the cost of insurance for the secretary and his/her dependents is $15,000, he/she is not contributing the entire $15,000 like Saez and Zucman say. Far more likely, he/she pays about 30% (typical for family coverage) of that ($4,500) and the employer pays the other $10,500. Secondly, Sanders’ plan says absolutely nothing about diverting what employers pay for health insurance to employee wages. As obvious above, Sanders wants the government to confiscate 75% or more of it by taxation and tax the employee another 4% of income.

So it’s patently clear that what Saez and Zucman say about the secretary was totally fabricated and pure propaganda. What chicanery advocates of Medicare for All will use to hype their cause! How many secretaries and millions of other voters will swallow Saez’s and Zucman’s lie that Medicare for All will raise their pay? Many who commented to the op-ed at The Guardian swallowed the lie.

Medicare for All Myths

This USA Today opinion article exemplifies the myths, propaganda, and falsehoods about Medicare for All. The following text in italics is from author Donald Berwick's article.

The truth is the opposite: Medicare for All would sharply reduce overall spending on health care.

The truth is Berwick's assertion is pure fantasy. Even the Urban Institute, a left-leaning think tank highly respected by Democrats, projects that a plan similar to what Bernie Sanders and Elizabeth Warren are pushing would require $34 trillion additional federal spending over its first 10 years (link). For comparison, total federal government revenue is expected to be about $3.44 trillion in 2019. 10 x $3.44 trillion = $34.4 trillion.

Less than 20% of the US population has Medicare now. Yet Berwick says 100% of the population will be covered with bigger benefits (e.g., no copays, no deductibles, long-term care) and it will cost less!

Lastly, Berwick's assertion logically implies that income to health care providers and their support personnel will be sharply reduced. So how many jobs in the healthcare industry does Berwick want to destroy and how deeply does he want to slash the incomes of nurses, orderlies, receptionists, technicians, workers doing billing and collections and claim processing, accountants, doctors, and so forth that remain?

Medicare for All would be simpler, easing the onerous burdens of billing for doctors, endless paperwork for all health care professionals, and navigating the confusing coverage system for patients and families.

More myths. Unless Berwick wants the government to simply dictate low wages for doctors, doctors will still need to bill Medicare, Medicaid and whoever else is standing after the Medicare for All wrecking ball is done with its destruction. Rarely does government action simplify anything. Government epitomizes endless paperwork and bureaucracy. The complicated, confusing healthcare structure now in place was created by government fiats and regulations.

Faced with these facts, opponents of Medicare for All too often revert to myths instead.

Facts? LOL. It is the advocates of Medicare for All like Berwick that have nothing better than their own fabricated myths about what the future with Medicare for All would really be like.

But it is deeply misleading to pretend that this shift is an increase in family health care costs. It is not.

If Medicare for All bans employer-insurance like Bernie Sanders wants, at least in some of his newspeak, how does that not increase healthcare costs for employees and their families? If income or payroll taxes are raised, how does that not effectively increase healthcare costs for employees and their families?

Note that Berwick says nothing about eliminating private insurance. He also says nothing about employer-paid insurance for employees of the federal government, state and local governments, non-profits, unionized workers, and public school systems. Or does Berwick fail to understand the meaning of single in single-payer. It means Medicare pays and nobody else, period.

In summary Berwick's idea of Medicare for All is a mountain of myths.

Medicare for All and Insurance for None?

The demagogue-socialist-authoritarian-power-luster Bernie Sanders is very critical of private health insurance and wants to eliminate such insurance provided by employers, at least private for-profit employers. (Medigap and Medicare Advantage insurance will not be considered here.) His own website proposes separating health insurance from employment. But how sincere and consistent is he? Or is it lying propaganda?

Does BS intend eliminating insurance provided only by private for-profit employers or all employers? In other words, would he end all health insurance now provided to employees by the federal government, state governments, local governments, non-profits, unions, and public school systems? By what moral principle should those employees be more privileged than anybody else? If they continued to have employer-paid healthcare but nobody else, it would be a gross inequality and gross injustice. Government employees, union members, and public school teachers would get benefits denied to anybody else not a member of the privileged class. The not privileged would be treated as inferior, second rate citizens. The not privileged class with no insurance except Medicare would be forced to pay via taxes (and inflation) to serve the privileged, most of whose entire pay comes from taxes. The result would be a two-tier system -- one for government employees plus other favored groups, and a second, inferior one for the rest. It would be a two-tier system of masters and their servants. It would exemplify the situation in George Orwell's novel Animal Farm: "All animals are equal, but some animals are more equal than others." This is a proclamation made by the pigs who control the government in the novel. It is a comment on the hypocrisy of governments that proclaim the equality of their citizens but give power and privileges to a chosen elite.

BS claims to be a champion of equality, yet advocates Medicare for All which would treat all but the politically-privileged far worse. His advancing the power of the political ruling class and the subjugation and looting of the productive members of society is his primary goal, and has been for the last 40 years.

Nobody asks Bernie Sanders these questions

The demagogue-socialist-authoritarian Bernie Sanders wants Medicare for All. It would eliminate all private healthcare insurance (which pays more than one-third of all healthcare costs). He says he would raise taxes to implement it. He typically evades saying how much or in what form, and the fawning media doesn't press him for an answer. He hasn't said so, but he might target employers with a "healthcare tax" based on the $1 trillion or so employers now pay for health insurance for their employees.

Total healthcare spending was about $3.5 trillion in 2017. Sanders says total healthcare costs would be much less with Medicare for All. He believes other countries like Canada, Germany, and the United Kingdom have as good or better healthcare than the United States while spending much less. The average per capita spending in these three counties for 2016 was $4832, but $9892 for the United States (link). It logically follows from BS's premises that with Medicare for All: (1) U.S. healthcare costs would be only $1.7 trillion, and (2) spending by healthcare providers will also be reduced to only $1.7 trillion.

Q1: Assume in aggregate healthcare provider outgo is about 75% to pay workers, 12% for supplies and equipment, and 13% for miscellaneous (malpractice premiums, property, interest, taxes, and surplus -- the last mainly saved to pay for future expansion, new technology, and capital equipment replacement). So the question for Bernie is how many jobs will be eliminated and how much will  pay to workers and other expenses be cut in order to cut total spending by health care providers more than 50%? More specifically, how many jobs of nurses, orderlies, receptionists, technicians, workers doing billing and collections and claim processing, accountants, doctors, and so forth will be eliminated and/or how much will their pay be reduced?

Q2: Many employers that are nonprofits, state and local governments, and public school systems provide health insurance for their employees. Would Bernie advocate the same healthcare tax on them that he does on private employers and eliminate the health insurance such employers provide for their employees? Why should these employees have anything better than private sector employees?

Q3: Would the current healthcare plan for federal employees and retirees (Federal Employees Health Benefits Program) be eliminated? I much doubt it. Special and superior privileges for government employees is the usual for Sanders. But if not, why not? Why should federal employees have anything better than private sector employees?

Attention intruders

Glenn Harlan Reynolds has an article about Big Tech's efforts to get our attention (link). The cost of clickbait and advertising has apparently become so cheap, and/or the hosts want the revenue so much, that we are flooded with it. Most articles on the internet or a smart phone have several advertisements or other clickbait imposed within the article.  By other clickbait, I mean (a) links to other articles the host offers as a way to get more advertising revenues and (b) invitations to sign up to receive alerts or notifications to more content from the host by email or text messages.

I use ad-blockers to "gray" much of the content, but still find nearly all of it very annoying. If an advertiser or other clickbait maker had to pay me to show me their clickbait, my time on the internet and smart phone would be far more tolerable.