Medicare For All Bill Is Not Medicare Nor Is It For All

 
Bernie Sanders is not a policy wonk with a history of passing legislation in Congress. That’s why when the highly anticipated Medicare For All bill was introduced with none of the pay-for mechanisms that would allow it to actually be implemented, it was expected virtue signalling from a lifelong grandstander and sometimes grifter along with a host of Senate Democrats too weak or scared to say the emperor has no clothes.
 

Medicare For All “Bill” Isn’t Really A Bill

It’s aspirational. It does none of the hard work required to make single payer a reality. It makes the easy part of the argument (everyone should have healthcare) that’s been echoed ad nauseam by generations of progressives, while refusing to even touch the difficult part (how do we pay for it?) that’s been the obstacle to implementing such a plan. This has even kept places like California and Vermont from doing so on the state level. This bill also stakes out a maximalist version of single-payer that doesn’t resemble any working plan anywhere else in the world.
 
Whatever this is, it isn’t Medicare for All. Medicare has premiums and co-pays and plenty of things it won’t cover unlike this plan. If this is meant as an “opening bid”, it shouldn’t have been submitted as an actual bill which can be CBO scored and pinned on its cosponsors as the largest middle class tax hike in US history. Also, we probably shouldn’t submit “bills” that we don’t want to become law. Using our legislative engine for symbolic gestures is fraught with peril. Ultimately, no progress will be made toward this goal until somebody has the fortitude to honestly level with the American people about the trade-offs, sacrifices and disruptions required to make a plan such as this into reality.
 

How Are We Going To Pay For This Again?

For those who think there is an additional two to four trillion dollars a year to be squeezed out of the 1%, I have bad news for you. It isn’t there. The news is not all bad though.
 
The fact is single payer can work (though we prefer a hybrid approach like most of the rest of the organized, western world). Everybody’s taxes will have to go up tremendously, but it’ll be worth it. That’s a hard argument to make in America where people are loss-averse and skeptical of government.
 
Saying “the rich and corporations will pay for it” is the sort of disingenuous, pollyanna nonsense that’s kept universal healthcare from happening in this country as it’s a lie. Single-payer will require what will at least feel like a massive sacrifice from ordinary Americans. Take-home pay will go down significantly, but most Americans will save money in the net of healthcare expenditures (although some won’t, and those people will howl in a way that will make the reaction to the ACA look like a garden party).
 
Nonetheless, single-payer can still be seen as good policy; however, we have to stop pretending it’s something easy that can be done on the backs of the wealthy without meaningful shared sacrifice. Single-payer will conceptually reshape taxation in America for all people. If you believe that’s a good thing, make the argument for it. It’s cowardly and useless to perpetuate the comforting myth that healthcare for all is a simple problem with a simple solution.

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