The issue of heath care and I go back a very long way. I was honored to be one of the first people asked by Hillary Clinton to be a part of her health care team in January of 1993; I co-wrote the strategic plan that the pro-ACA coalition used to help get that bill passed in 2010, and served as an adviser to that coalition throughout that long fight; I was part of a small group of people who worked with Jacob Hacker on developing his proposal for Medicare for Everyone who wants it https://prospect.org/health/road-medicare-everyone/ that has become the basis of many of the Democratic proposals on health care in this campaign. So I have been working on Democratic health care plans and health care budgets for a very long time, and have supported a variety of approaches to the health care issue. And I can tell you that the attacks on Elizabeth Warren’s health care numbers are intentionally misleading and just flat out wrong.
It’s not just me saying this, by the way. I would start by noting that Donald Berwick, who ran the Medicare and Medicaid programs for President Obama and is widely regarded as the leading expert in the country on health care spending, backs up the budget numbers in Warren’s plan. And Simon Johnson, the economics professor at MIT who was the Chief Economist for the International Monetary Fund, backs the numbers as well. So when Mayor Pete, for example, says there’s a multi-trillion dollar hole in Warren’s plan, he is saying that some of the most respected economists in the country don’t know what they are talking about; when Biden refers to the plan s “sleight of hand”, he is dismissing Obama’s top health care official’s analysis.
What I like about Warren’s plan is that it takes most the financing from the two big areas we aimed for in the past Democratic plans I have worked on: making sure all but the smallest businesses pay for their employees’ health care costs, and making sure the outrageously high prices that drug companies and hospitals charge are rolled back. Those are the two biggest items in health care spending in this country; they are exactly the place we ought to be looking at in terms of paying for our health care system. And it’s very much in keeping with the financing done by Democratic plans in the past: Hillary’s plan, for example, was paid for in part by what we called the “employer mandate” (as opposed to the far more regressive individual mandate used in the ACA), asking medium and large sized businesses to pay their fair share of their workers’ health care costs. Both the Hillary plan and the ACA had as central goals a reduction in health care costs, although neither were able to roll back those costs nearly as much as a Medicare For All system.
Those who say employers shouldn’t have to pay in taxes what they are paying now in health care costs are just making up excuses and trying to frighten people; and those who say we can’t do that much cost control are letting all those campaign contributions from Pharma and the rest of the health care industry muddle their thinking. From all the health care budgets I have reviewed over the past three decades, the numbers in the Warren plan are quite doable.
The Biden campaign has also expressed horror at what they describe as a “complete revamping of defense, immigration, and overall tax policy in order to pay for it”. To my old friends in the Biden world, I say: take a deep breath. Warren is proposing essentially the same immigration reform plan you are proposing, but is quite logically saying that if we do that, we will be able to use the additional taxes collected because of a comprehensive immigration reform plan to pay for health care services. She is saying that, yes, the defense budget is wasteful and bloated, as even Pentagon auditors have noted many times over the years, and that at least some of those savings could be applied to health care. And she is saying that the wealthiest .2 of the top 1% can pay a little more. Doesn’t seem like that any of that is either a “complete revamping”, or worth all the hyperventilation going on here.
I have always been pragmatic when it comes to health care, supporting different approaches that meet my fundamental goals: lessoning the power of the insurance industry to control our lives, lowering health costs and inflation, and getting as close as we can possibly can get to universal coverage. I have always thought Medicare For All would be very tough to pass and thus have been supportive of improvements to the health care system like what Hillarycare would have been and what the ACA became. But after 30 years of reviewing health care budget numbers, there is no doubt in my mind that the numbers on the Warren Medicare For All plan makes sense, and that it is outstanding public policy. She should welcome this debate about whether drug companies and hospitals should lower their prices as much as she suggests, and whether Amazon and Wal-Mart should pay a price for their workers’ health care. It’s a debate I think she will win.