Unspoken Arguments Against Medicare For All
There was a time in my life when I protested taxes because I didn’t want to pay for the health consequences of choices made by people who smoked cigarettes, ate too much, and consumed alcohol. I was for a time, a “tax protestor”. And I was about as conservative and libertarian as they came back in the 1990s. I was one of those people who followed the Vince Foster conspiracy theories.
But time did something for me that no amount of logic could do. It gave me a sense of mortality. I met people and friends along the way who showed me how isolated I was. They showed me that I can’t be the judge of other people, for they are fighting battles that I know nothing about.
Over time, my heart softened. I learned more about who I am and what I can do to make my own life better. I became more aware of my own battles, and my desire not to be judged for them. I had the help of other people to learn that in the end, I am not a free agent in a bag of skin. I learned what we owe to each other.
As I looked back upon the debate about health care, and the most common talking points, I began to see what was unsaid. And by the way, I was against the health care plans offered by Hillary Clinton when she proposed them. Not because I knew anything about them. I opposed “Hillary Care” just because all I could hear was that “the government was going to take over the health care system.”
I now see that such specious arguments are a lost cause. The government has already taken over the health care system. They are the biggest customer of the health care system and will continue to be for the foreseeable future. The only question that is before us is, “who should profit from a government-run health care system?”
Conservatives will talk a lot about taxes. They’ll talk up health care choice. They say that most people like the health insurance that they have. Yeah, they like it better than nothing. Choosing between life and death is not really a choice in what is supposed to be a free market, and our health care market is anything but free.
Conservative Democrats and Republicans both say that under Medicare For All, we would not have a choice of doctors. We don’t have a choice of doctors under our current insurance plans. I don’t even like my own health insurance plan as it is right now, but I have it because the other choices are unpalatable. They are not economical. And my current choice binds me to my employer for purely economical reasons.
The subtext of the conservative talking points I hear is that they don’t want to be paying for abortion through the government. I think that’s the big one, right there. With Medicare for all, conservative Christians will wind up paying for the consequences of choices made by other people. And they will pay for that with a tax.
Christian conservatives like to squawk about abortion as if that’s the only issue they’re concerned about. But they’ve been very quiet about raising this issue in the Medicare For All debate. I think I know why. There’s a fair bit of hypocrisy afloat here. What they really don’t want to talk about is that these same conservative Christians blindly support Israel and their misguided plans to annex everything in the Middle East that they can get their hands on.
See, what they really don’t want to talk about is that we send Israel billions every year, and Israel is a country where the government pays for the vast majority of abortions carried out there. Clearly, we see that conservative Christians are showing deference to the Jewish religion. In Judaism, life springs from the first breath. So abortions get a pass and they are paid for by the US and Israeli governments.
So here in the United States, Christian conservatives don’t want to pay for the consequences of the choices made by other people. But their unwavering support of Israel suggests a double-standard.
Conservatives like to talk up taxes when it comes to Medicare For All. They seem very concerned that our taxes will go up if we move to a Medicare For All system. But they seem to omit one very important talking point. Even liberal Democrats miss this point. Much of the cost of health care is inflicted upon us by a Congress that is mostly bought and paid for by the industries they claim to “regulate”.
Dean Baker, a senior economist with the Center for Economic Policy and Research, has done a lot of research on the cost of health care and how to pay for it in the United States. He describes the hypocrisy of conservative talking points about health care as an effort to support a “Conservative Nanny State”. In simple terms, he says that conservatives like government intervention in the markets just as much as liberals do. The main difference is that conservatives promote policies that distribute income upwards.
For example, in a recent article by Baker on his CEPR blog, “Beat The Press”, he provides a strong defense of Elizabeth Warren in her refusal to put taxes front and center. In “Senator Warren’s Answer on Taxes and Medicare for All is Exactly Right”, Baker rightly points out that conservative just want to talk about the taxes imposed by the government, without talking about what we will actually get for our money with Medicare For All.
Worse, conservatives are (mostly) unwilling to admit that most of the studies done on Medicare For All show that we will pay less in taxes than we are already paying to the health care industry now. Most of the banter that passes for conservative political discourse fails to make a real comparison of the costs between private insurance and Medicare For All.
And finally, Baker also notes that the patents and copyrights acquired by the healthcare industry, with a particular focus on drug patents, impose a huge cost on Americans. Drug patent royalties amount to a private tax imposed by the government and collected by private drug companies, hospitals, and insurance companies. There’s real money in this for everyone, as long as you’re not a patient.
To break it all down in very simple terms, the debate over health care has little to do with taxes. Rather, it’s about who should bear the burden of health care. Businesses would love to get out of paying for the health care of their employees. They would love to lose the paperwork, the billing, the coding and all the administrative overhead that goes along with health care for their employees.
But many business owners are conservative, and they honestly believe that the business they have was built up by their will and talents alone. Some CEOs appear to believe that the lemmings that work for them had nothing to do with their personal success. So they are loathed to pay the taxes required for the health maintenance of their employees. And they fight legislative initiatives on that basis alone. They act like free agents in a bag of skin.
The entire health care debate can be boiled down to a game of shifting burdens. The hospitals want to make money. The doctors want to maintain a rate of pay that is well into the top 10%, and even 1%, and double the pay of other doctors in most OECD countries (think Europe, Japan). Insurers think that $80 million a year is fair compensation for at least one CEO. On average they paid their CEOs $18 million and 62 insurance CEOs made more than $1 billion last year, all while sitting on their own sweet tushes. With compensation like that, I’d say that someone is shifting the cost of health care onto someone else.
Yet, I see few conservatives, some of whom claim to know something about economics, even bother to question whether or not the way some people make money off of health care is an efficient allocation of resources. I mean, capitalism is supposed to do that, right? I’ve heard people say that capitalism is the most efficient system for allocation of scarce resources in an economy. Can anyone say that with a straight face about the American health care system?
I guess I have to wonder then if capitalism is so great at allocating health care resources, why is there a shortage of doctors? Why is there a shortage of nurses? Why does Congress impose strict limits on the number of doctors who get training as residents in hospitals? Why do states impose strict limits on the number of people who can practice medicine? I’d say that those limits are evidence of government intervention in the health care market, with a very specific intent: to keep the wages of doctors high by limiting supply.
Health care supply is limited by patents, licensing, training opportunities and on and on. I have yet to see any politician of any persuasion make a serious and credible argument in favor of bringing more doctors into America to practice medicine according to American medical standards. None. Zip. Zero.
Conservative pundits talk up supply and demand as if they’re economists, but none of them will suggest that we bring more doctors into the country. None of them will suggest that we increase the supply of doctors from within. Or the supply of drugs. Or the supply of medical devices.
I recall that in my reading of economics when prices go up, there is a greater incentive to meet demand. When prices go up for a commodity, more of that commodity is produced to meet demand. I don’t see that happening at all for doctors, drugs or devices. That suggests that a very powerful and effective intervention by the government is at work.
I bet if we could bring our costs in line with most other OECD countries, instead of seeing budget deficits forever, we’d start seeing surpluses. And we could do that by increasing the supply of what we need. We certainly do that for TVs. Why not for health care?
Patents increase the cost of drugs, but that didn’t increase the supply of drugs. High doctor salaries didn’t increase the supply of doctors to meet demand, either. Even high nursing salaries didn’t increase the supply of nurses enough to meet demand, or their salaries wouldn’t be so high. And medical devices, with patents that last 20 years aren’t really doing much to increase the supply of innovative devices, or their costs would come down. The most likely cause of high health care costs must be government intervention in the market.
If government intervention in the market keeps health care costs high, it can reduce health care costs by increasing supply to meet demand. And as long as we keep playing the game of shifting burdens, we’ll need laws like Medicare For All.