One of the most informative bloggers that I have had the privilege of reading is David Anderson from Balloon Juice. For years, he posted under the name Richard Mayhew at Balloon Juice. Nearly all of the clarity and understanding that I have about Obamacare comes from reading his posts.
So, in case you didn’t know, Senator Warren published the substance of her Medicare-4-All plan.
I am not a fan. Never was. Saw it as an unforced error from the beginning.
We haven’t fully supported Obamacare. There’s so much that we could do with the Constitutionally-Approved Obamacare. Healthcare is a positive issue for the Democrats. I saw Medicare-4-All as being a serious unforced error for any Democrat to present.
So, here are two constructive criticisms of Warrant’s Medicare-4-All Plan.
Under pressure for months for having refused to release detailed plan to pay for her single-payer, everyone-and-everything-covered government health care plan dubbed “Medicare for All”, Sen. Elizabeth Warren finally released such a plan on Friday. The plan is being highly praised among single-payer ideologues. Some are even trumpeting the fact that she put out a plan at all – the bare minimum that should be expected of someone running for president – as heroic.
Warren released a financing plan that is hasty, one that appears designed more to quell the criticism that she doesn’t have a plan to finance her single-payer proposal than to actually pay for her single-payer proposal, and one that looks more like swiss cheese than Swiss healthcare.
The savings from Elizabeth Warren’s single-payer Medicare for All financing plans aren’t even close to what she claims, and the plan won’t raise nearly as much revenue as she hopes.
Let’s delve into the financing plan’s major savings and revenue provisions.
Warren’s financing plan accepts the basic framework of a report published by the Urban Institute last month. The report examined multiple health care coverage expansion ideas, among them three different versions of Medicare for All. The option in that report that most closely resembles Warren’s plan is estimated to cost the federal government an additional $34 trillion over the first decade of implementation.
But Warren says her plan is better and it will require the federal government to raise just $20.5 trillion. How? Warren claims to have found $7 trillion in “savings” and believes that Congress can directly tax state governments to the tune of $6.1 trillion.
Warren fails the administrative cost vs. health care utilization challenge.
Almost $2 trillion in savings in Warren’s plan comes not from an actual policy but from an assumption. Warren’s plan simply assumes that traditional Medicare’s 2.3% administrative cost will remain flat, which allows for a $1.8 trillion in savings against the analysis from the Urban Institute. Having studied the idea, the Urban Institute says that holding administrative costs for Medicare to 2.3% when it is required to cover both everyone and everything, is impractical.
The rest of the article looks cold and hard at the numbers Warren presents to overhaul 1/6 of the American Economy.
For me, it’s the cavalier attitude that she had in response to what will happen to the TWO MILLION PEOPLE that she admits will lose their jobs because of her program. It was blithe. It was dismissive. And, I find that angering, as a Democrat who want to win in 2020.
The second piece is from David Anderson.
218-60-1-5 and the Warren plan
by David Anderson
At 8:49 am on November 4, 2019.
In November 2008, the Senator Max Baucus (D-MT) ,chair of the Senate Finance Committee, released a 98 page white paper. This was a crucial precursor to what eventually became the ACA. Some of the white paper made it into the bill. But that was not why this white paper was important. Instead, it was the last major Democratic choke-point holder laying out what he was willing to do and not do with healthcare reform. With this white paper, all the major Democratic Party actors who held explicit or implicit veto positions were at least onboard with a rigorous exploration of passing an individual market, subsidized and standardized and a major expansion of Medicaid eligibility. There was a pathway forward.
Fast forward to this week. Senator Warren released a Medicare for All plan. It is a plan that won’t get sixty votes in the Senate. It is a plan that will need the approval of Senators Manchin and Sinema. It is a plan that will need 218 votes in the House. In addition to the 218 votes it needs in the House, it also needs a floor slot and committee time. That is problematic.
We talk some about how difficult it would be get a maximalist left-wing agenda through a narrowly divided Senate.
We haven’t talked at all about how difficult it would be to get it through the House, especially with a not especially cooperative Speaker. https://t.co/zPLwuFss58
— Bill Scher (@billscher) November 2, 2019
Significant elements of the critical pathway to enactment are screaming that they are not interested in another run up the hill of health finance and delivery system transformation. Senators Manchine and Sinema are veto players. Speaker Pelosi is a veto player. They aren’t onboard with the vision that Senator Warren is outlining. This is a major problem if you support Senator Warren (and/or Senator Sander) and her health care plans. Even if she wins, enactment will be extremely unlikely if the rest of the veto players are indifferent at best to it.
The Speaker is trying to tell you. What works in San Francisco doesn’t usually work in Michigan, because we are a diverse country. And, those with the vetoes are telling you that their neck of the woods will not look kindly on this, and that you need to think long and hard before you go down this road. Barack Obama and Nancy Pelosi did what was necessary to get it through the House and the Senate.
They counted the cold, hard votes needed to make this law. We don’t have to like it, but, in order to get it out of the House, Speaker Pelosi has to get it past those members who come from purple districts that enabled the Democrats to take back the House. Ignore those folks and their concerns at your peril.