To Expand Health Coverage, Simpler Is (Much) Better

To Expand Health Coverage, Simpler Is (Much) Better

What can you say about a political party that argues endlessly about how much they’d have to raise middle-class taxes to pay for a leading candidate’s proposal? Elizabeth Warren has run herself — and much of the Democratic Party — into this political ditch.

Early on, the Massachusetts senator said, “I’m with Bernie on Medicare.” Bernie Sanders’ plan would raise federal spending by about $3 trillion a year, according to the Urban Institute. Warren now says she’ll provide details on funding her “Medicare for All” plan in due course. Gosh, can’t wait.

Both Warren and Sanders note that under their programs, taxpayers would save more on their health care costs than they’d pay in added taxes. That might be so, but the masses don’t study that deeply. They hear that they would face a tax increase in return for a new health care system whose outline remains vague. And the 155 million Americans now insured by an employer would lose that private coverage, whether they like it or not.

As for Republicans: Once they drove fiscal conservatives out of their party, they stopped letting sophisticated analyses bog them down. By the 2016 campaign, the Affordable Care Act (Obamacare), had become popular. Candidate Donald Trump knew he couldn’t get elected saying he’d end the health benefits of millions of newly insured Americans. Instead, he promised to replace the ACA with “something terrific.”

Something terrific. He produced not a single typed page on what his “something terrific” would look like or cost. But he got away with it.

I figured that as president, Trump would be up to no good. But even I was astounded by his crusade to demolish the ACA with nothing — zero, zip, nada — to put in its place.

But Trump did have a thing to not pay for, a huge thing. Republican presidents habitually push through massive tax cuts by telling the public that the cuts would fund themselves. That’s their free lunch.

It’s true that lowering taxes can spur economic activity, but the resulting revenues usually don’t come close to offsetting the taxes lost. Ronald Reagan and George W. Bush both pushed through enormous tax cuts that were advertised as paying for themselves but instead piled up mountains of federal debt.

But Trump has outdone his predecessors. He called his massive tax cut plan “the biggest reform of all time.” And as America was debating it, his then-top economic adviser, Gary Cohn, proclaimed that “we can pay for the entire tax cut through growth.”

As predicted, the tax cut sent the lion’s share to the richest Americans (including a number of New York real estate developers with extra goodies just for them). Wall Street rejoiced. Not long after his mission was accomplished, Cohn — former president of Goldman Sachs — fled the administration.

The Congressional Budget Office now predicts federal deficits will soar to $1 trillion a year for the next nine years. For comparison, Barack Obama left office with a deficit of $672 billion.

Economists blame the tax cuts — in addition to spending hikes and Trump’s trade war — for this developing fiscal nightmare. The economic boost has largely petered out.

Republicans have fallen silent on deficits. Democrats, oddly, aren’t speaking up. Instead, they’re focused on how Warren will raise taxes for her ambitious health care plan.

Last January, Warren wisely kept things general. She said her goal was “affordable health care for every American” and there were “different ways we can get there.”

The simplest, least detail-burdened way is to add a public option, a government-run health plan, to Obamacare. Yes, that’s Joe Biden’s plan, folks.


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