Indeed, it is disturbingly easy for Democratic politicians to promise free health care in exchange for votes. It’s also true that the US has the most advanced health care technology in the world. And that, whether or not government insurance is a good idea, government-operated health care provision would be awful. No argument.
But Lanhee Chen’s economic arguments are pretty easy to pick apart. Firstly: he cites a study from the libertarian Mercatus Center to scare us about tax increases that might result from Bernie Sanders’ “Medicare for All” proposal.
Yes of course, there would be big tax increases. Because we (and our employers) would no longer pay any premiums to insurance companies! Chen conveniently avoid any mention of this, making it sound like a new burden would be slapped on top of all of our current expenses.
Secondly… It obviously is supposed to shock us that, in quasi-socialist Ontario, 46% of the government budget is for health care. Let’s do some back-of-envelope math to compare this to the US. Today, 18% of the whole US economy is spent on health care (up from 7% in 1970.) Currently, the US government only pays for about $1,050 billion of that (via Medicare plus Medicaid), and this $1,050 billion is just 34% of the entire government budget. Some key figures ($ in billions):
Suppose, now, that the US government instead paid for all health care (like in Canada’s single payer system). The Health Care portion of our government budget would shoot up from $1,050 billion to $3,500 billion:
And now, instead of Health Care being 34% of our government budget, it would be a whopping 63%! (Kind of makes Ontario’s 46% look pretty low now, doesn’t it?) In either scenario, we in the US are still paying all of the $3,500 billion for health care; in the first scenario, we pay it partly through private insurance, in the second scenario, we pay all of it via taxes. Either way, our national health care cost percentage is way above Ontario’s. We’re the ones with a cost problem, not them.
One benefit of single-payer in the US is that it could eliminate some of the inefficiency and price-gouging that occurs throughout the US health care system, thus bringing down average health care spending. That’s the point Bernie Sanders has been trying to make: yes, taxes would go up, but if we don’t go to some kind of single-payer system, the net financial burden per citizen will be even higher than under a Medicare for All system.
Weirdly, at the same time that Mr. Chen criticizes Democratic single-payer proposals, he also tries to make the argument that things like hip and knee replacements, cataract surgery, and so forth are your basic right. As though the Democrats are trying to take your basic rights away from you. It’s hard to miss how hypocritical his argument is. If anyone is trying to guarantee a right to basic health care, it is the Democrats.