Do you expect valuable stuff for free? If you do, you’re Elizabeth Warren’s sucker.
The Massachusetts senator is basing her presidential campaign on massive new benefits for the middle class, paid for by somebody else. Her juiciest offering is “free” health care financed by new taxes on businesses and billionaires. Under her Medicare for all plan, nobody would ever pay an insurance premium, a co-pay, a deductible or any other kind of medical bill. The government would cover it all.
It’s a terrible idea because Americans don’t need free health care. What they need is affordable care providing good value for the money. Free health care might sound great, but it wouldn’t really be free and it probably wouldn’t provide good value when factoring in all the necessary tradeoffs. Paying a reasonable price for care is a much better idea, for at least three reasons:
People shop better when they pay. When something is free, you consume it wantonly. When you have to pay you’re a lot more careful, generally buying only what you need. This would be crucially important under Medicare for all because there’d probably be a shortage of doctors and hospitals under Warren’s plan. The single-payer program would pay doctors and other caregivers a lot less than private insurers pays now, so some doctors would probably leave the profession and fewer might go to medical school. Some hospitals are barely profitable now, and they’d be forced to close if payments shrunk. For several years at least, there would be fewer sources of care just as 28 million new people have coverage. Patient cost-sharing would reduce unnecessary tests and doctors visits and help more people get crucial care.
It would be an important source of revenue. Warren has understated the cost of her plan by about $1.4 trillion per year, and she’d probably need revenue sources in addition to the higher taxes on businesses and billionaires she has outlined. Warren says her Medicare for all plan would cost $2 trillion per year, but the Urban Institute pegged the cost at $3.4 trillion, and other estimates are in that range. Vermont Sen. Bernie Sanders, who backs the same plan Warren does, proposes a 4% income tax surcharge to pay part of the cost, which he says would still amount to less than half what the typical family pays for health care today.
Pay-ins might forestall other problems. Warren’s financing plan calls for repealing the 2017 tax cut, which would raise the corporate tax rate from 21% back to the 35% level it was at before the cut. She would also impose a new corporate tax of 7% on all profits above $100 million. And she’d slap new taxes on Wall Street firms. Overall, corporate taxation would be higher than it was before the 2017 tax cuts. That would be a problem, because many economists felt U.S. corporate taxes were too high compared with other countries, which encouraged some firms to flee U.S. territory. Even President Obama favored lowering the corporate tax rate to 28%. Pushing business taxes as high as Warren wants to would make the United States a less favorable place to do business, which could depress job and income growth.
The main problem with the U.S. health care system is that care is far more expensive than it is anywhere else in the world. Shifting the source of financing around won’t do much to address the cost problem, and it could make it worse if demand for care skyrockets because it’s free. What middle-class families really need is affordable care that provides more bang for the buck and leaves more money available for school, groceries and the occasional vacation. Other plans make that a priority. Warren’s doesn’t.
Medicare itself isn’t free. Enrollees pay premiums, and there are co-pays and deductibles. Seniors generally like the program, however, because its buying power helps keep costs under control. It’s a good value, not a freebie. And that’s good enough.
Rick Newman is the author of four books, including “Rebounders: How Winners Pivot from Setback to Success.” Follow him on Twitter: @rickjnewman. Confidential tip line: firstname.lastname@example.org. Encrypted communication available. Click here to get Rick’s stories by email.