Team Clinton decides that “Medicare for all” is Actually Bad

During the last Democratic debate, Hillary Clinton took a shot at Bernie Sanders’s domestic policy agenda by citing a thoroughly-discredited price tag pulled straight from the Wall Street Journal:

But I want to quickly say, one of the areas that Senator Sanders touched on in talking about education and certainly talking about health care is his commitment to really changing the systems. Free college, a single payer system for health, and it’s been estimated were looking at 18 to $20 trillion, about a 40 percent in the federal budget.

$15 trillion of that “18 to $20 trillion” figure comes from single-payer health care, and it’s true that an analysis of legislation Sanders proposed in 2013 that would have enacted a single payer system came up with that level of government spending over a ten year period. Nationalized health care is expensive.

However, it’s a lot cheaper than private health care, which is currently on track to cost the American people close to $42 trillion over the next ten years. That’s why the analysis from which both Clinton and the Wall Street Journal get their eye-popping price tag is titled “How we can afford a national single-payer health plan.”

Sanders said as much during the debate, and multiple journalists said as much afterward. It didn’t matter. Since then, Clinton and her campaign have repeated and escalated their attacks on single-payer health care. Now, not only is Sanders’s plan to lower American health expenditures nearly two thirds too expensive, his universal health care plan will actually result in fewer Americans having access to health care. From MSNBC:

The Clintons on inauguration day, via Wikimedia Commons

The Clintons, via Wikimedia Commons

Stumping for her mother for the first time in 2016 on Tuesday, Chelsea Clinton directly criticized Bernie Sanders on health care policy, echoing Hillary Clinton’s recent attacks on the Vermont senator.

Asked about mounting enthusiasm for Sanders among young people, the daughter of the Democratic presidential frontrunner urged younger voters to focus on the “specifics” of Sanders’ policy proposals.

Sen. Sanders wants to dismantle Obamacare, dismantle the CHIP program, dismantle Medicare, and dismantle private insurance,” she said during a campaign stop in New Hampshire. “I worry if we give Republicans Democratic permission to do that, we’ll go back to an era – before we had the Affordable Care Act – that would strip millions and millions and millions of people off their health insurance.

Focusing on the “specifics” of Sanders’s proposal for single-payer health care would require Clinton to disclose that after dismantling Obamacare, CHIP, Medicare and private insurance, all of those things would be replaced by what Sanders has consistently described as “Medicare for all.” Instead, she’s found a different way to make the same kind of disingenuous claim about the consequences of single payer. On the cost side, Clinton’s camp zeroes in on everything that happens after the new system is implemented, ignoring the savings realized by eliminating the existing system. On the benefits side, Clinton’s camp ignores everything that happens after the new system is implemented, zeroing in on all of the benefits Americans currently receive. In neither case is the plan considered as a whole — perhaps because 81 percent of Democrats (and 58% of all US adults) support the idea.

The Clintons’ claim that Sanders’s proposal kicks health insurance back to Republican controlled states is also wrong. The legislation Sanders proposed in 2013 would require every state to set up their own single-payer system under a federal umbrella, which Clinton has used to claim that — a la Republican states’ refusal to set up health insurance exchanges or accept the Medicaid expansion under Obamacare — Sanders’s bill opens the door for millions of Americans in red states to be denied health insurance. As The Week’s Ryan Cooper responded today, this is bunk:

[Sanders’s bill] would require each state to set up its own single-payer plan, and fold all existing federal health care programs, except for Veterans Affairs, into that system. While one might criticize that structure…it is emphatically not optional. Under his plan, a federal board will oversee the system as a whole and take direct control of any state program that doesn’t meet its requirements.

This makes red state non-compliance with Bernie’s plan less like the Medicaid expansion and more like insurance exchanges. Republican governors couldn’t massively resist the program, they would simply face the choice of setting up their own program or folding in to the federal government’s version. Everyone would be covered one way or another.

As Paul Waldman wrote in the Washington Post today, if Clinton wants to hit Sanders over single-payer, there are more honest and, frankly, more popular ways to do it. Given that Democrats are practically guaranteed to have a minority in the House and, at best, a majority in the Senate that can’t break a filibuster, there is absolutely no hope for Sanders’s single-payer plan to become a reality. So Clinton could say that she’s on board with Sanders’s ideals, but that’s all they are: ideals. She could say that she lives in the real world, and is interested in actually passing legislation that expands access to health care — however incremental that legislation may be. That may not sound exciting to the progressive base, but they’d probably shrug their shoulders and count it as an acceptable disagreement.

That isn’t what she’s done, though. From Waldman:

She’s making a second kind of argument, that single-payer is itself a bad idea — not that we might like to do it but we can’t, but that it fails on the merits.

To oversimplify a bit, the first argument is one you make to Democrats, and the second argument is one you make to Republicans, and maybe to independents. But we’re in the middle of a primary.

This back-and-forth over whether truly universal health care is good, or whether it’s Actually Bad, is part of the broader debate emerging between Sanders and Clinton over whether taxes can ever be good, or whether they’re always bad. By making a big deal out of single-payer’s price tag, Clinton is implying (correctly) that single-payer costs too much to fund solely through taxes on the wealthy. Ordinary Americans will have to give more money to the IRS in order to make it happen. Sanders is fine with this, and is betting that most voters will be too so long as that extra money they give to the IRS is less than the money they no longer have to give to their private insurer.

This argument is all but guaranteed to come up on Sunday at the next democratic debate. And both candidates think it’s an argument they can win. Clinton will just have to bring Republican talking points to a Democratic debate in order to do so.


Jon Green graduated from Kenyon College with a B.A. in Political Science and high honors in Political Cognition. He worked as a field organizer for Congressman Tom Perriello in 2010 and a Regional Field Director for President Obama's re-election campaign in 2012. Jon writes on a number of topics, but pays especially close attention to elections, religion and political cognition. Follow him on Twitter at @_Jon_Green, and on Google+. .

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25 Responses to “Team Clinton decides that “Medicare for all” is Actually Bad”

  1. angryspittle says:

    I understand your concerns. But i believe that Medicare for all and flat out eliminating the goddamn bloodsucking insurance industry completely from the picture, giving the government the power to negotiate drug prices, have it pay 100% instead of 80 etc. etc. would be expensive but not any more so than it is now. I wold rather have my taxes go up by 300 or so a month and be relieved of dealing with those bastards at all. AARP would be pissed because they ARE an insurance outfit as well. I pay over 300 right now for AARP/State supplementals now. There are lost of things to explore and consider and I don’t claim to have the answer to everything but I do believe going in that direction would benefit all. A friend broke an ankle in France and was taken care of, surgery and everything, and when asked what she owed they told her nothing! There is no reason “The Greatest Country on earth” couldn’t do the same thing.

  2. NYCrocks says:

    I’m also a recent Medicare enrollee. I do like that the paperwork is simpler. But what I don’t like is that I’m very limited by a prescription drug plan that only allows me to have less than $3000 worth of prescription drugs in a year and then I have to pay for them all myself for another $2000 if I go over that $3000 limit. If your doctor wants you to take any name brand drug it’s going to be too expensive and Medicare won’t pay for it, at least not for a whole year. When I had insurance I could get whatever drug I needed it’s my deductible was satisfied. I also have an AARP supplement and with the cost of Medicare and the supplement I pay over $400 a month. That’s no great big savings over private insurance as far as I’m concerned. I didn’t pay much more for insurance and I got a lot more. Of course the cost going to go up on both sides. If they would just change the prescription drug plan to allow for more value without the entire cost going to the patient in the coverage gap or if Medicare paid 100% of your healthcare costs instead of 80%, I would like it a lot better. I’m not retired yet, and I’m getting disability and that’s why am on Medicare. My income is drastically lower than when I worked. I don’t know how the government expects seniors or disabled people to be able to afford to pay $400 a month for their health insurance when they’re not even getting $2000 a month from Social Security. It’s a rip off.

    Medicare for all is going to be a lot more expensive than people think and nobody’s talking about the actual cost to the patients. They’re only talking about the government costs and how insurance companies fail. The real problem with medicine this country is the costs are ridiculously overinflated to begin with.

  3. Tired_of_poor_healthcare says:

    So trillions for wars. But not health care or education… shows where HRC priorities are.

  4. angryspittle says:

    As a recent enrollee with medicare (67 years old) I have to say it is a hell of a lot simpler than dealing with the insanity of insurance companies. When I show up for a dr. apt. or at the emergency room I just show my medicare and aarp supplemental and bingo, done deal. I remember, before I was on medicare, one time in the emergency room when I was in clear medical crisis and having to sit a fill out all sorts of shit before being admitted or even seen by any personnel and I could hardly sit up straight or write….The current system sucks.

  5. angryspittle says:

    Desperation. Pure and simple. And also shameful.

  6. 2karmanot says:

    Down with Hills….GO BERNIE!

  7. 2karmanot says:

    Exactly so

  8. Butch1 says:

    Unfortunately, I learned about Obama after I voted for him the first time. I didn’t make that mistake the second time; I voted for an Independent, a real Liberal.

  9. Butch1 says:

    I use the VA health-care system and it’s quite good. Appointment scheduling take a little time, but unless it’s an emergency that’s not a problem. If I have a real emergency I go to an ER and when I’m admitted, I notify the VA within 72 hrs of admission and the bill will be taken care of. If I want to see my “out-side of the system” physician, I can use Medicare/Medicaid Card like every other senior.

  10. Butch1 says:

    Well, well . . . the centrist-republican is finally coming out in her. She’s not the Progressive that she pretends to be. Bernie Sanders needs to immediately pounce on this. Perhaps as we approach the election she will reveal more about who she really is. I hope so. I do not want another Obama clone in office. We need this country to swing more to the left in the Oval Office (and in the Congress if we can get some real progressives in both the House and Senate for a once)

    These same old Democrats will continue to repeat the same old mistakes and continue to tack to the right with the rest of the Republicans. They will also, want to COMPROMISE with them. We have already given up too much. With new liberal blood, there will be no more compromises with these fascists who do Wall Street’s bidding. This is the way it really has to be if there is going to be any real change.

    We’ll have to see how they handle the Sunday debate: “Clinton will just have to bring Republican talking points to a Democratic debate in order to do so.”

    As a Centrist-Democrat, this should be very easy for her. (She’s been pretending to be a progressive-democrat since she entered the race.)

  11. Houndentenor says:

    There was an interesting moment last fall when Sanders went to Liberty University to speak and take questions from the audience. He was open and candid, things politicians rarely are especially in front of a potentially hostile audience, a situation almost no national politician would agree to. At one point he was talking about high tuition and the high interest rates on student loan debt and he got thunderous applause. Now if anyone in either party were smart, they would have heard that and responded. That was an amazingly good opportunity for a Rubio or Kasich to score huge points with both parents and students concerned about tuition and debt. Did anyone do that? No. And why not? Because the donor class could give a fuck about student loan debt since it doesn’t affect them at all. And that, right there, is what’s wrong with our politics. An issue that clearly resonates with CONSERVATIVES who are of voting age is ignored by the party because they don’t care about real Americans, only the people who are bribing them.

  12. Houndentenor says:

    What we are seeing in both parties is a large number of primary voters angry at the party establishment and well they should be. Why the establishment of both parties is doubling down rather than addressing these problems is a symptom of a problem that both parties listen to a few people (mostly wealthy donors) and ignore everyone else except when delivering an empty platitude they think will make us happy. It doesn’t.

  13. Houndentenor says:

    I’ve met Hillary actually. I like her as a person. I do think she’s stuck in the 90s. I loved the 90s. If I could live my whole life in the 90s I would but that era is over and not coming back. She seems out of touch with most of the country and that’s understandable. It happens to everyone at that level but lecturing me as if I’m an ignorant child because I ask reasonable questions about policy and her record is annoying. Her supporters just want us to ignore some obvious problems like her Iraq War vote, her coziness with Wall Street and her less than enthusiastic support of gay rights until everyone else had already gotten on board (at least the Democrats). At least address my concerns if you want my vote. Screaming “so do you want Ted Cruz instead” doesn’t help. If she’s the nominee I will vote for her. Actually I’d prefer her among the choices if it weren’t for this doubling down on past mistakes and blaming people who bring them up when they are legitimate issues. Also, this antagonistic approach to the press and anyone who isn’t kissing her ass is troubling as well. She’s almost as bad as Donald Trump in that regard. If people want Hillary to be the nominee and win the general someone needs to have a “come to Jesus” talk with her about how she addresses serious concerns.

  14. Houndentenor says:

    I have been against single payer my whole life. Not any more. We’ve been talking about this for over 50 years and the health care system as it applies to most Americans has gotten worse and more expensive during that time. Look in the office window the next time you go to your doctor’s office. Most of the people working there are trying to get things billed correctly to multiple insurance companies who do their best to avoid paying. It’s a nightmare dealing with this nonsense. How could single payer be worse even if it’s not any better?

    If people against single payer want to avoid us adopting that model, they need to start making the existing system work. Demonizing and fearmongering are no longer convincing, at least not to me. is it too much to ask that I be told what I’m going to be billed for BEFORE the procedure happens rather than get a bill for hundreds of dollars months later? That’s bullshit and we wouldn’t put up with it in any other industry. It’s time to stop tinkering with our broken system and chuck it and start over. If I’m wrong, prove that to me by fixing what is broken. If that were a possibility, though, why hasn’t it already happened?

  15. tigerp says:

    Chelsea belly-flopped first time from the high dive, seems to me ~ all of the under 30 voters I know personally are Feeling the Bern big time ~ with plenty of thanks to the universal health care idea, among others

  16. Don Chandler says:

    That’s why I want Bernie.

  17. BeccaM says:

    I know. Just pisses me off to no end to see HRC basically retreading her husband’s campaign strategies. I mean, the Dems cannot win any more simply by being the lesser evil and depending on votes against the GOP candidates. They need to make people want to get out and vote for something, not just against the alternative.

    Even though he fell down on the delivery part, Obama understood this in ’08. But once again, the establishment Democrats play to lose.

  18. hidflect says:

    Hillary’s donors have made her position on this very clear.

  19. Don Chandler says:

    Doesn’t matter who wins, the GOP will sink to new lows in the department of calumny.

  20. TheAngryFag says:

    When will people learn, Hillary Clinton is NOT a progressive. She’s a Corporatist like her Husband was and Obama is. Period.

    I am seeing a lot of outrage right now on social media about how those evil Republicans are so aweful because they repealed the mandatory labeling of meat with the country of origin. Mad about it? Redirect your anger to Bill Clinton because it was a treaty negotiated during his presidency that forced the repeal. Republicans didn’t do it out of spite or some gift to the meat industry. It was in response to getting sued in a corporate court set up in the General Agreement on Tariffs and Trade handled by the World Trade Organization. Mexico and Canada sued claiming the law was a barrier to trade. And guess what happens when corporations sue in a corporate court? They always win. So the law had to go or else the US would face billions in sanctions.

    And Obama wants to make this worse with his Trans-Pacific Partnership.

  21. BeccaM says:

    Jeebus…this woman seems determined to make it as hard as possible for me to vote for her if she’s the Dem nominee. All that’ll be left by time she’s done with her neo-liberal center-right pro-corporate triangulation is voting against the greater evil (aka ‘any GOP nominee’).

    I’ll be honest though and admit that with Sanders I hope we’re not seeing a potential McGovern repeat. Popular with the Dem base, but not with anybody else, especially after the GOPers start painting him as a communist.

  22. UncleBucky says:

    PHFFFFT.

    SINGLE PAYER UNIVERSAL. Medicare E for Everyone.

  23. 2karmanot says:

    Clinton is bad medicine!

  24. basenjilover says:

    First and foremost, the Clintons are CORPORATISTS and cannot be trusted. She will always side with the bankers and oil industries.

  25. nicho says:

    Not a good day for Team Clinton. First, MoveOn members voted 79 percent to 14 percent to endorse Bernie over Hillary. And polls from NH show Bernie with a commanding — and growing — lead among likely voters, even women. I guess it was time to unleash Chelsea to muddy the waters.

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