Robert Reich:
"The Tax Policy-Brookings Center has just come out with another report on Bernie Sanders's economic agenda (see below), claiming it will increase the federal deficit by $18 trillion, mostly due to Bernie’s single-payer healthcare plan. This assumes a single-payer plan will deliver health care at the same cost as our current private for-profit system, and Americans therefore will be no healthier because of it. In fact, as the experience of almost every other advanced nation shows, a single-payer plan is far cheaper and promotes better health. America pays more for health care (almost 18 percent of our entire GDP) than any other modern economy yet continues to lag almost every other advanced nation in health outcomes.
The fact that so-called “left of center” establishment think tanks continue to put out this misleading analysis suggests either (1) their analysts don’t know the effects of single-payer plans in other nations, (2) their major financial backers don’t want a single-payer plan in the U.S., or (3) they want to continue to discredit Bernie.
I don’t believe it’s (1). What do you think?"
The healthcare industry is second to Wall Street in lobbying, so I don't want to completely discount (2) and (3), but (1) is just plain misleading. It implies that Sanders' plan will quickly give the full benefits that other countries reap from having a single payer plan. If it was structured to begin with prices comparable to those single-payer countries pay, American healthcare expenditures would shrink from 16% of GDP to 8% or so. To say that would be disruptive is an understatement, aside from the fact it would never ever fly. I don't think its an exaggeration to say that the short run costs of this disruption would outweigh the medium run cost savings, with the long run cost savings being similar whether prices were negotiated down over time or immediately lowered.
"... While liberalism has often loathed the right, it hasn’t always been sufficiently attuned to the shape-shifting power of the right. Its attentions have too often been focused in the other direction, so fraught has been its relationship to the left. Till it was too late.
The left has not been entirely blameless in this. It, too, has been engaged in a two-front war: against liberalism and the right. On the ground, and in the streets, the left has understood the power of the right, but up in the chambers of political theory, intellectual debate, and elite party argument, the left has sometimes, and catastrophically, construed liberalism (or its positional surrogate on the ideological spectrum) to be its greatest and only enemy. Even at a moment like the present in the United States—when liberalism, at least as it has been historically understood in the United States, has been in abeyance, or at best, has played second fiddle—the left has tended to focus on the power and betrayals of liberalism ..."
"The Tax Policy-Brookings Center has just come out with another report on Bernie Sanders's economic agenda (see below), claiming it will increase the federal deficit by $18 trillion, mostly due to Bernie’s single-payer healthcare plan. This assumes a single-payer plan will deliver health care at the same cost as our current private for-profit system, and Americans therefore will be no healthier because of it. In fact, as the experience of almost every other advanced nation shows, a single-payer plan is far cheaper and promotes better health. America pays more for health care (almost 18 percent of our entire GDP) than any other modern economy yet continues to lag almost every other advanced nation in health outcomes.
The fact that so-called “left of center” establishment think tanks continue to put out this misleading analysis suggests either (1) their analysts don’t know the effects of single-payer plans in other nations, (2) their major financial backers don’t want a single-payer plan in the U.S., or (3) they want to continue to discredit Bernie.
I don’t believe it’s (1). What do you think?"
The healthcare industry is second to Wall Street in lobbying, so I don't want to completely discount (2) and (3), but (1) is just plain misleading. It implies that Sanders' plan will quickly give the full benefits that other countries reap from having a single payer plan. If it was structured to begin with prices comparable to those single-payer countries pay, American healthcare expenditures would shrink from 16% of GDP to 8% or so. To say that would be disruptive is an understatement, aside from the fact it would never ever fly. I don't think its an exaggeration to say that the short run costs of this disruption would outweigh the medium run cost savings, with the long run cost savings being similar whether prices were negotiated down over time or immediately lowered.
A good comparison for how American healthcare costs might change is Switzerland's experience, even though the country doesn't have a single-payer system. Paul Pierson:
"... In 1980, Switzerland and the United States had comparable per-capita spending, but Switzerland then moved more aggressively to control costs (as well as expand coverage to all citizens). Thirty years later, the Swiss are spending about a third less per person than we are. That may not seem impressive; Switzerland spends substantially more than other European nations. Yet had the United States followed the same trajectory since 1980, Americans would have collectively saved a whopping $15 trillion—enough to finance a four-year college degree for more than 175 million Americans, or have eliminated all federal deficits over the same period, with room to spare ..."
"... In 1980, Switzerland and the United States had comparable per-capita spending, but Switzerland then moved more aggressively to control costs (as well as expand coverage to all citizens). Thirty years later, the Swiss are spending about a third less per person than we are. That may not seem impressive; Switzerland spends substantially more than other European nations. Yet had the United States followed the same trajectory since 1980, Americans would have collectively saved a whopping $15 trillion—enough to finance a four-year college degree for more than 175 million Americans, or have eliminated all federal deficits over the same period, with room to spare ..."
I'm not trying to argue for gradualism, but I do want to point out that policy changes can have dramatic effects without containing aggressive actions that attempt to force quick results. Moreover, I disagree with Reich's approach to issues like these.
Now, the Tax Policy-Brookings Center analysis isn't perfect, and I think Reich is justified in his criticism that they don't sufficiently include cost savings. The authors themselves recognize their 0.5% reduction in cost growth might be too low. However, I don't understand why Reich didn't write a post disagreeing with their conclusion based on a criticism of their methodology - and the disagreement could be passionate and the criticism vehement - instead of implicitly questioning their morals and motives and grossly over promising the short run rewards of a switch to a single payer system. He could have written a very convincing argument, perhaps quoting them on how their cost saving estimate could be low, chastising them for such conservative estimates. Instead, he portrayed them as corrupt.
The same afternoon Reich posted a short status bemoaning the hostility between Sanders' and Clinton's supporters in the comments of his posts. He said they can disagree but should be united against Trump. This magnanimity towards Clinton and her supporters, embodiments to many of the "left of center", is at odds with his rhetoric. This is reflective of the Sanders' group think, in which one can portray the liberal institutions and individuals around and of the Democratic Party as corrupt while simultaneously and falsely claiming the moral high ground of factual honesty and leftist unity.
"... While liberalism has often loathed the right, it hasn’t always been sufficiently attuned to the shape-shifting power of the right. Its attentions have too often been focused in the other direction, so fraught has been its relationship to the left. Till it was too late.
The left has not been entirely blameless in this. It, too, has been engaged in a two-front war: against liberalism and the right. On the ground, and in the streets, the left has understood the power of the right, but up in the chambers of political theory, intellectual debate, and elite party argument, the left has sometimes, and catastrophically, construed liberalism (or its positional surrogate on the ideological spectrum) to be its greatest and only enemy. Even at a moment like the present in the United States—when liberalism, at least as it has been historically understood in the United States, has been in abeyance, or at best, has played second fiddle—the left has tended to focus on the power and betrayals of liberalism ..."
We need better leftists.
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