Sounds great, How Are we Going to Pay for it? Universal Programs Are the Most Fiscally Prudent Option

A number of candidates for president this year have as their mantra “sounds great, how are we going to pay for it?” It’s the kind of question that seems to make a lot of sense. Whenever we add something to our personal or collective spending plan that we’re not already paying for and that is discretionary (meaning we can choose not to buy it) it makes sense to figure out how we’re going to pay for it before we add it.  For example, if we take home $5,000 a month and our current expenditures are $5,000 a month and we want to add in a weekly massage at the cost of $50 a week, we have a problem.  We need to figure out either how to bring home or $200 more or how to cut $200 a month. 

But if we are already paying for something that we absolutely need and are going to buy anyway such as health care, childcare, housing or perhaps college education and we switch to a different plan to save money so that we can better afford those things, the decision to do is can be seen quite prudent and fiscally responsible.  It is much more REALISTIC to examine how we can actually afford affordable universal healthcare than it is to engage in fear-mongering and finger-pointing at those who are trying to do exactly that.

It is beyond the scope of this humble blog to track down all the numbers and make you charts on all this.  But this is a rational deductive exercise if you think about it.  Let’s do healthcare because that’s what I know best.  We are currently collectively paying trillions of dollars in health care costs.  Working families (meaning those who live on income derived from work rather than wealth, which means most of us) shoulder a disproportionate share of the cost of healthcare.  Those of us with “employer provided” health care benefits pay for it through decreased salaries in lieu of premiums.  Those of us without those health care benefits pay for it directly in premiums.  All of us pay for it in terms of co-pays, deductibles and other out of pocket expenses for healthcare services that we need but are not deemed covered by the insurance company.   These financial expenditures by working families are largely transferred directly to health insurance companies and big pharmaceutical industry in the form of billions of dollars in annual corporate profits.  Healthcare as an industry is one of the fastest growing sectors of our society.  Currently it is as if big pharma and the private health industry is taxing working families to the tune of $10s of thousands of dollars per family per year and then making us pay more for us to access the care the care we have already paid for.  How is that something we want to hang onto?

Switching to a Medicare for All system depending on how the details are worked out could reduce or eliminate the parasitic middle man.  Instead of sending all those billions to corporate profits and shareholders, they can be distributed throughout the system to cover the uninsured, eliminate co-pays and deductibles and cost-sharing.  Every single study ever done on this has shown that there is more than enough money in the system as long as it is distributed carefully.

Medicare for All alone could result in a transfer of wealth back to individual working families of as much as $10,000 a year.  Think what $10,000 a year more could do for your family.  It would also eliminate a whole host of really stressful elements of our current patchwork “system.”  You might never have to base your job, marriage, school choices on your healthcare coverage.  Take a second to imagine the relief that could bring, the joy, the freedom.

It’s also worth noting that Medicare for All has been studied to be the single biggest cure to state and local fiscal crises.  If we had a fully funded, transparent fair universal healthcare system that accounted for all costs states and local municipalities wouldn’t have to make up the difference by eating the cost of uncompensated care.  Obamacare began to move along on that front, but we have a long way to go. 

We’re also all already going into debt to afford housing, childcare, and college education our personal and national budgets. Not all of us are parents of young or college age children at the same time but all of us were once kids and we all know that we need more advanced education to prepare for the jobs of this century.  When we call for their universality we are simply being open, honest and pragmatic about what it really takes to fund them so that everyone can pay their fair share, especially the wealthiest among us.

In short the obstacles to Medicare for All and these other universal programs could never best be expressed as pragmatic.  These programs are demonstrably the most practical and affordable way to deliver necessary services.  That's why every other developed country uses them.  The obstacles in this country have only been political.  Vested wealthy interests make billions of dollars off the hodgepodge private status quo and candidates for president and Congress have mostly been willing to be their spokespeople and to pretend that there are policy objections. 

So next time you hear someone say “Sounds great, how are you going to pay for it?”  You might want to retort, “Great question, how are we all going to pay for healthcare, childcare, housing and higher education? Because right now my family is trying to do it all virtually all by ourselves and we need help.”