Well, that was fast.
Donny and Chucky and Nancy are now BFFs. And Donny is in a good mood because he got some good press; Chucky and Nancy said nice things about him, and he thinks he may have put one over on Mitch McConnell. In the meantime, the Resistance (remember them) is about to snuggle up to Donny because they may get to keep the spending machine cranked up for as long as the eye can see. Or the creditors ask for their money back, which may be sooner than anyone thinks. Especially the borrowers, who seem to think that there is an endless supply of free money out there.
Meanwhile Bernie Sanders (Democratic Socialist, VT) has introduced legislation for mandating a “single-payer” Medicare for all scheme. One of its truly unique features is that it is even more boneheaded than Obamacare, which is quite a feat when you think about it. At last count 16 Democratic Senators (not yet declared Socialists) were on board as co-sponsors of the measure, largely because when they look in the mirror they see a President.
When Senator Sanders last ventured into this territory he was in the middle of his ill-fated attempt to wrest the Democratic Presidential nomination away from Lady Clinton. The Urban Institute, hardly a den of right wing extremism, did a fiscal analysis of his plan. Normally these green eyeshade affairs are fairly dreary but this one is a real thigh slapper. The Urban Institute found that, all told, Sander’s plan would increase federal spending by about $32 trillion from 2017 through 2026. That is trillion with a capital T.
Sander’s tax proposals would raise an estimated $15 – $16 trillion leaving him about $15- $16 trillion shy of “paying for” his plan. The Urban Institute estimates that state and local spending would drop by about $22 trillion, and private spending would fall about $4 trillion, still leaving a deficit of $6 trillion after making the heroic assumption that for the first time in history the plan would cost what its sponsors say it would. This also makes the patently absurd assumption that the gargantuan tax hikes needed to finance this monstrosity would not have a negative impact on economic growth.
But the economics are the least of it. The heart of the problem is that single payer means, well, single payer. There would be no competition. None. Government would essentially fix the prices it would pay for health care services by executive fiat. Health care professionals would not be able to offer services on their own, because government would be the monopoly supplier. (Technically government would be a monopsony, and would control the system by acting as the sole buyer of health care services.)
The next step is rationing care. This would take the form of the bureaucracy (not your doctor) deciding who gets what services based on cost-benefit analysis. Inevitably that means that older patients will be tossed overboard because their prospective earning power is lower and life expectancy shorter than younger patients. That’s what happens in England and Canada and other places that have single payer government systems. Those patients whose governments refuse to provide treatment often come to the U.S. for treatment if they can afford to. Otherwise they just die.
Needless to say, individual freedom is essentially non-existent if the citizens are dependent on the federal bureaucracy for health care. Just ask Lois Lerner.
The conventional political wisdom is that this latest single payer plan is going nowhere. I wouldn’t be so sure. Donald Trump is quite capable of jumping on board with his new friends if they give him a fig leaf or two. After all, up until the time he launched his hostile take-over of the Republican Party, Donald Trump was essentially an outer borough Democrat (from Queens), which is what he remains. And since he is above all a committed narcissist, he will go wherever flattery leads him.
And so the question remains for the 62,979, 879 people who voted for him: Are you tired of winning yet?