Top Economist Robert Pollin Answers Key Questions on the Emerging Divide Between Sanders and Warren on Medicare for All

Democratic presidential candidate Sen. Bernie Sanders (I-VT) (L) and Sen. Elizabeth Warren (D-MA) embrace after the Democratic Presidential Debate at the Fox Theatre July 30, 2019 in Detroit, Michigan. (Photo: Justin Sullivan/Getty Images)

Top Economist Robert Pollin Answers Key Questions on the Emerging Divide Between Sanders and Warren on Medicare for All

"I clearly don't think it is premature to have detailed discussions on funding Medicare for All," says co-author of 200-page study on that exact subject. "How Sanders or Warren should handle the matter politically is another matter."

Economist Robert Pollin, co-director of the Political Economy Research Institute (PERI) at the University of Massachusetts at Amherst, admits there is no "perfect way to fund" Medicare for All but he remains on a mission to explain why simplicity is key when it comes to building a more efficient, more humane, and less costly alternative to the current for-profit status quo.

Despite a detailed economic analysis he and his PERI colleagues put out last year--presented in a 200-page study titled "Economic Analysis of Medicare for All," which examines the costs and benefits of legislation introduced in Congress by Sen. Bernie Sanders of Vermont in 2017--Pollin remains frustrated by the failure of many to grasp, or be honest about, the clear benefits of a single-payer system.

"The biggest thing that Americans will be enjoying will be something that is already being enjoyed in other advanced economies--i.e. guaranteed access to good-quality health care when one needs it, and getting the needed care without worrying about whether one can make all the various kinds of insurance payments."
--Prof. Robert Pollin, PERI/UMass
A proposal like the one put forth by Sanders in 2017, says Pollin--as well as the updated version now in the Senate as "The Medicare for All Act of 2019" (pdf)--will drive down healthcare costs for the United States overall even as everyone in the nation enjoys full and expanded coverage; even as utilization of care goes up; and even as no family ever again faces financial ruin due to tragic injury or unexpected illness.

The conversation around Medicare for All has been a focal point in the 2020 Democratic presidential primary and with leading progressives like Sanders and Sen. Elizabeth Warren facing off against their more centrist top-tier rivals Joe Biden and Pete Buttigieg who oppose it, Common Dreams asked Pollin for his perspective on some of the key facets of the current debate.

The healthcare issue will almost certainly come up during Wednesday night's Democratic Debate, hosted by NBC News, and candidates will once more try to make their case on the direction the country must take to address the crisis of medical bankruptcies, skyrocketing drug costs and insurance premiums, and the fact that tens of millions in the U.S. remain uninsured or underinsured.

Sanders has long been recognized as the nation's leading political champion of Medicare for All, but Warren--who has repeatedly said "I'm with Bernie" on his plan--has, in recent weeks, carved her own path by offering alternative approaches regarding key implementation issues. At the beginning of the month, Warren put a detailed "pay-for" funding plan for Medicare for All in which she claimed that unless you are "in the top 1%, Wall Street, or a big corporation--congratulations, you don't pay a penny more and you're fully covered."

Sanders, on the other hand, has admitted that under his approach taxes would go up for some (but not all) middle class and working families, but that without copays, deductibles, and higher costs of care--they would come out way ahead financially and in terms of security. While Warren's financing plan received praise by many, it also raised flags for some longtime single-payer activists and policy experts who warn that her funding approach is more regressive than what Sanders has put forth. In an interview with ABC News on Nov. 3, Sanders said his plan was "much more progressive" than what Warren is proposing.

Last week, Warren unveiled a separate transition plan for Medicare for All, which once again drew both praise and condemnation from progressive observers and experts. One of the key criticisms was that Warren will essentially move, if elected, to institute a public option styled on Medicare at the outset of her term and then subsequently--no later than her third year in office, she said--would push for Medicare for All.

"Nobody is purveying more nonsensical double-talk around Medicare for All than Biden."

With Buttigieg and Biden both attacking Medicare for All with talking points that sound a lot like the ones put forth by the insurance and pharmaceutical industries (not to mention Republicans), Pollin says clarity on key matters is needed now more than ever. Despite nearly two dozen interviews with journalists this month, he lamented, many continue to get the big picture of the story wrong.

Having done extensive research on Medicare for All, the Green New Deal, and the minimum wage--all key issues in the current primary--Pollin has become a highly sought after economist lawmakers and campaign policy shops. As such, he has provided input to both the Sanders and Warren campaigns in recent months, though he is not backing either candidate nor has he served in an official capacity for their campaigns.

In his interview with Common Dreams--a back and forth exchange which took place via email over recent weeks--Pollin explained that he was "just offering ideas as Bob Pollin, economics scribbler, with nothing politically at stake" for either himself or his fellow researchers at PERI. "I hope that this discussion helps clarify questions for lots of people," Pollin said, "and also helps give an additional boost of confidence to Medicare for All supporters, against this relentless onslaught of outrageous attacks." Pollin had choice words for both Buttigieg and Biden.

In order to get to the heart of understanding the economics of Medicare for All, he said, what's needed most--beyond understanding the basic concepts of cost-savings--is being "open-minded in weighing the relative strengths and weaknesses" of the various ways such a proposal can be funded.

"As for the financing plan, you can almost put mine on the back of a matchbook."

There are many important details to work through, says Pollin, but he wants people to understand there is a very simple bottom line: The United States of America can "deliver good-quality universal health care" to all its residents for less overall cost than we are doing now. Period.

"As for the financing plan, you can almost put mine on the back of a matchbox," Pollin said, even as he recognized that the intense political battles ahead will be anything but simple.

If and when Medicare for All is achieved, he notes, "The biggest thing that Americans will be enjoying will be something that is already being enjoyed in other advanced economies--i.e. guaranteed access to good-quality health care when one needs it, and getting the needed care without worrying about whether one can make all the various kinds of insurance payments."

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