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How to Pay for Medicare-for-All

The way to make the legislation work is to isolate the sources of the most hideous and immoral waste in the healthcare system and concentrate the pain on them.

Supporters of U.S. Sen. Bernie Sanders (I-Vt.) hold signs during an event on healthcare September 13, 2017 on Capitol Hill in Washington, D.C. (Photo: Alex Wong/Getty Images)

Medicare-for-All sounds great, but how do we pay for it?

In a normal country, the answer would be simple — just raise taxes. But in the United States, healthcare is so outlandishly expensive that the simple solution is anything but. Where Austria or Finland would be assured that a modest tax hike could (and did) cover everyone, America has to grapple with a bloated healthcare sector eating up over 17 percent of GDP — nearly 5 points (or about $1 trillion) greater than Switzerland, the second-most expensive country.

As Jon Walker argues, this reality forces Medicare-for-all advocates into one of two basic choices, neither of them easy:

1. Swallow the huge costs, shove through a really big tax hike, and hope that people will understand the taxes-for-premiums swap.

2. Try to cut costs, and keep the tax increase modest, but tempt the wrath of the medical lobby.

Some tax increases are certainly inevitable. But the second choice is by far the best, on grounds of both practical policy and politics.

When writing a Medicare-for-All bill, it is critical for legislators to understand that traditional Democratic logrolling — in the form of policy carveouts for powerful interest groups — will create more problems than it solves. The way to make the legislation work is to isolate the sources of the most hideous and immoral waste in the healthcare system and concentrate the pain on them, so as to provide a really excellent benefit for the broad population with a minimum of necessary new taxes.

Read the full article at The Week.

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Ryan Cooper

Ryan Cooper

Ryan Cooper is a national correspondent at TheWeek.com. His work has appeared in the Washington Monthly, The New Republic, and the Washington Post.

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