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The $11 Trillion Question Chris Cillizza Can't Answer

The key thing to remember is that Americans already pay enough in taxes to fund a decent Medicare-for-all system — we just have a colossal amount of wasteful spending

 If anyone should be interrogated about wasted money, it is centrist Medicare skeptics and their tut-tutting media enablers. (Photo: JIM WATSON/AFP/Getty Images)

If anyone should be interrogated about wasted money, it is centrist Medicare skeptics and their tut-tutting media enablers. (Photo: JIM WATSON/AFP/Getty Images)

Fact-checkers and political reporters in the mainstream media keep bungling their coverage of Medicare-for-all. CNN's Chris Cillizza wrote a recent inquisition of Alexandria Ocasio-Cortez, savaging her for not having a fully worked-out tax increase plan, while studiously ignoring her argument that you could pay for the program by scooping up the money currently going to insurance premiums. PolitiFact gave Florida Democratic gubernatorial candidate Andrew Gillum a "half true" for accurately describing a Mercatus Center report on Medicare-for-all.

The background assumption that saturates all this garbage coverage is that Medicare-for-all would mean a large increase in spending, and, therefore, the onus is on its advocates to provide detailed explanations of how it would be paid for.

But in reality, it is the status quo which is actually hideously unaffordable and projected to get much, much worse over time. If anyone should be interrogated about wasted money, it is centrist Medicare skeptics and their tut-tutting media enablers.

First off, putting together a workable Medicare-for-all payment plan is quite straightforward, as I outlined in detail here. The key thing to remember is that Americans already pay enough in taxes to fund a decent Medicare-for-all system — we just have a colossal amount of wasteful spending. Therefore, by comparison to peer nations, I argued that an aggressive Medicare-for-all plan could save roughly $160 billion in administrative costs, $260 billion in drug costs, and $400 billion at least in cuts to bloated service prices. Taken together, that would knock about 4 points of GDP off America's wildly excessive health-care spending, leaving only a modest tax increase of $210 billion to make up the remaining gap, which could be achieved with a 2-3 percent payroll tax or some other revenue stream. Hey presto, everyone gets covered with almost no cost-sharing at all.

This is obviously not a super-rigorous way of estimating things, but with such a gigantic reform, there's really no way of knowing what will happen with any degree of precision. That's doubly true because the price tag of Medicare-for-all will depend greatly on how the system is designed — especially how aggressive policymakers will get with cost controls. But we can say that my overall spending targets — which would merely erase most of the huge margin by which the U.S. system is the most expensive in the world, leaving it still in first place — is absolutely realistic. We're talking about methods and prices that are demonstrated to work in other rich countries (plus a comfortable margin of error), not some radical, untested utopian policy.

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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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