What Senator Elizabeth Warren has just unveiled is less a plan to pay for the costs of Medicare for All than a plan to hide them. A massive tax on all workers, including the middle-class ones she claims to shield from new taxes, will be disguised by the fiction that it applies only to their employers — a point her own economic advisers have in other contexts shown they grasp perfectly well. In the first hours since the plan’s release, the press has indicated it is ready to go along.
Drug prices will be controlled, with consequences in reduced innovation that will cost lives and health but not appear in a ten-year budget. Payments to doctors, especially specialists, and to hospitals will be cut too. If the press covers the inevitable consequences for access to care at all, it will be presented as a she-says/he-says matter of opinion.
Warren expects increased tax enforcement to raise $2.3 trillion over ten years. The Congressional Budget Office estimates that a dramatic increase in the enforcement budget would produce . . . about one-fortieth of that amount. This part of her plan should be treated as a fudge factor and statement of political positioning, nothing more.
That’s also true of her 6 percent tax on billionaires’ wealth. It is not only many times higher than European wealth-tax rates. Assuming a 4 percent return on wealth, it amounts to a 150 percent tax on the income from it, every year.
For what purpose does Warren ask Americans to risk reduced national income and declines in access to specialty care? Why should they be prohibited from having private health insurance? It can’t be in order to cover the uninsured: There are many ways — good and bad, conservative and progressive — to expand coverage without forcing everyone into a government-run system. Is it because Americans, even those who are well-off, must be saved from having to pay deductibles and co-payments? That hardly seems like a crisis demanding a sweeping governmental response.
Warren’s plan, heavy as it is on taxes and controls, is alarming in its own right. Still more so is the ideological fanaticism it expresses.