The screaming headline on Tuesday’s Wall Street Journal reads “Price Tag of Bernie Sanders’s Proposals: $18 Trillion.” This would comprise “the largest peacetime expansion of government in American history,” the Rupert Murdoch-owned newspaper warns.
The provenance of the figure is in many ways besides the point. Readers are intended to bug their eyes out at such a massive sum, and tsk-tsk at the deeply unserious, budget-busting promises of a democratic socialist. It’s the numerical version of a smear campaign.
But how did the Journal arrive at $18 trillion? They added up the 10-year price tags of seven programs Sanders has endorsed in his candidacy for president. It turns out that $15 trillion of the $18 trillion, or 83 percent of the total, comes from just one of these programs: establishing a single-payer health care system.
The $15 trillion figure is derived from an analysis of a similar single-payer bill, H.R. 676, introduced in 2013 by Rep. John Conyers. Gerald Friedman, a labor economist at the University of Massachusetts at Amherst, conducted the analysis.
What the Wall Street Journal won’t tell you is that $15 trillion in national health spending over 10 years would represent a massive savings for the United States. Right now we spend at twice that rate for health care. According to the Congressional Budget Office, in fiscal year 2013 alone, the U.S. spent $2.8 trillion on total health expenditures, not including the $250 billion tax break employers get for providing health insurance to their workers.
Accounting for cost inflation in health care and extending that out for 10 years, on our current trajectory we would spend more than $30 trillion, compared to the $15 trillion of a single-payer plan, which would totally supplant it.
The entire point of a single-payer health care plan, aside from covering everyone in the country, is to minimize costs, by reducing administrative bureaucracy, the profit motive and middlemen. It costs far less than the current system, which spends more per capita than any developed health system in the world.
That represents a giant savings for the nation, for employers as well as individuals. Friedman’s analysis, which is literally called “How we can afford a national single-payer health plan,” makes this point repeatedly. Assuming that single-payer is paid for through progressive taxation, people would spend far less for their coverage than they do today, if the Wall Street Journal’s explicitly stated numbers are correct.
You can disagree with single-payer on the grounds that it inhibits innovation (though the jury is out on that), or that it creates long lines and rationing (again, not exactly correct). But the Journal only questioned the price tag, claiming this would be catastrophic. Actually, it would put far more money in Americans’ pockets.
Where does the rest of the $18 trillion come from? $1.2 trillion is through expansion of Social Security. Sanders already has identified a dedicated funding stream for that, by eliminating the payroll tax cap above $250,000 in annual earnings.
The other spending programs, including rebuilding the country’s infrastructure, making public colleges and universities tuition-free, paid family and medical leave, bolstering private pension funds and a youth jobs program, add up to $1.8 trillion.
For context, last week Jeb Bush released a tax cut proposal that would cost $3.4 trillion over the next 10 years. I don’t recall the Wall Street Journal headline, “Price Tag of Jeb Bush’s Tax Cuts: $3.4 Trillion,” though perhaps I missed it.
Incidentally, the analysts at Citizens for Tax Justice estimate that over half of the income tax cuts Bush proposed would go to the richest 1 percent of income earners. Nearly all of Bush’s corporate tax cuts, and the repeal of the estate tax, would go to the same wealthy cohort.
But because tax cuts are seen as magical spending that doesn’t cost anything (which is true, except for the fact that it’s false, according to those leftists at the Wall Street Journal), only one multi-trillion-dollar policy proposal gets blasted across headlines. And whereas with one, rich people get an extra zero at the end of their bank accounts, with Sanders, the money funds tangible benefits for everyone.
You can certainly argue against the political feasibility of Sanders’ programs, given the current state of Congress. In fact, Bernie Sanders would agree with you on that; it’s why his campaign is predicated on fomenting a political revolution to make the impossible more possible. You can reasonably wonder if that’s realistic. But the Journal didn’t do that; they just dishonestly and irrationally fearmongered about the cost. It’s worth wondering if that political feasibility is connected to media gatekeeping that actively opposes all but the narrowest range of ideas.