Paying for Privatized Governance Is Still a Tax

Over the last couple of weeks, there has been a significant non-troversy over presidential candidate Sen. Warren’s refusal to state if ‘middle class people would see a tax increase’ (the phrasing is often different, but the idiocy remains constant). Leaving aside the reality that ‘middle class’ has no defined practical meaning in a political context, it’s still a stupid point. That said, Warren’s response wasn’t good, and she needs to up her game here.

After all, as some asshole with a blog Twitter feed noted, “Paying for privatized governance is still a tax.” It isn’t hard to make that point–Warren has done that with statements like this:

So the way I see this, it is about what kinds of costs middle-class families are going to face. So let me be clear on this. Costs will go up for the wealthy. They will go up for big corporations. And for middle-class families, they will go down. I will not sign a bill into law that does not lower costs for middle-class families.

Unfortunately, she is unwilling to say something along the lines of “the taxes you would pay under our system will less than the amount you currently pay private insurance payments and your payroll taxes that pay for Medicare and Medicaid.” (there are professional wordsmiths who can clean this up).

But more importantly, Medicare-for-All (M4A) advocates need to hit back with several questions of their own:

  1. Why don’t you tell the truth and say “You can keep your plan if your boss & insurer let you? If you can no longer afford your current healthcare insurance (and stop calling it a ‘plan’; insurance has more negative connotations), you won’t lose your healthcare, or your doctor. Under our plan, your employer can’t control what doctor you will see, or even if you will have healthcare. A healthcare premium is a private tax paid to a largely unaccountable corporation for something you can’t live without.
  2. Why are you negotiating against yourselves and not Republicans? If you really do believe that M4A is a step too far, and we need bold incrementalism, why not move farther towards M4A and meet Republicans in the middle, as opposed to doing what Democrats like Biden have done for decades, which is start with the compromise solution, and then wind up with something worse?
  3. How many will still die from lack of insurance under your plan? There’s no reason to be nice about this. When they say it’s too hard, make them spell out in flesh and blood terms what that means. If they are in the position to propose a healthcare plan, how many people are they willing to consign to needless death as their starting position? (see above)

The last point is critical here. M4A supporters have spent too much time arguing about how we pay for it, and not enough time emphasizing the carnage (Sanders, to his credit, is trying to do this, but very few are following his lead). Our healthcare insurance system kills the equivalent of a 9/11 massacre every 3-5 weeks. If terrorists were murdering people on that scale, would we be worrying about whether we ran deficits? Of course not. We would spend what we need to spend to stop the carnage. If asked how do you pay for it, I usually respond with something like, “The same way Republicans have paid for their stupid wars and tax cuts for the rich”, followed with “First, we need to stop the dying“:

What infuriates me is that, for the past quarter century or so, balancing budgets has taken priority over providing things we need (never mind providing nice things we want).

We’ve now reached the point where tens of thousands of people die needlessly every year due to inadequate healthcare. Many more suffer and are immiserated. People die because they can’t afford insulin. To use a prominent local politician’s phrase, our healthcare system, despite its overall expense, is inflicting massive American Carnage. This is a full scale emergency.

We need to staunch the bleeding.

We need to stop the dying.

First order of business must be providing healthcare to all. If we stipulate that everything must be paid for up front, it will be nearly impossible to stop the dying. Inflation might rise if we don’t have a payment mechanism, but we have ways to deal with that through both fiscal and monetary means. Yet we know, with near certainty, that if nothing changes, this year, and the next, and the year after that, people will die needlessly.

That is the crisis. The potential hit to after-inflation returns on unearned income pales by comparison.

People think in narrative and normative ways, and M4A advocates need to do a better job speaking in those terms. Then point out that they’re still paying a tax, just to a private corporation.

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3 Responses to Paying for Privatized Governance Is Still a Tax

  1. This under your point number 2 is particularly infuriating: “as opposed to doing what Democrats like Biden have done for decades, which is start with the compromise solution, and then wind up with something worse?” Why do they do this? Are they actually that incompetent? Do they not want to win? Do they wish they were republicans?

    • Mr grumpy says:

      They do it because their jackass consultants constantly feed them the myth that the public is much more conservative than they actually are.

  2. Rick Cooley says:

    Reblogged this on Rcooley123's Blog and commented:
    Another great essay from Mike the Mad Biologist addressing the endless debate concerning how to pay for Medicare for All. The bottom line is not whether we will all have to pay more in taxes. Rather, the bottom line will be how much we are paying for health care, who is served under the new system that is not currently covered and how many will live who otherwise would have died without adequate care.

    Making a big deal about having to pay more taxes downplays the fact that your tax dollars will get more people better care than similar private insurance has been providing for the same overall cost. Democratic debates to this point have not done a particularly good job of explaining this. Mike does. My intro doesn’t do the essay justice. I invite all to read it for yourselves and make up your own minds which plan makes the most sense. – rjc

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