How many times should something be explained before it can be assumed the opposition is being deliberately obtuse?

Bernie Sanders, Elizabeth Warren

A top issue right now in the 2020 Democratic party primary is healthcare. While most of the developed world has moved onto socialized healthcare systems, Americans remain under a privatized one. The policy differences among Democrats on this subject boil down to two different positions. Democrats like Joe Biden and Pete Buttigieg believe we should implement a public option, which would mean those that cannot afford private insurance could buy into public insurance at a means-tested price. Bernie Sanders and Elizabeth Warren are promoting Medicare For All, which would eliminate private insurance, and make it so that every American can get health insurance regardless of whether they can afford to spend anything on it.

There is a real conversation to be had about where healthcare should be headed in this country. This fact makes it all the more frustrating that some people are still peddling poorly developed arguments against Medicare For All, some of which have already been answered repeatedly on national stages.

‘I don’t understand how you pay for it.’

Every single time there is a Democratic debate, this problem is presented to Sanders and Warren. This concern is generally framed in two ways: individual costs, and total system costs.

When the individual costs are brought up, the question is usually “Will taxes go up for the middle class?” Warren struggles to directly answer this question, but always clarifies that household costs will go down for working class people. Bernie is comfortable saying that, yes, taxes will go up, but also reiterates that household costs will go down. This is true, because what middle class Americans currently pay in deductibles, co-pays, and surprise bills exceeds what they would pay in taxes under Medicare For All.

The question of total system costs is more of an issue, but still not very much of an issue. The Koch brothers found that in some scenarios, Medicare For All would cost less in total than our current healthcare system. They found that savings could come to approximately 2 trillion dollars, since many unneeded administrative costs could be eliminated.

Healthcare Spending Per Capita

The study also presents a potential increase in care given that could lead to an approximate 3 trillion dollar cost increase, due to there no longer being barriers to uninsured or underinsured people receiving healthcare. It is worth asking whether the added care doled out would primarily go to people who superfluously schedule extra doctor’s appointments just because they can, or people who are currently not seeing doctors because they live in poverty.

An important point to make here is that even if the total cost of the system does go up, that difference would be paid for by taxes on millionaires and billionaires, who would likely still end up being able to afford their thousand dollar brunches. It is subjective whether this cost to the 1% would be worth it to prevent Americans from going bankrupt because they got cancer.

‘Medicare for all would take away 149 million people’s health insurance.’

This idea is very scary. I certainly do not want to lose my health insurance, as I have diabetes and need my insurance to be able to afford insulin. Most Americans are probably similarly frightened by this figure, and it gets repeated at every single Democratic debate.

The assertion is a half-truth. Under Medicare for all, people would lose their private healthcare plans, but they would immediately be put on Medicare instead, which would include dental, vision, and hearing care. There is no waiting period within the transition from the Affordable Care Act to Medicare For All where Americans would find themselves uninsured and carrying the burden of their uninsured medical costs. So yes, people’s health insurance is being “taken away,” but they’ll then immediately be given better health insurance, which makes the fact less upsetting.

‘Medicare For All is a socialist proposal, and this is a capitalist country.’

I would like to present some short working definitions that I use with regards to these theoretical concepts. Capitalist policy focuses more on profit incentives, and socialist policy focuses more on public benefit. People tend to mistakenly understand the issue of socialism vs. capitalism in a black and white way, and they imagine if something is one of the two, it cannot also be the other. You can prioritize public benefit while still driving a profit, and you can prioritize profit incentives while still benefitting the public.

While industry in the United States is overwhelmingly capitalist, there are still government programs that should be considered socialist. Fire departments, DMVs, and even many elements of our current healthcare system are subsidized by tax dollars to provide services for those that, otherwise, could not access them. To some extent, they prioritize public benefit, but because they are democratically recognized as necessary, they get some amount of public funding.

Socialism is a very scary idea in our society, and that’s no accident. We are constantly reminded of countries like Venezuela that demonstrate socialism‘s failures. This evidence is weak, though; other things that may have been detrimental to countries like Venezuela are not mentioned, and the successes of countries that implement numerous large-scale social policies, like Sweden and Denmark, are not often highlighted.

Democratic Socialists of America

The reason our media systems perpetuate a misunderstanding of how social programs like Medicare For All can be good for society is simple: Socialist programs redistribute the massive amounts of wealth that have accumulated at the top of our society. Everything is owned by the same class of people, and the super rich owners of legacy media systems will generally prefer not to pay more taxes. It is incredibly disappointing, though, to see the politicians vying for our votes play the same dishonest game.

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