On my Facebook and Twitter feeds, which are as far left as one can imagine, there has been a lot of chatter about Senator Sanders (I-VT) recent Medicare for All bill. Senator Sanders' bill would give Americans coverage for hospital stays, doctors visits, dental care, substance abuse treatment, and reproductive health care.
Every year, an estimated 45,000 people die because they do not have adequate healthcare coverage. There is no moral justification for a nation that refuses to provide necessary care to everyone. Universal healthcare is already the norm across the world, and even though America is a larger and more diverse country than many others that have universal healthcare, there is no reason single payer healthcare is not possible here.
Full stop. Nothing in this blog post is going to say that universal healthcare is a bad idea. In fact, it's a great idea. It's an idea long-championed by Senator Sanders that should become a reality.
So this blog post is going to explain how to do that.
Unfortunately, as long as Paul Ryan is in charge, Medicare for All is going nowhere fast. Speaker Ryan (R-WI) has been vocal about his support for entitlement reform, which means Ryan looks forward to making cuts to Medicare and Social Security. In fact, Paul Ryan has been thinking about cutting Medicare and Medicaid since he was drinking out of kegs in college.
For a not-so-brief sidebar, Speaker Ryan isn't totally wrong. Entitlement programs like Social Security, Medicare, food stamps, and programs like them make up the vast majority of our budget. Looking at the 2015 budget 64% or $2.45 trillion dollars was spent on some form of entitlements.
Democrats like to tout the idea that most of our budget goes to military, and Republicans like to tout the idea that most of our budget goes to welfare programs, but neither of those are true. Yes, spending on the military does make up over 50% of our discretionary spending, coming in at a cool $598 billion dollars. But discretionary spending in general only makes up 29% of government spending. So while we spend a lot on the military, it's not the biggest ticket item in our budget.
And we spend even less on welfare programs. Most welfare programs are contained in our mandatory spending, the big piece of the pie. But SNAP benefits make up only 4% of that spending, or around $122 billion. Other welfare programs make up far less. What does our government spend the most money on? Social Security, coming in at a strong $1.25 trillion dollars.
I'm loath to agree with Paul Ryan on anything, but the man has a point. Any Republican who wants to really get serious about cutting government spending has to make a concerted effort to reform our entitlement system. Of course, I don't believe in cutting government spending, so I don't have to work to for entitlement reform. Just wanted to point out that *shudder* Paul Ryan isn't wrong.
Back to making Medicare for All happen. First, the Democrats are going to win back both the House and the Senate, with majorities that can overcome a presidential veto. At the very least, we're going to have to win in close enough margins that a few Republicans could flip to pass this bill. One of the very interesting statistics from 538 (also known as Bella's Holy Book) was that while 52% of Democrats back universal healthcare, only 33% of the public overall think its a good idea. If the Democrats are going to be the party of universal healthcare, we need to sell this idea to the American public.
Sanders outlines some ways to pay for Medicare for All, some of which are a marginal increase on income based premiums, some of which are an overhaul of our tax system. Making the wealthy pay their fair share of taxes has long been a platform of Sanders' policy, and there is a possibility that this will result in enough money to cover Medicare for All.
Of course, there is also a possibility that Americans will see an increase in their taxes, because many of the countries that have universal healthcare receive far more of their revenue from taxes. In the United States, 26% of our GDP comes from taxes, far lower than the average of 34%, and one of the lowest of industrialized nations. It's not out of the question that Americans will receive a tax increase in order to make Medicare for All a reality, which may be a tough selling point for some people.
This is not to say that Medicare for All isn't possible! It's just going to require not only a great messaging campaign by the Democrats, but also a radical shift in the Congressional balance of power and many years of work. I know I sound like the Arch Enemy of The Left when I say this, but universal healthcare is going to take compromise, and it's going to take a long time. But I'm in it for the long haul, and I hope other people are too.