Presidential hopeful Sen. Elizabeth Warren won’t answer a simple question about the healthcare plan she endorses, Medicare for All. Will it raise taxes on middle-class families?
Pressed by moderators at the most recent televised debate last month, she refused to give a straight answer. She parried late-night host Stephen Colbert’s query away. And at a recent New Hampshire town hall, she dodged a question on the topic.
And so Sen. Warren, the candidate who has a plan for virtually every one of the country’s problems, has gone silent about her plan for health care.
This is savvy, but cynical, politics. Medicare for All will of course require crushing new taxes on average Americans. Sen. Warren might be able to skirt that unpleasant reality in the primary, but if she makes it to the general election, it will come out—and spell her doom.
Medicare for All would ban private health insurance and dump all Americans into one new government-run health plan. The scheme would cost between $30 trillion and $40 trillion—yes, with a “t”—over its first ten years. And that’s a conservative estimate. The plan assumes that doctors, hospitals, and other healthcare providers would accept payments that are 40% less than they collect from private insurance.
Democrats want voters to believe that they’ll be able to cover that bill by raising taxes on the rich. But the math doesn’t work. Even ratcheting up tax rates on high earners to historic highs would only raise a small slice of that $30-some trillion. According to Mercatus Center economist Charles Blahous, doubling all projected federal individual and corporate income tax receipts still wouldn’t be enough to cover Medicare for All’s enormous price tag.
Most of the cost of Medicare for All is going to have to come out of the pockets of everyday Americans.
Senator Bernie Sanders—the creator of the plan Warren has endorsed—admits as much. To pay for his plan, Sanders has suggested a 4% employee payroll tax, a 7% employer payroll tax, and a $250 billion increase in self-employment taxes, among other levies.
And that’s just the start. Sanders’s proposed taxes only raise about half of the necessary funds. Kenneth Thorpe, an economist at Emory University, calculates that Medicare for All would actually require a 20% tax on payroll and income. All in all, more than 70% of working privately insured households would pay more under this system than they currently pay for health care.
It’s no shock Sen. Warren is being coy about all this. Once the public learns about Medicare for All’s true cost, support plummets. A majority of Americans—53%—are behind Medicare for All, in theory. But support craters to just 37% once people learn it will “require most Americans to pay more in taxes,” according to survey research from the Kaiser Family Foundation.
To further distract voters from concerns about cost, Sen. Warren loves to praise the quality of care patients would receive under Medicare for All. That, too, is fiction.
Consider Canada’s universal healthcare system, which is effectively the model for the Sanders/Warren Medicare for All plan. Our neighbors to the north must endure long waits for necessary care. The median wait for treatment from a specialist following referral from a general practitioner was 19.8 weeks last year.
Waits are particularly bad in certain specialties. In 2018, the median wait for treatment from a neurosurgeon after referral from a general practitioner was 26 weeks. It was 28 weeks for treatment from an ophthalmologist, and 39 weeks for orthopedic surgery.
Such waits are far from the norm in the United States. No one knows that better than Sen. Sanders. Following his heart attack on the campaign trail in Nevada two weeks ago, he had an angioplasty the same day. In Ontario, Canada, the healthcare system lists a target time from decision to receipt of the same treatment of “within 7 days” for high-priority patients—and up to 28 days for lower-priority ones.
The story is the same in the United Kingdom, where the government-funded National Health Service is in charge of health care. This past August, more than 13% of patients in need of attention at emergency departments in England waited more than four hours to be seen. Over 370 patients waited more than 12 hours.
Cancer care in the United Kingdom is also dismal. In July 2019, nearly one-quarter of Brits did not begin treatment within 62 days of being urgently referred for suspected cancer by their general practitioner. Almost one in five patients with an urgent referral for breast cancer symptoms were not seen by a specialist within two weeks.
Sen. Warren’s silence on Medicare for All isn’t politically tenable. The pressure to fess up to its true costs will mount as Americans learn more about the plan. It’s time for the senator to come clean—and acknowledge that her preferred brand of health reform will require punishing new taxes on American families.
Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Follow her on Twitter @sallypipes.