still more ideas on funding Medicare for All

This Washington Post article offers still more ideas.

  • Redirect existing spending on Medicare, Medicaid, military hospitals and the Veterans Administration. (makes sense, as long as “Medicare for All” fully replaces these programs. Everybody hates Medicaid and it should just die. It didn’t occur to me until now that “Medicare for All” would replace the Medicare for all Old People we have now. If that is the case, it is disingenuous to include the current price of Medicare for Old in the price of Medicare for All, just for sticker shock purposes. Of course, sticker shock is an old political game. State the cost of your rival’s plan as a 10-year total, in inflated dollars, and any number you come up with will be shocking. And finally, I am assuming the actual physical Veterans Administration hospitals will not go away. Should we even consider expanding those or giving civilians the option of buying into them?)
  • a national sales tax on “non-necessities”, or a “progressive sales tax” (basically a VAT, but less efficient and possibly more progressive. My take: We should just do a VAT like all other advanced countries do. It is a very efficient, counter-cyclical kind of tax. The criticism is always that it is somewhat regressive. This can be countered by just redistributing some of the proceeds in a progressive way.)
  • a wealth tax (this makes me nervous. Even though it is fair in a moral sense, I think it may be a slippery slope where once the government starts grabbing assets, it could eventually go too far.)
  • Just call the new tax a “public premium” to distinguish it from the private premium most people are paying now. Or try to call the plan a “middle tax cut” because it will reduce overall health care cost for the middle class. (makes 100% logical sense, but the “tax and spend” counterattacks are obvious. A certain segment of the population is emotional about taxes regardless of logic. I think most of these people vote Republican regardless, but some will consider voting for a Democrat who is against taxes and those are the voters you risk losing by being honest and logical.)

I personally am comfortable just going with a payroll tax. I personally would be comfortable keeping some level of co-payments or deductibles. Things that should be “free” include preventive care, long-term medication that reduces risk of needing more costly care (e.g. insulin, blood pressure and cholesterol medication), and coverage for catastrophic events. People clearly need mental health and addiction treatment. But then is still some room for personal choices to decide how much health care we want to buy for what we expect to get out of it, given much better information on prices and outcomes than we have available now.

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