"Nothing says 'fascist' more to Americans than denying them choice, especially choice over something as personal as health insurance."
Political Scientist Peter Lemieux
Medicare for All holds out the potential of dramatically reducing health care costs. Even the conservative pro-Trump New York Post posts an op-ed noting insurance costs are out of control.
Let me introduce it by noting that the employer premium for single coverage for an employee in 2017 is $6,690, and for family coverage is $18,764. And most of these plans have deductibles and co-pays to limit costs. Those costs are imbedded in personnel costs for an employer.

Under any system, someone is going to pay some large amount of money. Even if Medicare for All reduced overall costs by 30% while expanding coverage to everyone and adding the dental, vision, and mental health benefits widely discussed--an extraordinary achievement if it were to happen--it would still mean an extra $13,000 cost per family.
It is being discussed as inevitable new taxes on the middle class.
Yesterday this blog suggested that Medicare for All proponents focus on the employer saving, with the benefit being rebated in the form of W-2 wages (perhaps excluded from taxation.) I warned that the risk of losing something known--ones current employer-subsidized insurance--plus the prospect of higher taxes--all combined to make Medicare for All frightening for many.
Change the focus, this blog argued, from taxes to wage increase--a net plus for all but the wealthiest Americans.
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| Lemieux, age 17 |
Peter Lemieux was a classmate in college. He is a political scientist, with a Ph.D. from MIT. He taught there an at the University of Rochester, where his courses and research focused on political behavior, particularly voting. He also taught statistics for political scientists. He shares some of his work at his website: His work is rigorous and statistical.
The photograph is from the Freshman Register, what people in 1967 used before Zuckerberg morphed it into something bigger.
Guest Post by Peter Lemieux
You'd have to have a much greater level of trust in government than most of us do to believe that personal savings on private insurance would offset the massive tax increases required to finance a nationalized system. We just gave a massive gift to the wealthiest among us in the 2018 tax reform. Why would we imagine that taxes for national health insurance would be imposed in a fair manner? We can't even get rid of the ceiling on FICA-taxable earnings, something that would make it much easier for Social Security to survive in an era where the number of retirees grows faster than those paying taxes to support them.
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| https://www.politicsbythenumbers.org |
The same arguments apply to a carbon tax, whose economic basis was reiterated just today by economist Justin Wolfers on Twitter:
https://twitter.com/JustinWolfers/status/1175161296037261312
Tax-and-subsidy schemes make sense as a matter of economic theory, and I generally subscribe to them in theory. But I don't see our government as sufficiently well-intentioned to distribute those tax proceeds to those most injured by the tax. Does anyone really think the US government would redistribute the proceeds of a carbon tax to subsidize poorer households facing an increase in their heating costs? I don't, and I suspect most Americans don't either.
Trump has been quick to subsidize farmers for the costs imposed by his stupid tariffs. Do you think he would have reacted the same way if those bearing the costs were poor people living in Illinois or New York?
I think Warren's adherence to her insurance plan is her biggest liability as a candidate in the general election. (Supporting decriminalization of border crossings is her second biggest liability). I hope she recants and adopts some flavor of the public option. Otherwise I worry that she cannot be elected. She needs to do this gracefully and soon. It will only become more difficult to explain a shift in position as we get closer to the election."
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Note: Readers who want details on the recent cost of health care embedded in personnel costs might consult this report by the Kaiser Family Foundation. It provides authoritative information the burden to employers--which simultaneously provides a political and fiscal opportunity. Someone will benefit if that burden is off loaded.
http://files.kff.org/attachment/Report-Employer-Health-Benefits-Annual-Survey-2017






















