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The Price of BernieCare

Democrats object that Republicans are telling voters the truth about single payer.

By 

The Editorial Board

Oct. 11, 2018 7:42 p.m. ET

Chuck Schumer declared this week that health care is the issue that will define the November elections, and the Senate Minority Leader may be right for the wrong reason. Democrats could end up paying a big political price for signing up en masse for Bernie Sanders’s government-run health-care agenda.

Republicans are running ads slamming Democrats on single-payer health care, and President Trump framed the issue this week in a USA Today op-ed that said “Democrats would gut Medicare with their planned government takeover of American health care.” Democrats claim this is unfair because not every candidate has endorsed single payer, but if they now want to repudiate it they should say so.

Mr. Trump is referring to the Bernie Sanders bill known as Medicare for All, which has been endorsed by 16 Senators, including almost all of the left’s leading 2020 presidential contenders (Cory Booker, Kamala Harris, Kirsten Gillibrand, Elizabeth Warren). 

A companion House bill has attracted more than 120 co-sponsors, which is nearly two-thirds of the current Democratic caucus. Other devotees include the Democratic nominees for Governor in California (Gavin Newsom) and Florida (Andrew Gillum) and dozens of other candidates around the country. Did Democrats think they could endorse this to please their progressive base but then have no one notice?

Medicare for All would finance health care through taxes instead of insurance premiums, deductibles and co-pays. All care would then be “free” in the Venezuelan sense of the word. Government would dramatically cut the reimbursement rates doctors receive for providing services. All this would lower administrative costs and make health care more efficient, or so we’re told. And we’re not supposed to call this “government-run health care,” though who do you think would make the payment decisions?

Mr. Trump noted in his op-ed that the plan would cost the federal government $32.6 trillion over 10 years. That figure is from an analysis by the Mercatus Center’s Charles Blahous, a respected researcher and a former Social Security and Medicare trustee who sometimes writes for us. His findings are in the ballpark of every serious analysis.

That spending figure amounts to 10.7% of GDP in 2022 when the plan kicks in and then up from there. National defense—routinely derided as too expensive and wasteful—is a mere 3% of GDP today. And brace yourself: “Doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan,” Mr. Blahous says.

Liberals are griping that these estimates overlook what would be a decline in overall health spending, but Mr. Blahous goes out of his way to credit savings that would probably be illusory such as lower drug costs. As in every socialist system, the real “savings” would come from price controls and wait lists for many health-care services. Have a cold? Come on in. A hip replacement or breast reconstruction? Get in line.

And that’s the good news. The truth is that BernieCare would essentially blow up the entire current health system. The Sanders bill would eliminate employer-sponsored insurance, which now covers some 150 million Americans. The sales pitch for that should be: If you like your health-care plan, we won’t let you keep it.

BernieCare would also blow up Medicare as we know it by creating a new health system that young and old would have to join. We don’t like to see Republicans defending current Medicare as a perfect system, since it has many shortcomings and needs reform like premium support that Paul Ryan has proposed. But compared to BernieCare, Medicare is the Mayo Clinic for everyone.

Maybe Democrats should have looked at the results in Vermont when Bernie’s home state tried to set up single payer. A Democratic Governor abandoned the idea in 2014 once he was looking at an 11.5% payroll tax, plus a 9.5% income tax, and more increases to come. Progressives couldn’t even get single payer up and running for about 625,000 people in a state with a decent health profile. In 2016 nearly 80% of voters rejected a referendum to set up single payer in Colorado.

The charges of distortion from Democrats are especially rich given that they have spent tens of millions of ad dollars this year accusing Republicans of wanting to deny chemotherapy to cancer patients who lack insurance. The truth is that the GOP last year debated more rational ways to cover folks with pre-existing conditions other than mandates that raise the cost of premiums for everyone in ObamaCare. The GOP ideas that would cover pre-existing conditions include high-risk pools that subsidize tough-to-insure patients directly. 

Republicans are inept at defending themselves, and their failure to repeal ObamaCare has made them vulnerable to attack. But in dissecting single payer, the GOP is providing voters with crucial information about what Democrats want to do on health care when they next take power. ObamaCare was merely a down payment on BernieCare.