What should we call a cost that’s automatically taken out of our paychecks? If the payment goes into public coffers, we call it a “tax”, but for some reason, if it goes to a private company in the health insurance industry, it’s a “premium.”
David Dayen, writing in The American Prospect:
…Biden and Buttigieg take advantage of the fact that we use a bizarre and often faulty system to “score” legislation in the Congressional Budget Office, which only looks at a ten-year window for budgetary impact. If the public option is good, and it eventually becomes a kind of Medicare for All, the cost spike would all happen outside the ten-year window. So Biden and Buttigieg are either lying about how effective their public options will be, or they’re lying about how much they will ultimately cost. They can’t have it both ways.
Notice that I’m using the deficit-scold framing here. In reality, Medicare for All saves money, and maybe even more than we expect. The infamous libertarian Mercatus Center study estimated that Medicare for All would save $2 trillion over ten years, due to lower provider reimbursements, administrative costs, and drug outlays. But the CBO recently looked at a relatively modest prescription drug bargaining proposal from House Democrats, which would directly negotiate prices on just 25 pharmaceuticals per year, and found it would save $345 billion in federal spending for Medicare. If that’s the payoff on just 25 drugs, increasing bargaining power across the health care space would presumably go well beyond $2 trillion.
The problem with cost debates on health care is that much of the current system is largely submerged, set up to hide the true cost to the individual. Quick—how much does your employer-provided health care actually cost in total, beyond just the number that shows up on your paycheck and in co-pays? Most of us have no idea unless we work in a corporate HR department. When you surface these submerged payments, they feel like brand-new tax burdens. But you’ve been paying them all along…