Warren releases her plan to fund Medicare for All

This morning, Senator Elizabeth Warren released a detailed policy plan to pay for Medicare for All. As with many of Warren’s proposals, this one was posted to Medium. It’s titled “Ending the Stranglehold of Health Care Costs on American Families.” And it is very long. Medium estimates it at a 37-minute read, and my quick count puts it at more than 9,000 words. That’s about 30 printed pages. Point being, we’re going to have look at this through the lens of summary, and if you’re curious about the deep details, go look at those show notes. Up top, I have the actual policy, which is very readable despite being long. And then there’s a series of media explainers, each of which is also long.

Also, one procedural note. Warren uses a bunch of experts in health care matters to arrive at her figures here, so when I say “Warren” in terms of a spending estimate or whatever, I really mean “Warren and her team of experts.” It’s worth looking at that team to get a sense of the deep bench here. It even includes the guy who ran Medicare for the Obama administration…and that’s just one person on the team.

Okay, the plan has two parts, and they happen to echo the two questions I ask of every policy proposal: first, how much will this cost; and second, how do you propose to pay for it. The first thing is really important. You have to understand of the cost of a Medicare for All plan versus the current health spending we do today. If that figure is out of whack, the whole exercise is meaningless.

So in that cost section, Warren starts with an estimate provided by the Urban Institute, which puts the overall cost of a single-payer system like Medicare for All at $59 trillion dollars over 10 years. That’s $7 trillion dollars more than we’re projected to pay for the current system, in part because if you remove co-pays and deductibles and stuff like that, people tend to actually go to the doctor and use health care when they need it.

But Warren looks at that estimate and differs on many key factors. First, she emphasizes efficiencies that a single-payer program would gain in terms of administrative costs. Warren pegs that cost at the rate that Medicare’s single-payer program pays right now. With that change, she’d save $1.8 trillion dollars on the cost side. Here we’re saying that’s LESS than what the Urban Institute estimated.

On drug prices, Warren is more aggressive than the estimate as well, and more than doubles their estimate for savings on brand-name drugs. That saves another $1.7 trillion dollars.

Next up is the amount we pay doctors for their services. Here, again, Warren is more aggressive than the estimate, but not by much. Here she shaves off another $600 billion dollars, but keeps these prices 10% higher than the current Medicare payment rates.

There are more key places where Warren shaves off dollars, but in the end she arrives at a total cost of $52 trillion dollars over ten years. That happens to be the same figure projected by the Urban Institute if we just leave the system as-is, with the expected changes coming over that ten-year period.

Okay, so we’ve got a cost figure: $52 trillion bucks. So how does Warren suggest we pay for that? Well, this is painfully also complex, and it’s a VERY good reason to go read either the plan, or maybe an explainer, both of which lay out the precise details.

But BASICALLY, Warren takes the existing US government spending on health care—including state and local spending—and pushes it all over into the Medicare for All column. Then she takes the employer contributions—that’s what your company pays for its share of your health care, knocks 2% off of that, and instead has the company pay that to the federal government. Large companies are ALREADY required to pay for this under the Obamacare system, so that change makes a lot of sense.

That part is simple, and big, and gives you the majority of the money you’d need for the program. Then comes what Vox calls the “grab bag.” It’s a bunch of taxes and fees and moving stuff around. For instance, reading from Ezra Klein’s piece in Vox:

“Americans currently spend $3.7 trillion [dollars] paying their share of employer-provided health insurance premiums. That money, left in their wallets, becomes taxable, adding $1.4 trillion [dollars].
Warren proposes a financial transactions tax of 0.1 percent of the value of every stock, bond, or derivatives transaction. That raises $800 billion [dollars]. Then she adds a “systemic risk fee” on financial institutions with more than $50 billion [dollars] in assets. That’s another $100 billion [dollars].”

That’s the first two bullets in a list of seven that constitute the grab bag. The others include some real whoppers. One of those is increasing Warren’s wealth tax on billionaires from 3% all the way up to 6% on assets over $1 billion dollars. Yes, that is a 6% annual tax on assets over $1 billion dollars. That’s a major bummer for the billionaires, but then again, it raises a staggering $1 trillion dollars over ten years. So, add it to the grab bag.

Another item in there is funding IRS enforcement. This is a really obvious win that, in my humble opinion, we should be spending on anyway, and Warren estimates that better funding the IRS to track down tax payments gets us another $2.3 trillion dollars in tax revenue. This is because people are getting really good at dodging taxes and the IRS doesn’t have a ton of money for audits. No more, says the grab bag.

There’s more in the grab bag, including a very brief mention of how comprehensive immigration reform would create a larger tax base, which in turn would generate another $400 billion dollars in new taxable income over that decade-long period.

With all the math accounted for, Warren does manage to pay for all of the projected spending. And she does it without raising taxes on the middle class. Now, she DOES substantially raise taxes on the wealthy—especially the billionaires. She also raises taxes on businesses. But if you’re looking for middle-class taxes here, I’m not seeing them, nor are any of the articles I read about this today.

I want to close out this segment with a bit that Warren put up top in her policy, which is a statement of values. I think this is important in understanding how the candidate frames the policy overall, which helps to understand why this gigantic effort has gone into defining the super-specific funding plan:

“All my plans start with our shared values. There are two absolute non-negotiables when it comes to health care:
One: No American should ever, ever die or go bankrupt because of health care costs. No more GoFundMe campaigns to pay for care. No more rationing insulin. No more choosing between medicine and groceries.
Two: Every American should be able to see the doctors they need and get their recommended treatments, without having to figure out who is in-network. No for-profit insurance company should be able to stop anyone from seeing the expert or getting the treatment they need.
Health care is a human right, and we need a system that reflects our values. That system is Medicare for All.
Let’s be clear: America’s medical professionals are among the best in the world. Health care in America is world-class. Medicare for All isn’t about changing any of that.”

A new poll of Iowa sets everyone’s hair on fire

Today, The New York Times released a poll conducted by Siena College focusing on Iowa voters. We covered one of these last week, and the big news there was that Mayor Pete Buttigieg was looking very strong in second place, with Warren in first.

Well, first up, a methodology note. The poll has a margin of error of plus or minus 4.7 percentage points, and it focuses on Iowa Democratic caucusgoers ONLY.

So here’s the big headline. For first choice in Iowa, Warren remains in first place with 22%, Sanders is right behind at 19%, Buttigieg is right behind at 18%, and Biden is also right behind at 17%. Nobody else makes double digits in this poll. With those numbers—22, 19, 18, and 17, and looking at the margin of error that’s getting pretty close to 5%, those top four candidates are within the margin of one another. It’s arguable that yeah, Biden is 0.3% out of that margin, but he’s in the pack. They’re all in it, and trying to draw deep distinctions out of 1% differences is not super-useful at this point.

Now, Iowa has a special love for second-choices. Within a caucus, people often do have to move over to their second choice. So, how’s that looking? Well, if you add first- and second-choices together, for those top four candidates, the order is the same. Warren gets 47%, Sanders gets 34%, Buttigieg gets 31%, and Biden gets 28%.

Now, before we all flip out TOO much about any of these results—most notably the idea that in yet another early voting state, Biden is in fourth place—here’s another notable statistic revealed by this poll. According to Alexander Burns writing for the Times, “Two-thirds of likely caucusgoers in The Times poll said they could still be persuaded to change their minds.”

So this reveals at least three ways to read this poll. One way is simply, hey, look at how Warren still has the top spot, Sanders remains as strong as ever, Buttigieg is surging, and Biden is lagging. That’s a legitimate, simple way to look at it.

Another way to look at it is, yeah, we’re in that wacky season right before Iowa votes in which TWO-THIRDS of its voters still claim to be persuadable. This is a massive opportunity for movement for all of these campaigns. In other words, we have NO IDEA what’s really gonna happen here.

And for the third way, I’ll quote reporter Dave Weigel of The Washington Post writing on Twitter. He points to Buttigieg as having an edge here:

“...[I]t’s I[owa], where any campaign that’s this dominant as a *second choice* is formidable. Warren in danger of more Harris etc voters begin[ning] to prefer Buttigieg as their safety.”

So, with 90-something days until that vote, candidates will be on the ground doing everything in their power to persuade those two-thirds of persuadable voters.

The Trump impeachment stuff in three minutes or less

Next up, a summary of the impeachment proceedings in three minutes or less. Today I’m aiming for less, because Congress is in recess.

Over the past week, we’ve heard that both Charles Kupperman and John Bolton, who share a lawyer, have filed legal objections to clarify whether they have to follow a White House rule preventing their testimony or a House of Representatives rule requiring it. Well, a judge has been assigned and that judge will hear arguments on December 10th about the cases. That judge also says he plans to rule quickly. Now, why does this matter? Two reasons.

First, Bolton is scheduled to appear next week, but there’s no way he’s actually going to, given this legal stuff. And second, it’s yet more evidence of why this impeachment proceeding in the House could push way longer than previously expected. If that decision doesn’t even happen until mid-December, I don’t see how the House realistically wraps this up until maybe January. At best. Their other option is essentially to bail on people who won’t sit for interviews, and just move on with what they’ve got.

Anyway, yesterday, Tim Morrison, who is a high-level National Security Council official, testified before the House. His testimony reportedly confirmed much of the whistleblower complaint, though Morrison suggested he didn’t think the call itself was illegal. And then he left his post at the White House, to be replaced by somebody else. At the moment it’s unclear whether he quit or was fired.

Meanwhile, Adam Schiff, who is Chairman of the House Intelligence Committee, said that transcripts of the various interviews already conducted could be released as early as next week. When those transcripts come out—whether it’s next week or later—expect a new flood of analysis on details we haven’t previously heard. In the immortal words of Samuel L. Jackson in Jurassic Park, “hold onto your butts.”

Checking in on Castro’s self-imposed fundraising deadline

Back on October 22nd, I reported that Julián Castro announced his need for $800,000 dollars by October 31st. Which was yesterday. Now, I watched his Twitter account leading up to the show yesterday and he had not made that goal by the time I headed into the booth. So that was a little troubling.

Earlier this week, Castro announced that his campaign was about 80% of the way to its goal. They proceeded to set up a phonebank operation, dubbed the Castro Call-a-Thon. That reportedly involved more than 10,000 calls over the span of two hours. After that effort, the team had made progress, but still had not crossed the finish line.

So how did it all turn out? Did Castro manage to raise the remaining money YESTERDAY AFTERNOON? Short answer, yes. Though it does appear to be a bit of a squeaker. The campaign said it received more than $1 million dollars in the entirety of October, and said Castro would remain in the campaign. Meanwhile, he has zero of the required polls for either the November or December DNC debates, so that would be the next thing to work on.

How to have fun looking at electoral betting markets

Last up today, a quick item that I just thought was fun. If you go to ElectionBettingOdds dot com, you’ll see an average of several betting sites’ odds on various political things. You know, like who might win the primaries or the presidency overall, or whatever. And yeah, it IS legal in the US to bet on this stuff, and NO, I do not recommend it and I do not do it.

But, here is the fun part. There are people, apparently a statistically significant number of them, who are out there placing bets for fun. So here’s you have fun with these sites. Go to the website and scroll all the way to the bottom. Looking at the bottom right now, according to this site, Dwayne “The Rock” Johnson currently has 0.1% betting odds of winning the WHOLE THING—becoming president!—in the 2020 election. So if you want to make a truly extreme bet, I mean, be my guest. The payout would be pretty shocking.

Now, personally, I would put his odds a little lower than 0.1%, but, I gotta say, The Rock 2020 or The Rock 2024, or even just “Dwayne Johnson for President” does have a certain ring to it, right? Right? I mean…I support his position on saving his family from giant earthquakes in California. So, at least he has that issue totally solved.

Well, that is it for one more episode of the Election Ride Home. I have been your host, Chris Higgins. You can always find me on Twitter @chrishiggins. How shall we round out this big week of news? Maybe by talking about candy. As is our usual tradition, my wife and I turned off all the lights and retreated from the neighbor children, hiding behind a big scary hedge and watching an episode Survivor in the dark. It was a good episode. No spoilers. And today, I am proud to say I have no leftover candy because there was no candy to start with. There should probably be some kind of proverb about that. Let’s make one now. Um. The family that giveth no candy eateth no candy itself? Close enough for government. So cross-stitch that on something and watch that sugar intake. As always, thanks for listening, and I will talk to y’all on MONDAY.