Elizabeth Warren’s ‘Medicare for All’ Math(nytimes.com)
nytimes.com
Elizabeth Warren’s ‘Medicare for All’ Math
https://www.nytimes.com/2019/11/01/upshot/elizabeth-warrens-medicare-for-all-math.html
43 comments
Do you have another proposal for implementing a wealth tax in a way that's easily enforced? I don't necessarily support a wealth tax via stocks, but it seems pretty close to the way startup stock options get taxed for employees pre-IPO, so it's not like there isn't a precedent here.
Wealth is how much money you have to spend, not what your theoretical paper worth is. The government can’t buy medicine or fix roads with theoretical paper worth, and until you can buy food with stocks / shares / yachts / art, it shouldn’t be treated as if it is taxable currency.
Taxing the flow of money is the only moral way a government can bring in revenue and the only way to increase that revenue is to raise taxes. Higher income tax and higher capital gains tax means the more you benefit from sharing this society with everyone else, the more responsibility you take for funding it through taxation.
Taxing the flow of money is the only moral way a government can bring in revenue and the only way to increase that revenue is to raise taxes. Higher income tax and higher capital gains tax means the more you benefit from sharing this society with everyone else, the more responsibility you take for funding it through taxation.
I don't really agree with any of your points. Wealth is a measure of your total assets at any given point in time. If you can liquidate it for cash, it's part of your wealth. Additionally, non-cash assets can be and are used as collateral all the time, so your statement about what the government can and can't do doesn't make much sense.
Also, taxing the flow of money is not enough. Earning more in investments than you spend is pretty much the entirety of getting wealthy in the first place. If you only tax money flows, you're doing very little to combat inequality at a fundamental level, and at the same time leaving open giant loopholes to avoid paying taxes for things like MfA.
Also, taxing the flow of money is not enough. Earning more in investments than you spend is pretty much the entirety of getting wealthy in the first place. If you only tax money flows, you're doing very little to combat inequality at a fundamental level, and at the same time leaving open giant loopholes to avoid paying taxes for things like MfA.
Conflating stocks with yachts or art doesn't make sense. The stock market is extremely liquid (unlike the market for yachts or art), so from a practical standpoint assets in the form of stocks are extremely close to cash in terms of "money you have to spend".
How else can we avoid austerity? The entire point is to prevent dollars from sitting idle. Also, are you really a one-percenter, or just cosplaying?
Isn't this basically how property taxes are levied?
A home gets assessed and taxes paid based on the current market worth, not just when sold.
A home gets assessed and taxes paid based on the current market worth, not just when sold.
This, to me, is classic Warren: Brings up about a popular problem, and proposes an amateur solution, clearly demonstrating total lack of expertise in the affected field.
I struggle with any plan that lines up 99% of people to raid the wealth of 1% of people. It reminds me of the idea that minorities need the most protection because by nature, almost by definition, the majority doesn't have their interests in mind. A democratic system makes it very easy to hurt and further marginalize those people.
This is probably an unpopular opinion so I'll add: I'm not a billionaire, I'm not even a millionaire, and I know there's a lot of valid (but not necessarily good) arguments for why rich people deserve to pay more. But my moral compass is spinning.
This is probably an unpopular opinion so I'll add: I'm not a billionaire, I'm not even a millionaire, and I know there's a lot of valid (but not necessarily good) arguments for why rich people deserve to pay more. But my moral compass is spinning.
Maybe if they paid their due tax, those ideas wouldn't come up.
Also why are you standing up for ultra rich? They have enough power and influence to stand up for themselves. Somehow they never stand for the poor.
Also why are you standing up for ultra rich? They have enough power and influence to stand up for themselves. Somehow they never stand for the poor.
Don't forget, those 1% are hoarding 99% of all money. (Ok its really 0.1% of the people).
Think of it not so much as reverse-discrimination, but rather a revolution. Returning the economic system to something that works, instead of the broken dysfunctional mess its gotten into.
I agree we need more than tax adjustments to complete the task. The paths money follows need realigning, back to something like they used to follow in the 70's or something. But its a start.
Think of it not so much as reverse-discrimination, but rather a revolution. Returning the economic system to something that works, instead of the broken dysfunctional mess its gotten into.
I agree we need more than tax adjustments to complete the task. The paths money follows need realigning, back to something like they used to follow in the 70's or something. But its a start.
That money is out making more money by investing in the macroeconomy. It isn't sitting in their bedsheets. Bill Gates doesn't sleep on a pile of gold like scrooge mcduck. He created something the world needed and valued. Now his money out creating new things. Money does NOT follow the laws of thermodynamics
Implication: People who cannot create things that the world needs or values, should not have as much money. However, our society requires a modicum of money for survival. How do you square our failure to give people a modicum with the moral implications of being unable to produce value?
The sum of money that's genuinely "required for survival" is so low as to be almost insubstantial. People, even the extreme poor in fact, spend a lot of their discretionary income on what amounts to social inclusion, not bare survival. (But social inclusion is basically a collective good, that's far more cheaply delivered by altering social norms in a direction that boosts provision of social capital.)
So, its OK that 0.1% of everybody has 99.9% of the money? This is productive somehow?
Its fine if we all borrow money from BG and friends, to create businesses, and the profits are bled back to BG&F as interest etc. So we create value, but its almost all for them?
Of course money gets moved around. But its important to understand the flows. And the flows are all to the rich, so they get richer. This is so well understood, I have to suspect the simplistic comments as trolling.
Its fine if we all borrow money from BG and friends, to create businesses, and the profits are bled back to BG&F as interest etc. So we create value, but its almost all for them?
Of course money gets moved around. But its important to understand the flows. And the flows are all to the rich, so they get richer. This is so well understood, I have to suspect the simplistic comments as trolling.
So Bill Gates spends annually 100% of his income in reinvestments? None of it's just sitting in the stock market? But helping small businesses and entrepreneurs? (Don't get me wrong I admire Bill Gates), but a LOT of money IS just sitting in accounts collecting interest and doing nobody a lot of good. Till they die then it goes to their spoiled brat children who hardly deserve it - I mean they didn't do the work to get it, why should they get it?
How about an estate tax of 100% over 10 million, 0 under 10 mill. That's plenty of money for anybody, and puts the money back in play.
Honestly, if i were filthy rich, my kids wouldn't get a ton of that money. I want my posterity to be self-enablers, not born with golden spoons like Trump and others.
Though, I think the best way to pay for this is MANY different ways: Companies already pay healthcare --make them keep paying that just as a tax to the pool for everyone's care.
Create a VAT tax that's something like 5%, 10% for non-residents. (Bonus this makes it so illegal/legal visitors from other countries actually pay more in taxes (at least VAT) than we do so people shut up about "those lazy immigrants don't contribute nothin'" -- now they do, so shut up about it.
Next we need to do whatever we can to get our bottom tier of American's to rise higher. The higher they rise the more they spend locally, the more VAT they pay, the more income tax they pay. GBI could help, or just free education, or re-trainment programs for lost jobs or those in shitty jobs who want to move up to something better.
America's also desperately facing infrastructure issues all over the place from falling bridges to natural disasters destroying things. We need a guaranteed jobs bill where anyone who wants work gets to work.
We also can legalize and tax Marijuana and natural psychedelics and decriminalize. This puts more people to work -can't work in jail, and increases tax flows.
A tax on speculation could also help as well. What about a foreign tax on property. All property owned by non U.S. citizens has a 10%/year tax -- make China pay for our healthcare!
A small 1% tax on all NYSE/Nasdaq trades. Again lots of foreign money circulates through there so some of that tax will come from foreign investors.
Find other ways to save money. Maybe cut the military budget 50%. Cut foreign aid. Close down some air bases and get rid of a lot of our out-of-america buildings/offices/etc. Let's stop being 'police of the world' and focus more on homeland security and our own borders.
Most people on the left are trying hard to make the rich pay for all this, when a lot of the middle class and lower class would be happy to chip in. Sure we all can't afford a million/year but 1k per 20k of income in medical tax from every working American should be do-able. If the average family makes $50k that's 1 trillion/year. If an employer is required to pay $5k/year/employee we now have 2 trillion/year allotted for M4All.
There's definitely wiggle room. Or they could just do 500/20k income w/ no caps... that would make someone earning 2 billion/year paying 10 million/year -- a drop in a bucket for them, and a win for everyone.
How about an estate tax of 100% over 10 million, 0 under 10 mill. That's plenty of money for anybody, and puts the money back in play.
Honestly, if i were filthy rich, my kids wouldn't get a ton of that money. I want my posterity to be self-enablers, not born with golden spoons like Trump and others.
Though, I think the best way to pay for this is MANY different ways: Companies already pay healthcare --make them keep paying that just as a tax to the pool for everyone's care.
Create a VAT tax that's something like 5%, 10% for non-residents. (Bonus this makes it so illegal/legal visitors from other countries actually pay more in taxes (at least VAT) than we do so people shut up about "those lazy immigrants don't contribute nothin'" -- now they do, so shut up about it.
Next we need to do whatever we can to get our bottom tier of American's to rise higher. The higher they rise the more they spend locally, the more VAT they pay, the more income tax they pay. GBI could help, or just free education, or re-trainment programs for lost jobs or those in shitty jobs who want to move up to something better.
America's also desperately facing infrastructure issues all over the place from falling bridges to natural disasters destroying things. We need a guaranteed jobs bill where anyone who wants work gets to work.
We also can legalize and tax Marijuana and natural psychedelics and decriminalize. This puts more people to work -can't work in jail, and increases tax flows.
A tax on speculation could also help as well. What about a foreign tax on property. All property owned by non U.S. citizens has a 10%/year tax -- make China pay for our healthcare!
A small 1% tax on all NYSE/Nasdaq trades. Again lots of foreign money circulates through there so some of that tax will come from foreign investors.
Find other ways to save money. Maybe cut the military budget 50%. Cut foreign aid. Close down some air bases and get rid of a lot of our out-of-america buildings/offices/etc. Let's stop being 'police of the world' and focus more on homeland security and our own borders.
Most people on the left are trying hard to make the rich pay for all this, when a lot of the middle class and lower class would be happy to chip in. Sure we all can't afford a million/year but 1k per 20k of income in medical tax from every working American should be do-able. If the average family makes $50k that's 1 trillion/year. If an employer is required to pay $5k/year/employee we now have 2 trillion/year allotted for M4All.
There's definitely wiggle room. Or they could just do 500/20k income w/ no caps... that would make someone earning 2 billion/year paying 10 million/year -- a drop in a bucket for them, and a win for everyone.
What exactly is "sitting in the stock market"? If I pay for a stock I get a piece of a company - what happens to the money?
Forget about stocks. How about if I just put money in a savings account? What happens to that money?
I'd suggest that even if Bill Gates is shoving money under his mattress it still might be doing work. What if there's a set amount of money Bill wants to have in case things go poorly. He shoves that amount under the mattress.
Is the money under the mattress doing anything? Technically, no but in another sense what it's doing is allowing Bill to invest in what ever other riskier things he's like to do. If you say well, we should take the money under Bill's mattress he's not using it, it may well be that Bill will just remove money from investments to replenish that money.
Forget about stocks. How about if I just put money in a savings account? What happens to that money?
I'd suggest that even if Bill Gates is shoving money under his mattress it still might be doing work. What if there's a set amount of money Bill wants to have in case things go poorly. He shoves that amount under the mattress.
Is the money under the mattress doing anything? Technically, no but in another sense what it's doing is allowing Bill to invest in what ever other riskier things he's like to do. If you say well, we should take the money under Bill's mattress he's not using it, it may well be that Bill will just remove money from investments to replenish that money.
>> Is the money under the mattress doing anything? Technically, no but in another sense what it's doing is allowing Bill to invest in what ever other riskier things he's like to do. If you say well, we should take the money under Bill's mattress he's not using it, it may well be that Bill will just remove money from investments to replenish that money.
Let me put this another way...
Say you own 5 houses. You don't much need any extra income, so you don't waste time Airbnb'ing them or anything.
When you're not using them, they basically just sit unoccupied. These are maybe 5-10 bedroom houses. 1-2 families could live in these, but no -- someone somewhere is homeless while you have abundance that you don't actually need. I mean could you not afford to rend a studio or small apartment if you needed to visit NY or Florida, or Seattle?
The point is that people have more money than they know what to do w/ and also that generational wealth is also a huge issue.
Not saying we take everything but we need trickle down economics failed miserably.
Let me put this another way...
Say you own 5 houses. You don't much need any extra income, so you don't waste time Airbnb'ing them or anything.
When you're not using them, they basically just sit unoccupied. These are maybe 5-10 bedroom houses. 1-2 families could live in these, but no -- someone somewhere is homeless while you have abundance that you don't actually need. I mean could you not afford to rend a studio or small apartment if you needed to visit NY or Florida, or Seattle?
The point is that people have more money than they know what to do w/ and also that generational wealth is also a huge issue.
Not saying we take everything but we need trickle down economics failed miserably.
So it's okay to set the rules and then retroactively change them and take money away from those who managed to do really well?
Don't be a troll. They didn't "do really well". They looted the economy for essentially all the wealth in the world, by changing the rules so only they win.
Changing the rules back, is no more or less moral.
Changing the rules back, is no more or less moral.
You're missing the fact that the US already uses the money raised from citizens for its existing healthcare. The US government expenditure is very high for healthcare.
You could continue to spend the same amount of money and have healthcare free at the point of delivery for all.
You could continue to spend the same amount of money and have healthcare free at the point of delivery for all.
This is also why I don't understand this raid. I pay lots of taxes in Canada and I'm not hyper rich. And we have universal Healthcare. I'm huge on the concept of socialism. I just don't get why the unfair raid is needed.
I see this as a first change from taxing income (work) to taxing significantly above average success (luck).
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Matt Bruenig did a good breakdown of the shortcomings of Warren’s plan here:
https://www.peoplespolicyproject.org/2019/11/01/warrens-perp...
As well as the more rational avenues through which Medicare for All could be funded:
https://www.peoplespolicyproject.org/2019/10/30/how-to-appro...
https://www.peoplespolicyproject.org/2019/11/01/warrens-perp...
As well as the more rational avenues through which Medicare for All could be funded:
https://www.peoplespolicyproject.org/2019/10/30/how-to-appro...
A point which I didn't think of: we are already paying for everyone's healthcare. Doctors and hospitals can't turn anyone away and they aren't losing money. So it's really an accounting problem how do we collect the money which people and businesses are already paying and how to distribute which Medicare already does sufficiently well.
That's not quite correct. Hospitals can't turn away patients with life-threatening conditions until they are stable. In practice that means everyone gets triaged. A better system would run public clinics, staffed by PAs and nurse practitioners (with possibly a physician) near the ER, and force the people who have had a cough for two weeks to go to the clinic first. Work everyone near the top of their training, and give hospitals safe harbor for sending non-emergency patients to the clinic first.
That's just one sensible (I think) proposal. We don't need to refinance the current system, we need to completely reengineer it.
That's just one sensible (I think) proposal. We don't need to refinance the current system, we need to completely reengineer it.
This comment reminds of some of the hospitals in India where up-skilling is becoming commonplace to remain efficient and cost-effective. https://www.bloomberg.com/news/features/2019-03-26/the-world...
The easier solution is letting small business buy into medicare.
That seems pretty strongly like a non-solution because if you lose your job at a BigCo (which employ over 40% of Americans, and rising), you're still completely hosed.
I'm quite concerned as a self-employed American contractor abroad. Shifting the costs to employers might very well include myself. While I don't mind my taxes going up per se, expanding current Medicare to all ages as the system currently exists means I still wouldn't get coverage as there's no deals with foreign systems or vouchers or exemptions for Americans abroad from the bill that I read. This would mean I'd more than likely have to pay even more than the current compulsory 12.4% for Medicare to still not get any usable health coverage outside the States. The current health system lets me exempt myself from the healthcare tax being based elsewhere.
I'm very much in favor of Medicare for All as a whole as it's shown to definitely bring down the average cost per American as well as remove the middle-man insurance companies taking their cut and give the government better leverage against drug prices and services. However, considering many proposed M4A plans are covering green card holders and undocumented workers, it would be nice to know that citizens abroad could be in the loop too with a name like "for all".
Also, can change the abbreviated version to "M∀"?
I'm very much in favor of Medicare for All as a whole as it's shown to definitely bring down the average cost per American as well as remove the middle-man insurance companies taking their cut and give the government better leverage against drug prices and services. However, considering many proposed M4A plans are covering green card holders and undocumented workers, it would be nice to know that citizens abroad could be in the loop too with a name like "for all".
Also, can change the abbreviated version to "M∀"?
> This would mean I'd more than likely have to pay even more than the current compulsory 12.4% for Medicare
Social Security is 12.4%, Medicare is 2.9%.
Social Security is 12.4%, Medicare is 2.9%.
You are right about the chunk of the 15.3%--I read, meaning misread, it like 5 times the last couple of days. I also missed the threshold for low-earning self-employment being exempt skimming the 20 pages of the proposal. I guess my fears have subsided, although I believe I would still prefer some sort of coverage.
Governments have a poor track record to manage our money.
Are there any proposals to just regulate insurance providers, pharmaceuticals and hospitals as non-profits? In addition other industries that provide for basic human necessities should simply be regulated as non-profits.
It is simply perverse for insurance companies to profit out of my misfortunes and further optimize those profits to pander to industry and investor whims.
An enterprise which is "regulated as a non-profit" is just a for-profit enterprise with opaque money flows, corruption etc. etc. Genuine non-profit enterprises require commitment, and the private sector is better able to deliver that.
Not disagreeing with you, but wouldn’t the government be more successfully regulating and policing these health non-profits instead of becoming a health provider? I’m only speculating the relative success between the two options.
From an election standpoint, it also seems like a good way to galvanize the support bases - something that presidential candidates are looking for currently.
From an election standpoint, it also seems like a good way to galvanize the support bases - something that presidential candidates are looking for currently.
Our approach to the healthcare sector should start from de-regulation, not piling even more red tape on it. That would be the best way to decrease undue profit margins in the industry as well.
What if government could enforce CEO caps of 500k.
No bonuses. No sales staff. Transparent prices both on insurer/hospital side.
100% tax of company profits at end of the year use or lose all the income earned.
Basically make it impossible for corruption/self-enrichment at the expense of others.
Also make insurance a national thing, i.e. plans cross state-lines. How much money is wasted because an insurer needs to hire people who know the laws of utah, more people to work within the laws of AZ, etc... and create plans centered around different states and their nuances?
If we can streamline some of this stuff, and make it uniform across the nation maybe they save money and pass that savings to us.
(I say this as possible solutions to the non-profit thing, but I'm a huge supporter of Single-payer). There's other options on the table for sure, but something definitely needs to change. Better we bankrupt the entire country than 100k people die from Cancer over the next 10 years who could've lived, had children, and one of those children end up discovering FTL drives or curing Global Warming.
100% tax of company profits at end of the year use or lose all the income earned.
Basically make it impossible for corruption/self-enrichment at the expense of others.
Also make insurance a national thing, i.e. plans cross state-lines. How much money is wasted because an insurer needs to hire people who know the laws of utah, more people to work within the laws of AZ, etc... and create plans centered around different states and their nuances?
If we can streamline some of this stuff, and make it uniform across the nation maybe they save money and pass that savings to us.
(I say this as possible solutions to the non-profit thing, but I'm a huge supporter of Single-payer). There's other options on the table for sure, but something definitely needs to change. Better we bankrupt the entire country than 100k people die from Cancer over the next 10 years who could've lived, had children, and one of those children end up discovering FTL drives or curing Global Warming.
“The top 1 percent [...] would pay taxes on increases in investment value annually, instead of waiting until assets are sold.”
Taxing all stockholders of a company on the fiction that they all could have sold all their shares at the maximum possible price, without crashing the price, is naively out of touch with how markets actually work.
Investments, especially stock, have no precise value until they are sold. It’s unfair to preemptively tax a capital gain before the capital gain has occurred. Otherwise the IRS will assess your unsold Beanie Baby net worth to have increased by $14k and tax you on 20% of it come the end of the year when in fact it turns out your collection has no resale value at all on an open market.
This is just as silly as market cap — the idea that just because someone paid $X to buy 0.1% of a company that’s currently in high demand and short supply it does not follow that, should every stock holder suddenly decide to panic sell 100% of the company, they would collectively get $X,000 in return.