By David Dayen
The Intercept, Sept. 15, 2015
The screaming headline on Tuesday’s Wall Street Journal reads “Price Tag of Bernie Sanders’s Proposals: $18 Trillion.” This would comprise “the largest peacetime expansion of government in American history,” the Rupert Murdoch-owned newspaper warns.
The provenance of the figure is in many ways besides the point. Readers are intended to bug their eyes out at such a massive sum, and tsk-tsk at the deeply unserious, budget-busting promises of a democratic socialist. It’s the numerical version of a smear campaign.
But how did the Journal arrive at $18 trillion? They added up the 10-year price tags of seven programs Sanders has endorsed in his candidacy for president. It turns out that $15 trillion of the $18 trillion, or 83 percent of the total, comes from just one of these programs: establishing a single-payer health care system.
The $15 trillion figure is derived from an analysis of a similar single-payer bill, H.R. 676, introduced in 2013 by Rep. John Conyers. Gerald Friedman, a labor economist at the University of Massachusetts at Amherst, conducted the analysis.
What the Wall Street Journal won’t tell you is that $15 trillion in national health spending over 10 years would represent a massive savings for the United States. Right now we spend at twice that rate for health care. According to the Congressional Budget Office, in fiscal year 2013 alone, the U.S. spent $2.8 trillion on total health expenditures, not including the $250 billion tax break employers get for providing health insurance to their workers.
Accounting for cost inflation in health care and extending that out for 10 years, on our current trajectory we would spend more than $30 trillion, compared to the $15 trillion of a single-payer plan, which would totally supplant it.
The entire point of a single-payer health care plan, aside from covering everyone in the country, is to minimize costs, by reducing administrative bureaucracy, the profit motive and middlemen. It costs far less than the current system, which spends more per capita than any developed health system in the world.
That represents a giant savings for the nation, for employers as well as individuals. Friedman’s analysis, which is literally called “How we can afford a national single-payer health plan,” makes this point repeatedly. Assuming that single-payer is paid for through progressive taxation, people would spend far less for their coverage than they do today, if the Wall Street Journal’s explicitly stated numbers are correct.