Medicare for all sign Onefinancing option? A mandatory public premium averaging $7,500 percapita – the equivalent of $12,000 per individual not otherwise onpublic insurance. (Photo: Shutterstock)

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A preliminary estimate of the financing burden of a Medicare forAll plan recently released by the Committee for a ResponsibleFederal Budget (CRFB) consists of a list unpalatable choices,suggesting that the committee is not all that keen on asingle-payer health care system for Americans.

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The report, "Choices for Financing Medicare for All: APreliminary Analysis," describes nine ways to finance aMedicare for all system, assuming a $30 trillion price tag over thenext decade—an number that is on the low side of some recentestimates.

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Related: CBO: Medicare for All a 'majorundertaking'

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The report said such a figure could be financed by any one ofthe following measures:

  • A 32 percent payroll tax.
  • A 25 percent income surtax.
  • A 42 percent value-added tax (VAT).
  • A mandatory public premium averaging $7,500 per capita – theequivalent of $12,000 per individual not otherwise on publicinsurance.
  • More than doubling all individual and corporate income taxrates.
  • An 80 percent reduction in non-health federal spending.
  • A 108 percent of Gross Domestic Product (GDP) increase in thenational debt.
  • "Impossibly high" taxes on high earners, corporations and thefinancial sector.
  • A combination of approaches.

Different plans, different points of view

The CRFB, one of the nation's most prestigious economicthink-tanks, is known for its hawkish view of deficits. Theorganization boasts an A-list of board members, including formerFed chairs Janet Yellin and Paul Volker; Reagan budget directorDavid Stockman; and other high-profile policy makers and businessleaders. As such, it's not known for embracing the kind of dramaticeconomic change that a Medicare for All system would represent.

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The group's analysis came out at roughly the same time thatpresidential candidate Sen. Elizabeth Warren, D-MA, released a plan detailing how she would pay forher Medicare for All proposal. Warren had been under fire for nothave specific numbers for her plan, and the new proposal is likelyto be controversial as well. For example, Warren projects aten-year price tag for her proposal at only $20 trillion.

Devil is in the details—and we're short on details

The CRFB, for its part, also lacks specifics, saying that itwill follow up this estimate with more detailed reports. In thisanalysis, the approach of giving separate financing solutions theirown cost estimates seems not entirely realistic, since any Medicarefor All plan is likely to use a variety of ways to fund healthcare. For example, the paper simply labels taxes on corporationsand high earners as "impossible," instead of considering that suchtaxes might somehow be in the mix—as it is with the Warrenplan.

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Michael Hiltzik, business columnist for the Los Angeles times,reviewed the CRFB proposal recently by wrylynoting that since Halloween was coming up, the group picked a goodtime to "scare the hell" out of American taxpayers.

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Hiltzik, who is generally more supportive of Medicare for Allproposals, notes that even the CRFB analysis says that under somescenarios, Medicare for All might reduce health spending overall inthe U.S. "Given the uncertainties about the details of any healthcare reform proposal, [the] argument that the committee is largelyworking out the 'distributional' issues that arise when revenuesfrom taxes are substituted for premiums and co-pays looks a bitlike placing one's thumb on the scale against Medicare for all,"Hiltzik said.

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