Two questions that solve the Medicare-for-All dilemma.

It takes only two things to keep people in chains: The ignorance of the oppressed and the treachery of their leaders.


Before you read yet another article about Medicare-for-All and the “Who Will Pay For It” question, please take some time to think about, and answer, just two questions:Image result for hospital bed ill people in hospital

  1. Do you believe every American should have medical care, or should some Americans be forced to do without medical care?
  2. If you believe every American, rich or poor, should have medical care, who will pay for it?

Peter Suderman, the features editor at, writes regularly on health care, the federal budget, tech policy, and pop culture. He believes the government should not pay for health care.

I don’t know why; he never says. He is a libertarian, so he doesn’t like “big” government. Why? Again, he never says. How big is too big? Yet again, he never says.

But if the government doesn’t pay, all who’s left is you.

    • You pay if your company pays because your company figures the cost of health care insurance as being part of your salary.
    • You pay if your insurance company pays; it’s in your premiums.
    • You pay if the hospital emergency room pays because that forces the hospital to raise prices for all other services.
    • You pay if no one pays, and some Americans lack health care; their ill health means they can’t be productive contributors to the U.S. economy.
    • You pay if your city, county, or state pays for health care because these governments rely on your taxes to fund all their spending.

In short, there is no magic. You always have to pay, directly or indirectly. Except, there is magic. It’s the magic of Monetary Sovereignty.

The U.S. federal government is Monetarily Sovereign. About 240 years ago, the new U.S. government created the U.S. dollar — millions of them from thin air — simply by creating laws from thin air.

Alan Greenspan: “A government cannot become insolvent with respect to obligations in its own currency.”
Ben Bernanke: “The U.S. government has a technology, called a printing press (or, today, its electronic equivalent), that allows it to produce as many U.S. dollars as it wishes at essentially no cost.”
St. Louis Federal Reserve: “As the sole manufacturer of dollars, whose debt is denominated in dollars, the U.S. government can never become insolvent, i.e.,unable to pay its bills. In this sense, the government is not dependent on credit markets to remain operational.”

Since then it has continued to create laws and dollars, all from thin air. The very first dollars were not funded by taxes. They were created by laws.

And ever since then, the tax dollars you send to Washington, DC, willingly or grudgingly, still pay for nothing. Even if you don’t send a single tax dollar or even a tax penny to Washington, the U.S. federal government still could continue spending, endlessly.

So you, as a voter, have two choices:

  1. You can continue to pay for your healthcare, either via direct payment from your checking account, or via indirect payment through your company’s insurance plan, or via indirect payment via higher hospital charges, or you can pay by being sick without care, or
  2. The federal government can pay, and it would cost you nothing.

That’s it. Just two choices. There are no other options.

All those people who complain about the cost of Medicare-for-All really are telling you that you should pay, directly or indirectly.

Keep that in mind as you read the following excerpts:

How to pay for Medicare-for-All. Multiple estimates have found that the single-payer plan, which would eliminate virtually all private health insurance, would require more than $30 trillion in additional government spending over a decade, a historically unprecedented sum.

Additional federal government spending costs you nothing. The federal government already has spent more than $20 trillion dollars, and it has cost you nothing.

How do I know? Because the federal debt is more than $20 trillion dollars, and the federal debt represents federal spending you clearly have not paid for. 

Further, the taxes you paid don’t even fund any federal spending. Unlike state and local taxes, federal tax dollars are destroyed upon receipt. (The federal government creates brand new dollars, ad hoc, every time it pays a recipient.)

And if an additional $30 trillion really is needed for healthcare, that means Americans currently are doing without $30 trillion worth of healthcare. That’s way too much sickness not being treated in this, the world’s wealthiest nation.

Bernie Sanders cited a a study “that just came out of Yale University, published in Lancet magazine, one of the prestigious medical journals in the world.”

The study purports to show that Sanders’ Medicare-for-All plan would save $450 billion a year, and 68,000 lives.

A detailed article produced by Kaiser Health News and Politifact, however,  (disagrees).

The Lancet study assumes, for example, that the Sanders plan could pay Medicare rates across the board.

Medicare rates are far lower than private insurance rates, and the hospital lobby is a powerful political force that has successfully fought off payment reductions in multiple venues.

Suderman ignores one simple fact: The “hospital lobby” has existed a long time, and Medicare exists — and “its rates are far lower than private insurance rates.” How did that happen?

Could it be that past left-wing Congresses were more caring and moral than today’s right-wing Senate?

Not that it really matters, for as we have said on numerous occasions, the federal government, being Monetarily Sovereign, can afford anything. In fact, the more the federal government deficit spends, the more economic growth dollars enter the private sector.

That is how economies grow.

The Lancet study Sanders cites also lowballs the likely increase in utilization that would come from eliminating copayments and other cost-sharing mechanisms, as Sanders’ Medicare-for-All plan calls for.

Although it allows that the newly insured would use more care, it assumes that the currently insured would not seek to use more health services.

As Harvard health policy researcher Adrianna McIntyre points out, that’s deeply unrealistic.

Yes, utilization would increase, and that is a very good thing, indeed.

It is quite doubtful that people would make unnecessary visits to the doctor or hospital, just because they are free. So the additional utilization would benefit healthfulness. That is the whole idea: To improve America’s health.

There are other problems as well, most notably that the study simply doesn’t account for about $4 trillion in expected long-term care spending that would be part of the bill under Sanders’ Medicare-for-All plan.

Is this supposed to be a bug or a feature? The lack of long-term care, particularly for the elderly, is a real disgrace in America. Visualize yourself without long-term care insurance and having to choose between care at a facility, and no care, dying alone at home.

The heartlessness of Suderman’s position is truly stunning.

The study handwaves away research suggesting that its headline “lives saved” figure is substantially overstated.

Is 68,000 lives saved too high and estimate? Suderman never says what the “correct” number is. How about 50,000 saved lives? 40,000 saved lives? How many saved lives are too few for Suderman to be concerned about?

The question of how to pay for Medicare-for-All has come up quite frequently in the debates, and the repetition may even be having a substantial impact on the race.

Sen. Kamala Harris (D–Calif.)struggled with the (payment) question. Her stumbles probably contributed to her declining position in the race, and she eventually left the field.

Sen. Elizabeth Warren (D–Mass.) released a complex financing scheme. This generated substantial criticism and helped demonstrate how she relies on a veneer of wonkiness to avoid tough questions.

Eventually, Warren released a second plan that called for a delayed implementation of full-fledged Medicare for All, which many (understandably) read as a sign that she wasn’t serious about the idea.

In both cases, we learned something essential about the candidates and how they respond to pressure: Harris didn’t have a firm initial grasp of the policy mechanics, and she flailed and flip-flopped in search of a politically palatable answer. Warren bandwagoned with the most progressive candidate, eventually releasing a dubious (but detailed) plan that suggested she wasn’t serious, then followed it with another one that undercut the first, all while pretending it didn’t.

The same is now true of Sanders. And his response, it appears, is to point to an obviously unsound study conducted by a sympathetic voice, and then lie about the rest of the existing research.

The Medicare for All financing question is not just a policy question. It is a test of character—and Sanders failed it.

No, Mr. (Libertarian) Peter Suderman, the Medicare-for-All is not just a test of character. It also is a test of economic knowledge, and you failed both tests.

You failed the test of character by giving the back of your hand to all the sick people who are or will, lead lives of misery or die early because they can’t afford proper care. You throw compassion to the wind, and prefer to talk about money.

And you failed the test of economic knowledge because you don’t understand the difference between federal financing vs. state and local government, business, and personal financing.

You also don’t understand the effect that illness has on America’s economic growth. (Perhaps the coronavirus will teach you.)

And while the Democrats may favor Medicare-for-all for compassionate and economic reasons, they too display a stunning ignorance of federal financing.

And that ignorance will kill a program the people of this nation so greatly need.

6 thoughts on “Two questions that solve the Medicare-for-All dilemma.

  1. I am rutinely astonished by the ignorance of our leaders regarding the money system. Your monetary sovereignty and related policies are excellent. The one thing I would suggest is considering my idea of a 50% discount/rebate policy at the point of retail sale as it would completely eliminate any possibility of inflation (the inflation rate in the US has never exceeded 15% and that was only after we’d been at war for over 10 years and the Arab oil embargo raised the price of petroleum by almost 400%). This single policy would also double everyone’s earned income purchasing power which as I’m sure you know has been eroding for the last 45 years. It would also double the actually available revenue for every enterprise’s goods and services which means it would be politically integrative of the traditionally opposed constituencies of labor and management. Finally, as inflation would be eliminated it would free us to increase the fiscal spending absolutely necessary for the kind of mega projects we will need to survive climate change.

    Finally-finally, I have suggested a second 50% discount/rebate policy at the point of note signing for all big ticket and ecologically sane consumer products which would make it possible to begin a huge cost effective bottom up green consumer product trend. Imagine $50k EV autos for $12500 and $300k solar and wall battery homes for $75k. ($300k reduced to $150k at point of sale and to $75k at note signing)

    If we didn’t have to worry about inflation



    President Donald Trump’s response to the spread of coronavirus proves he does not understand the danger nor how to slow the outbreak, a World Health Organization (WHO) official has warned.

    WHO Special Adviser to the Director Dr. Ezekiel Emanuel told MSNBC Wednesday that Trump’s briefing on the virus was largely “incoherent” and betrayed how little the president knows about the challenges facing public health.

    Trump announced Wednesday that Vice President Mike Pence—who has been criticized for an anti-science stance on issues including an HIV outbreak in Indiana—will lead the response to the outbreak. The president maintained that the risk to Americans is “very low” and that the country is “ready” to respond.

    Trump compared the COVID-2019 strain to the flu and said he was surprised to learn that regular flu kills between 25,000 and 69,000 people in the U.S. each year.

    But the briefing did not elicit much confidence among experts, including Emanuel. He told MSNBC host Chris Matthews that most of what Trump said was “a little incoherent.”

    Trump’s surprise at the impact of flu revealed more about public health and about the health of the American public,” Emanuel added. “Every doctor knows that and lots of health policy experts know that.”

    Emanuel said the president was wrong to conflate coronavirus with the flu. “We don’t know how similar or dissimilar this is to the flu,” he explained. “We know one thing, it actually is more communicable than the flu, it passes between people very, very easily.”


  3. Trump Didn’t Just Botch the Coronavirus Response. He Enabled Its Spread.

    Even as China was announcing that its deaths from the novel coronavirus had surpassed its toll from SARS, President Donald Trump released a proposed budget for 2021 that slashed funding for our chief defender against epidemics by 18 percent.

    Within the overall proposed cuts detailed on Feb. 10 for the Centers for Disease Control and Prevention was a reduction in spending to guard against “emerging and zoonotic diseases” from $635,772,000 to $550,464,000.

    Zoonotic diseases are those that have crossed from animals to humans, as the novel coronavirus is believed to have done. The $85,308,000 proposed budget cut is less than the cost of 5 miles of border wall.

    The budget proposal would save the cost of another 2 miles of border wall by zeroing out a $40 million funding line for the Epidemic and Lab Capacity Program.

    The ELCP supports state labs that monitor health emergencies at the local level. A state lab in Texas confirmed the first case of Ebola in the U.S. in 2014.

    For the cost of less than 7 miles of border wall, the proposed budget would leave all of us less protected against a potential epidemic.

    The Trump administration made its priorities even more explicit when Health and Human Services Secretary Alex Azar discounted a suggestion that border wall funds could be diverted to fight the spread of the coronavirus.

    We might have had earlier warning of the outbreak, but previous budget cuts caused the CDC to end its global security program in China in 2017.

    In another failure of foresight two years ago, the White House eliminated the National Security Council’s position for combating global health crises.

    The NSC’s Senior Director for Global Health Security and Biothreats post was held by the highly regarded Rear Admiral Tim Ziemer—whose sudden departure in May of 2018 happened to coincide with a new Ebola outbreak in Africa.


  4. I’m sorry but do not compare me to an old Republican. As I said, I wouldn’t mind paying more so that everyone can have cheap or free healthcare.

    My experience with the British system (and hearing about the Polish system) doesn’t make me enthusiastic about a 100% single-payer system. Nearly all my friends in these countries take advantage of private medical care on top of the government system.


    1. In the United States, which is Monetarily Sovereign, there would be no reason to pay more for Medicare for All.

      You seem to be saying that because your friends in other countries use private payers, you wouldn’t want free, government paid-for health care in the U.S.


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