Medicare for All: Your one misunderstanding that ruins everything

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

With regard to Medicare for All, here is one little huge misunderstanding that ruins America the world.

Ryan Cooper

Consider, for instance, these excerpts from an article by Ryan Cooper, a national correspondent at  — a man who advocates the passage of a Medicare for All bill, though ironically, his article helps prevent it.

The solution to America’s health-care problem is obvious: Medicare. For. All.

With Republicans busy trying to pass a spectacularly unpopular bill to strangle ObamaCare and grind Medicaid down to a tiny stump, simply expanding the most generous and functional part of the welfare state to everyone makes increasing political and practical sense as a bold counter-offer.

Single-payer dramatically strengthens the rest of the social safety net. It would get rid of the patchwork of janky mandates and systems that provide for unemployed or disabled people.

No more messing around with the obnoxious (and often unaffordable) COBRA or exchange plans.

Then, with health care decoupled from employment, unemployment insurance, paid family and sick leave, and disability benefits would be correspondingly strengthened.

It would cover “inpatient, outpatient, emergency services, dental, vision, mental health, and nursing home care” without any premiums, deductibles, or co-pays.

Medicare already has all three of those, in varying degrees based on income and tax-payment history.

No, Medicare does not cover all those things, “without any premiums, deductibles, or co-pays.”  Never heard of Medicare supplement insurance? Never heard of long-term care insurance? Never heard of Part D pharmaceutical insurance?

Medicare is a good program as far as it goes, but it’s a long way from a comprehensive plan, even for those over 65.

But, why shouldn’t “the greatest nation on earth” (we like to proclaim) provide comprehensive, top-notch health care for every man, woman, and child in America?

Sadly, Mr. Cooper provides a reason — a non-reason, really: Cost. And even more sadly, he focuses the entire rest of his article on this non-reason — his misunderstanding — that ruins everything.

Medicare-for-all isn’t going to be cheap. California has been considering such a plan recently, and the headline price is $400 billion, according to a state legislative analysis. By American standards, that’s an expensive program even for the federal government.

Yes, it is an expensive program for California, a monetarily non-sovereign state, but not expensive for the federal government. 

Nothing is expensive for our Monetarily Sovereign federal government, that creates an unlimited amount of its sovereign currency by the process of paying its bills.

California can run out of dollars; the federal government cannot. California taxpayers fund California spending. Federal taxpayers do not fund federal spending. That is the fundamental difference between a Monetarily Sovereign government and a monetarily non-sovereign government.

But it can still work. While ideally single-payer would be passed at the federal level, California (and New York) are good candidates for a proof-of-concept test run. If done right, it would be a huge success, and it would place all other social programs on a much sounder footing.

In fact, California and New York are terrible candidates, unless you oppose Medicare for All. 

Being monetarily non-sovereign, they will run short of dollars to fund comprehensive Medicare for All programs. So they will have to make cuts. And these cuts will “prove” to the doubters that Medicare for All can’t work.

It would be like a man trying to fly by flapping feathered wings — and failing — thereby “proving” man never will fly.

And what is the “concept” these programs would prove? That providing people with comprehensive health care, like the rich already enjoy, is a good benefit? Is this a concept that needs proving?

The important thing to remember regarding the state budget is that California already spends about $200 billion on Medicaid and Medicare — it’s just that those programs are administered at the federal level.

Per the state analysis, employers also already spend an additional $100 billion to $150 billion, so the state would “only” have to find $50 billion to $100 billion in fresh revenue.

Better check your numbers, Mr. Cooper. Medicare for All involves comprehensive (“inpatient, outpatient, emergency services, dental, vision, mental health, and nursing home care without any premiums, deductibles, or co-pays”) for every man, woman, and child in the state, not just those over the age of 65.

What about the billions of insurance dollars currently spent by individual people who aren’t on Medicare or Medicaid? Even most employer plans require contributions from employees.

All of the above is why California is a terrible test. Either the program will not be comprehensive or it will be unaffordable.  Either way, it absolutely, positively will “prove” to the doubters that a comprehensive Medicare for All plan cannot work.

Single-payer would be quite a lot cheaper than $400 billion, too, if it weren’t for America’s preposterously expensive medical prices. Good thing that will change.

Remember, single-payer gives the government far greater leverage over prices than currently exists, through bargaining leverage or simple price controls.

“Leverage over prices” means that Mr. Cooper wants the federal government unnecessarily to reduce what doctors, nurses, other medical workers, hospitals, and pharmaceutical companies receive.

Think about the effect that would have on the supply of doctors, nurses, and other health workers –– which already are in short supply.

And exactly how does it benefit America for hospitals to receive less income?

Though pharmaceutical companies often are reviled, they are the ones we expect to develop new drugs.  Is that something we want to cut?

What Mr. Cooper doesn’t take into consideration is while state and local spending does not add stimulus dollars to the economy, federal spending does. Every cut to federal spending is anti-growth, and federal spending costs taxpayers nothing.  Nothing!

Finally, the proposed California program would be substantially more generous than extant Medicare. All told, while it would be a huge outlay, it’s worth the money.

Yes, comprehensive Medicare for All will be “substantially more generous” not only than extant Medicare, but more generous (i.e. more expensive) than any but the most platinum of current health care plans.

And that is a good thing, if it’s supported by the Monetarily Sovereign, federal government (though a bad thing if supported by the monetarily non-sovereign, state and local governments).

Now, actually putting such a system through would be tough.

It’s virtually guaranteed that the Trump administration would refuse to allow a blue state to mess around with its Medicaid/Medicare money at all, and they would have to worry about rich people skipping out of the state to avoid taxes, not to mention state prohibitions on borrowing money.

Yes, the politics are such that Republicans don’t want any plan that will help the middle class and the poor, and Libertarians don’t want any plan that increases government spending. Both groups do the dirty work of the very rich.

They are the people responsible for insufficient economic growth, insufficient health care and the widening Gap between the rich and the rest.

The Gini Ratio indicates the “Gap” — the distance between the richer and the poorer. A ratio o f”0″ would indicate perfect equality, where everyone has the same. A ratio of “1” would indicate that one person has everything. A rising line indicates the rich are growing richer and the rest are growing comparitively poorer.

So, it’s up to you voters to make an offer the politicians can’t resist, and that only can happen if you understand that a Medicare for All plan need not cost you a single penny if it is funded by the Monetarily Sovereign federal government.

While state and local taxes fund state and local spending, federal taxes do not fund federal spending. The federal government creates dollars, ad hoc, every time it pays a bill.  

Even if all federal tax collections were $0, the federal government could continue spending, forever. It never can run short of its own sovereign currency.

Some people are turned off of single-payer when they hear it means more taxes. I very strongly believe such sentiments are driven by an unreasonable skepticism about social insurance created by decades of duplicitous conservative agitprop.

Such sentiments are driven by the Big Lie — the lie that federal taxes fund federal spending, and that the poor are lazy takers who will stop working if they are given any benefits.

Educate the public about the realities of Monetary Sovereignty, and suddenly all objections to single-payer would disappear.

After all, who would not want to receive a lifetime’s worth of free, comprehensive medical care? And who would want to deny it to poor families?

Europeans who visit America are rightly flabbergasted that citizens of the world’s wealthiest large nation tolerate their countrymen having to scrounge for money to pay medical bills.

Worse than scrounging for money, some of us do without health care. The right wing blames the victims for being lazy.  They are sure that if the government provides benefits to the poor, this will disincentivize the poor from working. That is what the rich tell them.

But here’s the bottom line: The left must get behind single-payer, and trumpet it loudly. It’s critically important for the left to maintain the courage of its convictions. It is not enough to be against the American Health Care

It is not enough to be against the American Health Care Act, or to compromise for janky middle-of-the-road attempts at bipartisanship like ObamaCare. It’s long past time that the Democratic Party stood for something big and bold.

But to be “big and bold” one must understand the facts, and the primary fact is this: Comprehensive Medicare for All would not cost you one cent. In fact, federal spending for Medicare for All would stimulate economic growth.

Truly guaranteed health care would mean relief from the constant nagging worry that job loss, or a change in coverage plan, or a sudden emergency landing you in an out-of-network hospital would lead to untreated illness or financial ruin.

No more would illness mean taking up a second job trying to navigate the brain-melting complexity of a monstrous, wasteful billing system.

Medicare-for-all would be a relief on so many levels that many Americans simply can’t conceive of it. But if it were to pass, it would be immediately popular — and forevermore politically untouchable.

It will pass if columnists like Ryan Cooper first would learn the truth, then tell the truth.

Is that too much to ask?

Rodger Malcolm Mitchell
Monetary Sovereignty


The single most important problems in economics involve the excessive income/wealth/power Gaps between the have-mores and the have-less.

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.

Implementation of The Ten Steps To Prosperity can narrow the Gaps:

Ten Steps To Prosperity:
1. ELIMINATE FICA (Ten Reasons to Eliminate FICA )
Although the article lists 10 reasons to eliminate FICA, there are two fundamental reasons:
*FICA is the most regressive tax in American history, widening the Gap by punishing the low and middle-income groups, while leaving the rich untouched, and
*The federal government, being Monetarily Sovereign, neither needs nor uses FICA to support Social Security and Medicare.
This article addresses the questions:
*Does the economy benefit when the rich can afford better health care than can the rest of Americans?
*Aside from improved health care, what are the other economic effects of “Medicare for everyone?”
*How much would it cost taxpayers?
*Who opposes it?”
3. PROVIDE A MONTHLY ECONOMIC BONUS TO EVERY MAN, WOMAN AND CHILD IN AMERICA (similar to Social Security for All) (The JG (Jobs Guarantee) vs the GI (Guaranteed Income) vs the EB (Economic Bonus)) Or institute a reverse income tax.
This article is the fifth in a series about direct financial assistance to Americans:

Why Modern Monetary Theory’s Employer of Last Resort is a bad idea. Sunday, Jan 1 2012
MMT’s Job Guarantee (JG) — “Another crazy, rightwing, Austrian nutjob?” Thursday, Jan 12 2012
Why Modern Monetary Theory’s Jobs Guarantee is like the EU’s euro: A beloved solution to the wrong problem. Tuesday, May 29 2012
“You can’t fire me. I’m on JG” Saturday, Jun 2 2012

Economic growth should include the “bottom” 99.9%, not just the .1%, the only question being, how best to accomplish that. Modern Monetary Theory (MMT) favors giving everyone a job. Monetary Sovereignty (MS) favors giving everyone money. The five articles describe the pros and cons of each approach.
4. FREE EDUCATION (INCLUDING POST-GRAD) FOR EVERYONE Five reasons why we should eliminate school loans
Monetarily non-sovereign State and local governments, despite their limited finances, support grades K-12. That level of education may have been sufficient for a largely agrarian economy, but not for our currently more technical economy that demands greater numbers of highly educated workers.
Because state and local funding is so limited, grades K-12 receive short shrift, especially those schools whose populations come from the lowest economic groups. And college is too costly for most families.
An educated populace benefits a nation, and benefitting the nation is the purpose of the federal government, which has the unlimited ability to pay for K-16 and beyond.
Even were schooling to be completely free, many young people cannot attend, because they and their families cannot afford to support non-workers. In a foundering boat, everyone needs to bail, and no one can take time off for study.
If a young person’s “job” is to learn and be productive, he/she should be paid to do that job, especially since that job is one of America’s most important.
Businesses are dollar-transferring machines. They transfer dollars from customers to employees, suppliers, shareholders and the federal government (the later having no use for those dollars). Any tax on businesses reduces the amount going to employees, suppliers and shareholders, which diminishes the economy. Ultimately, all business taxes reduce your personal income.
7. INCREASE THE STANDARD INCOME TAX DEDUCTION, ANNUALLY. (Refer to this.) Federal taxes punish taxpayers and harm the economy. The federal government has no need for those punishing and harmful tax dollars. There are several ways to reduce taxes, and we should evaluate and choose the most progressive approaches.
Cutting FICA and business taxes would be a good early step, as both dramatically affect the 99%. Annual increases in the standard income tax deduction, and a reverse income tax also would provide benefits from the bottom up. Both would narrow the Gap.
There was a time when I argued against increasing anyone’s federal taxes. After all, the federal government has no need for tax dollars, and all taxes reduce Gross Domestic Product, thereby negatively affecting the entire economy, including the 99.9%.
But I have come to realize that narrowing the Gap requires trimming the top. It simply would not be possible to provide the 99.9% with enough benefits to narrow the Gap in any meaningful way. Bill Gates reportedly owns $70 billion. To get to that level, he must have been earning $10 billion a year. Pick any acceptable Gap (1000 to 1?), and the lowest paid American would have to receive $10 million a year. Unreasonable.
9. FEDERAL OWNERSHIP OF ALL BANKS (Click The end of private banking and How should America decide “who-gets-money”?)
Banks have created all the dollars that exist. Even dollars created at the direction of the federal government, actually come into being when banks increase the numbers in checking accounts. This gives the banks enormous financial power, and as we all know, power corrupts — especially when multiplied by a profit motive.
Although the federal government also is powerful and corrupted, it does not suffer from a profit motive, the world’s most corrupting influence.
10. INCREASE FEDERAL SPENDING ON THE MYRIAD INITIATIVES THAT BENEFIT AMERICA’S 99.9% (Federal agencies)Browse the agencies. See how many agencies benefit the lower- and middle-income/wealth/ power groups, by adding dollars to the economy and/or by actions more beneficial to the 99.9% than to the .1%.
Save this reference as your primer to current economics. Sadly, much of the material is not being taught in American schools, which is all the more reason for you to use it.

The Ten Steps will grow the economy, and narrow the income/wealth/power Gap between the rich and you.