Jonathan Martin and Abby Goodnough discuss a brewing Democratic Party debate about Medicare For All in The New York Times. Does it mean a single-payer system in which the government covers everyone’s health care costs? Or is it just rhetoric intended to mean “I support a better health care system” without a commitment to challenging insurance industry power?
Martin and Goodnough helpfully note that only one likely 2020 presidential candidate is committed to a single-payer system: Bernie Sanders. But their article is also misleading in its discussion of Medicare For All policy, politics, and polling. Their errors are all too common in news articles and anyone wishing to responsibly cover politics over the next few years needs to correct them.
First, when it comes to the policy implications of Medicare For All, Martin and Goodnough characterize single-payer health care as a system “in which many would lose their current insurance options and pay higher taxes.” They fail to mention that the policy replaces people’s “current insurance options” with more expansive coverage that (under Sanders’ plan) eliminates premiums, copays, and deductibles.
As pretty much every distributional analysis of proposed single-payer plans show, the vast majority of people will pay substantially less money in taxes plus health care costs under Medicare For All than they currently pay. The omission of these details is akin to implying Martin should have felt “uneasy” about losing his health insurance options and paying higher taxes in 2013 – without mentioning that he was replacing his insurance and making a higher income by moving from Politico to The New York Times.
Second, in an attempt to support Michael Bloomberg’s claim that single-payer health care will “bankrupt” America, Martin and Goodnough cite a study from the Mercatus Center that “predicted [Sanders’ plan] would increase federal spending by at least $32.6 trillion over the first decade.” That study also predicted that combined private and public spending on health care in the United States – the most important number in health care cost estimates – would fall by $2 trillion, but Martin and Goodnough don’t mention that fact. As Matt Bruenig has documented extensively, it’s hard to read the numbers in the Mercatus report as anything other than an endorsement of Sanders’ plan.
Mercatus doesn’t want us to read their study that way, which brings us to the second way in which the Times article is misleading. Martin and Goodnough describe Mercatus as the “Mercatus Center of George Mason University,” giving it the imprimatur of impartial academic institution, when Mercatus is in reality a right-wing think tank funded by the Koch family foundations. This neutral description is inconsistent with how the Times news pages describe other think tanks – they routinely call my old employer, the Center on Budget and Policy Priorities, “liberal” or “liberal-leaning” – and erroneously suggests to the reader that the concerns Mercatus raises come from an objective source.
Third, Martin and Goodnough cherry-pick the Medicare For All polling data that makes their preferred case. They acknowledge that the term itself “has broad public support,” but they highlight how support for the policy drops “when people hear that it would eliminate insurance companies or that it would require Americans to pay more in taxes.” A result from the same poll that goes unmentioned? That support for the policy rises when people hear that it would “guarantee health insurance as a right for all Americans” or “eliminate all health insurance premiums and reduce out-of-pocket health care costs for most Americans.” Martin and Goodnough also cite a Gallup poll finding that “70 percent of Americans with private insurance rate their coverage as ‘excellent’ or ‘good’” without pointing out that the number jumps to 79 percent for Americans on Medicare or Medicaid.
What Martin and Goodnough get right is that “attitudes [about Medicare For All] swing significantly depending on…the details.” If you tell people that the policy will result in them losing their current insurance, paying higher taxes, and interacting with a bankrupt federal government, they’re less likely to support it. If you tell people the truth, however – that public insurance in the United States is well-liked and more cost-efficient than private insurance, that other countries with similar systems spend way less money while covering a much higher percentage of their populations than we do, and that, under a Medicare For All system, most will get better coverage while paying less than they do today – people are on board.