Over the past several months, everyone from debate moderators to fellow candidates have pestered Warren about whether her Medicare-for-all plan would raise middle-class taxes, hoping she’d say “yes.” Like them, Warren clearly believed this was the sort of thing future attack ads are made of. In response, she talked about how medical expenses are equivalent to taxes, without actually answering the question itself.
Any politician, no matter how talented, would have struggled to get away with avoiding the question. But Warren, as the woman with a plan for everything, needed to answer the bell. People wanted a plan that showed Warren would not up middle-class taxes? Well, here you go! Her proposal would convert the current spending of employers on health insurance to a tax, raise even more money by such mechanisms as a financial transactions tax on stock trades and an increased tax on billionaires. (Raising taxes on the rich is always popular among voters, if not Washington politicians.)
But now Warren is facing — as likely could have been predicted — a new buzz saw of gotchas. Instead of satisfying her critics, her plan raised even more questions, further emboldened her naysayers on both sides of the political spectrum, and left her more enmeshed in an uncomfortable debate. Medicare-for-all opponents have no plans to stop criticizing the policy just because Warren now has a plan she says will pay for it. Former vice president Joe Biden, for one, doesn’t believe it — his communications director released a statement Monday claiming the assertion this won’t impact the finances of middle-class families is “simply not true.” And she’s getting attacked from the left, too. Even Sen. Bernie Sanders (I-Vt.), who agrees with Warren on Medicare-for-all, complained about her approach. He favors a payroll tax on employers (which is effectively a tax on employees) and claimed her plan would “have a very negative impact on creating jobs.”
To be clear, there’s no small amount of hypocrisy at work among many of Warren’s critics. A number of her Democratic opponents have not exactly been forthright about how they would get their own health-care fixes enacted. (Biden, for instance, is relying on what appears to be nonexistent Republican goodwill.) Similarly, the obsession with demonstrating how change will be paid for is not fairly applied. There was no credible analysis that showed the Trump tax reform package passed by Congress in 2018 could pay for itself or would lead to increased business investment. But President Trump and Republicans simply insisted — falsely — that this would happen and passed the bill anyway. The result is a soaring deficit. And finally, for all the laments about how many dollars will be spent, the media and Medicare-for-all opponents suddenly don’t like talking numbers when it comes to how many lives will be saved.
But it’s also true that converting the country to a single-payer health-care system in a relatively short time means radically changing the way we finance medical services in this country. Sanders, to his credit, confronts that head-on. “My guess is people in the middle class will be paying somewhat more in taxes, but they are going to be paying significantly less overall in health care,” he said in July. “If you consider premiums, as I do, a tax, the working class of this country is very heavily taxed.” The typical American pays thousands of dollars annually for all their medical expenses. Wouldn’t they rather know that in return for that money they would get some guarantees they wouldn’t receive surprise medical bills totaling thousands of dollars, that they could fill their prescriptions without risking a financial crisis, that they wouldn’t be expected to go “shopping” for health insurance or compare MRI costs? Perhaps the answer is yes, perhaps it is no, but there’s no doubt about where Sanders stands. Warren, on the other hand, is still trying to insist the middle class will barely feel a thing.
Warren, who talks about taxing billionaires and employers, could be right, maybe a middle-class tax increase is not necessary. But it’s also true that successful politics requires the ability to confront uncomfortable subjects head-on. Warren, who has spent the majority of her adult life as a lawyer and professor, not a politician or entertainer, is relatively new to this. When it comes to discussing how to finance her version of Medicare-for-all, her inexperience showed.