The bottom line here is correct:
Elizabeth Warren wants to finance a single-payer health care system by, in part, requiring employers to take their current per-employee spending on health insurance and kick it over to the government instead.
This helps her achieve her desired talking point that the plan does not involve an increase in taxes on the middle class. But it’s also a highly unusual program design that you don’t really see in foreign health care systems. And as her plan acknowledges, it wouldn’t really be sustainable over the long run to have different employers facing sharply different health care costs when their employees are all getting the same health care regardless.
Bernie Sanders, who has not released a similarly detailed financing scheme, has criticized this idea and instead touts an employer-side payroll tax and an income tax hike (with an exemption for low-wage workers) as better financing mechanisms.
Somewhat contrary to the main public image of the two New England progressives, Sanders’s idea here seems more technocratically sound while Warren has basically chosen to fulfill a talking point at the expense of sound program design. On the other hand, you can’t change the health care system unless you win the election first. And new polling conducted by YouGov Blue on behalf of Data for Progress confirms that with her preferred pay-for, Medicare-for-all polls better than if you use alternate tax ideas.
Poll numbers obviously don’t change the fact that a payroll tax would probably be more financially advantageous for most people. But in a world where even if the 2020 election goes extremely well for Democrats there is extremely little chance of a full-blown Medicare-for-all plan being enacted, all these proposals are campaign props more than real policy blueprints. And Warren has narrowly succeeded in crafting the prop she needs — something consonant with her “plans” schtick (which Sanders’s purposeful vagueness would not be) that also polls well.
This difference echoes the debate over the individual mandate during the 2008 primaries, in which Obama chose the more popular position and Clinton the more technocratically sound one. Obama won, and yet the final version of the ACA had the mandate anyway — the specific details of a policy will get worked out after you get enacted so might was well run on the most popular version. Only in his way Obama was onto something: it’s not a coincidence that the mandate, the one component of the ACA that polled badly, is also the core component Republicans have been able to get rid off. And it turns out that the carrot is much better incentive than the stick anyway.
And, of course, as Yglesias says the stakes are much lower this time, because there’s no way in hell the next Congress is enacting any version of Medicare For All no matter who wins the election. So run on what polls well, not on what the most formally sound version of the policy would be.