It is reassuring that on some levels the Democratic party establishment is shifting significantly leftward on health care policy, but there is one aspect where nearly the entire left is inexplicably small “c” conservative: almost everyone from the center to the left is focused on making sweeping health care reform budget neutral according to the Congressional Budget Office (CBO).
In response to my analysis of the Center for American Progress’s Medicare Extra for All plan claiming its cost sharing is too high, CAP Senior Fellow Topher Spiro admitted, “On AV, I want to go higher if the math works.”
This obsession is shared on the “true left,” where my own MICA plan was criticized by staunch single-payer supporters for not being fiscally conservative enough since I didn’t meticulously try to balance all potentially projected spending with new revenue.
Similarly, Physicians for a National Health Program (PNHP) President-Elect, Adam Gaffney, criticized the CAP plan claiming, “Without big [administrative] savings, how do we afford *fully* universal coverage? We probably don’t.” Gaffney claims the budget is “not at all my primary concern. I want single-tier, universal, comprehensive, no cost-sharing coverage. But that does cost real money, and at some point there will be a CBO score.”
Consider for a moment that both CAP and PHNP believe they can convince a majority of Democrats to stand up to the most powerful industry lobbyists in the country and deprive them of billions in revenue, but that convincing Democrats not to worry so much about the CBO’s educated guesses is too big of a political challenge.
There are four reasons why this shared obsession with fully paying for universal health care is both bad politics and bad policy.