Rutland Herald and Montpelier (Barre) Times Argus

Sunday May 29, 2016.

I must be careful when I make this point. I know and am friendly with many Bernie Sanders supporters, particularly in Vermont. And they are certainly not the kind of people who would be attracted to a nativist, prevaricating, fear-mongering presidential candidate like Donald Trump.

Nevertheless, substantial numbers of Sanders supporters have told pollsters they would vote for Trump ahead of Hillary Clinton. Beyond that, there does appear to be some significant overlap among Sanders and Trump supporters – namely, in their willingness to suspend their disbelief and pretty much accept what their candidate says without asking too many questions.

Trump says he is going to make America great again. How? By building a wall on the border with Mexico; expelling 12 million illegal aliens; banning entry to untold millions of Muslims? Yet however fanciful, totally impractical or amoral Trump’s ideas may be, most of his supporters don’t care and are all for them.

Senator Bernie Sanders is not suggesting anything as egregious as Trump’s proposals. But it might come as a surprise to many of his supporters that Sanders’ central campaign ideas - to turn Obamacare into a single-payer healthcare system and increase Social Security benefits – could double the national debt. This is not my opinion, (nor that of the editorial page of the Wall Street Journal.) It is the conclusion of the non-partisan, Urban-Brookings Tax Policy Center.

Its director is Len Burman, a nationally recognized tax policy expert who is also the Daniel Patrick Moynihan Professor of Public Affairs at Syracuse University. He served as a tax analyst in the Department of the Treasury and for over a decade was a senior economic analyst of the Congressional Budget Office.

The Urban-Brookings analysis of the costs of implementing the principal themes of the Sanders campaign did not get a lot of attention when it came out in early May. But it did prompt this critique of Sanders, by Washington Post editorial writer Steven Stromberg.

“Sen. Bernie Sanders (I-Vt.) has attracted a passionate following because he is selling his followers a fantasy. And not just any fantasy – but one of epic proportions. A group of respected, nonpartisan experts (has) offered the public a sense of the scale, releasing the most thorough analysis yet on Sanders’s plan and finding that it is profoundly flawed.”

After outlining the assumptions of the analysis- that it was very progressive and would massively increase taxes on the rich and provide a range of new benefits for the poor- Stromberg attacked. “But there is a massive catch. Sanders’s assurance that he has a ‘plan to pay for every spending program he has introduced to date’ is wrong. And not just wrong but extravagantly so. Even with his large tax increases, Sanders would fall $18 trillion dollars short over ten years. Factoring in interest costs his plan would add $21 trillion to the debt over a decade.” That is more than the Treasury owes today.

The Washington Post editorial page has not supported Sanders. Still, this is one of the toughest treatments of Sanders I have seen anywhere

This is an area outside my expertise, yet these numbers certainly give one pause. I was already troubled by Sanders’ casual assurances that as most Western democracies provide universal healthcare for their citizens there is no reason the U.S. can’t do this as well. Unfortunately that ignores the historical realities of how, in the aftermath of WWII, each country arrived at its heathcare programs.

Take Canada for example.

In the mid-1930s the farmers of Saskatchewan, who were among the hardest hit by the Depression and several years of drought, formed a socialist political party known as the Cooperative Commonwealth Federation - the C.C.F. In 1944 that party won election to become the first socialist government in North America. Among its first acts was to provide government subsidized hospital insurance for everyone in the province. Encouraged by the success of this program, in 1962 doctors were added to the coverage. For many in the medical profession this was a step too far in the direction of socialized medicine, and 90% of the province’s doctors went on strike.

The government responded by bringing in doctors from Britain, the U.S. and other Canadian provinces and within two weeks the local doctors’ resolve began to weaken. On the 23rd day of the strike a compromise agreement was reached giving the doctors some flexibility, slightly better fees and a role in the administration of the program. The significance of this is that the Saskatchewan model proved to be workable. And within a decade, all nine other Canadian provinces had adopted a version of this model of universal medical care.

In Europe, a Labor Government was elected in Britain before the war in Asia was even over, in no small part because of the promise of universal healthcare. In post-war France and Italy, Socialist and Communist political parties backed by powerful trade unions which were willing and able to call national strikes, ultimately achieved universal government healthcare. In Sweden, Norway and Denmark, the establishment of a strong social support system was consistent with the Scandinavian ethos.

Meanwhile, in the United States after the war, healthcare became tied to the private sector. Major unions made their deals with their employers and healthcare benefits became part of the pay check. Many Americans had very good coverage under this system. But it was a patchwork which left many workers with little or no health insurance - while the power to grant or deny certain medical treatments was increasingly appropriated by the insurance companies. Finally, after half a century Obamacare was passed to address the inequities in that system and to get more people covered. That is still a work in progress.

One other thing made healthcare in America significantly different - it became a huge for-profit industry that now employs millions and according to some estimates, accounts for nearly 20% of the U.S. gross domestic product. That makes it virtually impervious to change - and immune to electioneering slogans.

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