I make no apologies. I really do like medicare for all. I want to support it. I just struggle to find the funding given how much UBI costs, and don't want to push things too much. Still, I've been rethinking elements of medicare for all lately and having a fixation on the policy, I want to come up with my own medicare for all plan. Funding sources for this would come from a mixture of Bernie's, and Warren's M4A plans, as well as Medicare Extra for All. I might also look at some ideas from the Medicare for America Act.
Costs
Costs vary, but Bernie set his goal at $17.5 trillion over the next 10 years, which is $1.75 trillion a year, and Warren put hers at $20 trillion over 10 years, or $2 trillion a year. This is not including existing costs on medicare and medicaid, which would be used to fund the remaining costs. All in all, I will aim to draw in roughly $1.75-2 trillion per year.
How to pay for it
Employer side payroll tax- $520-880 billion per year
First, I would start with an employer side payroll tax. I made the error in previous calculations of trying to include this in laffer curve limits, but these costs are invisible to workers, and visible to employers. That said they do not count against the laffer curve peak on the worker side of the paycheck, but they might negatively influence employer costs, meaning they hire fewer employees. Bernie's 7.5% payroll tax is estimated to bring in $520 billion per year, while Warren calculates hers by estimating employers would spend $9 trillion on healthcare over the next 10 years, so she expects employers to calculate how much they would normally spend and direct the money to the government instead (more or less, it's slightly more complicated than this). Both are attempts to replace an already existing cost in the system and function as a "free lunch".
Excise taxes - $33 billion
I think the idea of having excise taxes on certain unhealthy products is a good thing. Medicare extra for all would increase excise taxes on alcohol, tobacco, and sugary drinks. I mean if we're going to be giving people healthcare after they make themselves sick consuming such things, it makes sense to tax them and bring the revenue in. To calculate costs, I'll look at Medicare for America's tax numbers (link above), and compare that to how much the federal government already brings in from such things.
Tobacco- Currently we bring in $12.5 billion per year from excise taxes on tobacco. I estimate that the Medicare for America changes would double it, giving us an additional $12.5 billion in revenue.
Alcohol- Currently we bring in $10 billion per year and Medicare for America would radically change the tax rates. Some stuff would not go up much, but some things would be increased by a favor of 16. I'm not sure how to weigh this stuff so I would just estimate bringing in another $10 billion this way.
Sugary drinks- It's unclear how much revenue we would bring in from the tax on sugary drinks, but in line with alcohol and tobacco, I would guess $10 billion or so. I'll just go with that for now.
Additional take home pay subject to taxes- $140 billion
In Warren's plan, Warren points out that some income is tax exempt as it is used as a tax write off to pay for health insurance already. Given M4A would free people from this burden, that income is now subject to taxation and is estimated to produce $140 billion per year.
Changes to the corporate tax code- $290-300 billion
Both Bernie and Warren have plans to change the corporate tax code to bring in roughly $300 billion per year. I would maintain this plan.
Wealth tax- $275 billion
This comes from the Medicare Extra for All plan, but they estimate a wealth tax could bring in $275 billion per year.
For the 99.8% Act- $34 billion
This is an estate tax that Bernie supports that would bring in some extra revenue.
Improved tax enforcement- $230 billion
Warren believes improved tax enforcement could bring in $230 billion per year to fund medicare for all.
4% tax on income - $532 billion
Bernie Sanders has a 4% tax on households making above $29,000 a year in his plan. This exempts low income households from taxes. However, given I give everyone a UBI, I'll just apply the tax to any earned income other than UBI by the same formula I use for UBI. That's a $13.291 trillion tax pool, and at a 4% rate, that means we should raise $532 billion in revenue. This would raise the marginal rate on the rich from 67% under my other plans to 71%, or from 69.6% to 73.6%, but it's only slightly over 70% so I'm not worrying too much about it.
These combined plans should give us a total revenue of $2.054 trillion to $2.424 trillion, which is overkill. We could probably do without one or a few of the funding sources and still pay for it, which might be wise given I remember wanting to use Biden's plan of corporate tax increases to pay for infrastructure and stuff like that. This plan also gives us some leeway in case the plan comes up short.
Conclusion
Would I support this plan? Well, I would ideally like to see someone more qualified than me actually run the numbers, but I like this plan in theory. It funds medicare for all in part from existing costs and in part from taxes on the rich that don't count against the laffer curve. It could theoretically work. And if I do draw in that much revenue, I could easily redirect it to other stuff if it's more than needed. I like this plan, it seems to work.
At the very least it would be a nice bargaining chip to use to shift the overton window left. If this plan ends up being to grandiose, we could downgrade to medicare extra, although I suspect this plan is actually far better in practice.
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