Portside

Every now and then, federal officials admit some truths that are inconvenient to the corporations that own the government — and this latest admission is pretty explicit: Scrapping corporate health care and creating a government-sponsored medical system would boost the economy, help workers, and increase longevity.

Those are just some of the findings from the Republican-led Congressional Budget Office (CBO) in a new report that implicitly tells lawmakers just how the existing corporate-run health care system is immiserating millions of Americans — and how a Medicare for All–style system could quickly fix the catastrophe.

If that sounds like hyperbole, consider the analysis in its own words. The CBO reports that under a single-payer health care system:

• “Households’ health insurance premiums would be eliminated, and their out-of-pocket health care costs would decline. . . . Administrative expenses in the health care sector would decline, freeing up productive resources for other sectors and ultimately increasing economy-wide productivity. . . . Longevity and labor productivity would increase as people’s health outcomes improved.”
• “Workers would choose to work fewer hours, on average, despite higher wages because the reduction in health insurance premiums and (out-of-pocket) expenses would generate a positive wealth effect that allowed households to spend their time on activities other than paid work and maintain the same standard of living.”
• “That wealth effect would boost households’ disposable income, which they could then split between increased saving and nonhealth consumption. Although hours worked per capita would decline, the effect on GDP would be offset under most policy specifications by an increase in economy-wide productivity, an increase in the size of the labor force, an increase in the average worker’s labor productivity, and a rise in the capital stock.”
• “States could respond to the (ensuing) budget surplus by growing their rainy-day funds (at least temporarily), reducing state tax rates, increasing spending on government purchases or public services, or a combination of all three.”

The report’s findings tacitly admit that the existing employer-based, corporate-run health care system locks the non-rich into toiling more and more hours just to be able to afford ever-higher costs for insurance coverage and medical care.

Indeed, CBO declares that under a single-payer system, households would “retire at younger ages” and “hours worked would be lower for most households across the income distribution.” Under the five single-payer scenarios the agency evaluated, a “reduction in hours worked would be largest among lower- and middle-income households because those groups would see the largest percentage increase in wage rates and reductions in (out-of-pocket) expenses and premiums.”

CBO’s report seems to cast these forecasts as a warning — but they should be welcome news. Studies have long shown that on average, Americans work more hours than their counterparts in other industrialized nations, and they receive among the fewest hours for vacation and paid family leave.

CBO is effectively admitting that the corporate health care system is intensifying that problem.

One health care option evaluated by the CBO includes more robust coverage for home- and community-based care services, which provide patients with long-term assistance with daily living activities such as bathing or dressing. In addition to increasing eligibility and expanding those services for patients, the report notes that increased funding would create a 7 percent pay increase for home health care workers, who are among the lowest paid workers in the economy.

And yet for all the single-payer health care benefits outlined by CBO, Medicare for All remains stalled in a political system where stakeholders in the existing corporate health care system are spending hundreds of millions of dollars to buy elections and public policy.

That political influence was on display in the most recent presidential election, when Joe Biden kicked off his campaign with a fundraiser with a health insurance CEO, and then vowed to veto Medicare for All legislation if it came to his desk. He instead touted his proposal of building upon the Affordable Care Act with a public health insurance option.

But Biden hasn’t pushed that public option plan as president — he even omitted it from his budget plan last year. He and Democratic leaders have instead adopted proposals from health insurance lobbyists to put more Americans on subsidized for-profit health insurance plans.

More recently, California’s attempt to create a first-in-the-nation single-payer system failed after corporate interests won the day in a state where an overwhelming majority of voters believe the governor and legislature should prioritize working toward guaranteeing all residents health insurance coverage. The single-payer bill was killed by Democratic lawmakers just after their party received a $1 million check from a major private health insurer.

Despite those setbacks, the new CBO report is a loud alarm about the establishment’s sociopathic hostility to commonsense health care policy — and it comes from an important source.

The office is hardly some bastion of left-wing utopianism, and in a money-drenched political system, the federal government rarely ever admits such scathing truths about the status quo — especially truths that underscore how much better life could be with the kinds of reforms other nations long ago made.

David Sirota is editor-at-large at Jacobin. He edits the Daily Poster newsletter and previously served as a senior adviser and speechwriter on Bernie Sanders’s 2020 presidential campaign.  Aditi Ramaswami is an editorial fellow for the Daily Poster.