(Bloomberg Opinion) -- Mayor Pete Buttigieg of South Bend, Indiana, and Massachusetts Senator Elizabeth Warren have been cast as the “wonk” candidates in the Democratic presidential primary: the cerebral number-crunchers putting out detailed and thoughtful policy proposals, with hers being ambitious and left-wing and his modest and moderate.
But both the contrast and the wonkiness are overstated. In key respects, Buttigieg is running on a Warren-lite agenda. Some of their plans also have more to do with achieving political and ideological objectives than with solving any pressing problem in American life.
In the past, some Democrats have been open to reining in the growth of Social Security benefits. Now even those considered moderate are running on expanding the program. Warren wants to give every senior citizen, Warren Buffett included, $2,400 more each year. Never mind that older Americans are less likely to be in poverty and more likely to say they are financially secure than younger people. It’s purely a vote-buying plan: Older Americans are more likely to vote than younger ones, too.
Buttigieg would at least do more to target the extra benefits to keep seniors out of poverty. But even he would give somewhat larger checks to the richest beneficiaries. And the tax increases on high earners included in both candidates’ plans would be anything but moderate: The top tax rate would rise to at least 49% from 37%. Either of the candidates’ Social Security plans would include the biggest increase in the top rate since the 1940s. And that’s before they raised taxes to pay for any of their other plans.
That includes their health-care plans. Those proposals have been much debated. But an important question has been sidestepped in the discussion of their cost and coerciveness — and that’s the question of the purpose of the plans. Both Warren and Buttigieg want everyone to get their health insurance from the federal government, with no private health insurance.
Warren wants to outlaw private insurance in the third year of her presidency. Buttigieg wants to travel more slowly to the same destination. He intends to create a public option that would out-compete private insurers and drive them out of business (presumably with the help of such advantages as the ability to use taxes to cover losses).
But why should we remake the health system this way? We don’t need single-payer, or even a public option, to expand insurance coverage. Obamacare, whatever else one thinks of it, proved that. If the problem policymakers need to address is the high cost of health care, moving toward single payer is, to put it mildly, not the obvious solution.
It’s true, as proponents of single payer often point out, that other countries with single-payer systems spend less on health care than the U.S. But no country has started with a system as expensive as America’s and then simultaneously added new benefits and cut costs.
It’s also true that if you want a system in which almost all medical services are free at the point of care, with no deductibles or co-payments, you’ll need to move toward government-run insurance. But that change subverts the goal of lower costs: If something is free, it will be consumed more. And, again, why should abolishing out-of-pocket payments be the goal?
The plausible answers to that question are ideological rather than practical. They rest on the belief that, as a matter of principle, co-payments, the profit motive and the private sector have no place in health care. There has long been a current of thought on the left that hews to exactly this view.
Now Democrats are taking a lot of political risk and creating a lot of disruption in American health care in order to realize it. Even the supposedly moderate ones.
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Ramesh Ponnuru is a Bloomberg Opinion columnist. He is a senior editor at National Review, visiting fellow at the American Enterprise Institute and contributor to CBS News.
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