What Medicare For All Might Mean For Jobs
This is the indicator from planet money on n. p. R. <music> medicare for all is everywhere. The idea has gone from the fringes of the healthcare conversation to being centerpiece of it in a few short years turn on on any of the democratic presidential debates and you'll hear about it and medicare for all would be a massive overhaul of the healthcare system one that it supporters like because it would give health insurance ernst to everyone and pretty generous insurance at that and that's a big deal in a country where nearly twenty nine million people didn't have health insurance last year but with a massive overhaul the holcombe trade-offs and here's one big one that interested us as some proponents of medicare for all will acknowledge it could cost a lot of jobs during the transition in fact what inspired this whole episode was this opinion piece by elizabeth rosenthal that i saw in the times earlier this year it was called medicare for all could kill two million jobs and that's it's okay that kind of blew my mind. I just wanted to learn more and of course my policy would put people out of work is not the most effective campaign platform form true true especially in the country that slowly clawed its way out of a recession and is scared of another one. I'm darius rafi on and i'm danielle. Nail kurds laban filling in from the n._p._r. Politics podcast today on the indicator we talk about medicare for all and one aspect of it in particular the potential for it to eliminate lots. It's in lots of jobs and we talk about what that says about our healthcare system and just how hard healthcare reform is support for this podcast. The following message come from google from connecticut to california from mississippi minnesota. Millions of american businesses are using google tools to grow online learn more at google dot com slash grow support also comes from wicks dot com with wicks you can build your own robust website and web applications set up up your own databases with service hassle free coating go to wicks dot com. That's w. i. X. dot com slash indicator to get ten percent off. Let's start with a quick refresher. Medicare for all is what democratic presidential candidate bernie sanders calls his single payer health proposal. He is named after the current popular government run health health insurance plan for older americans medicare and while lots of people have co-opted his branding his single payer plan is what we're going to be referring to today when we talk about medicare for all just to be clear and when we say single payer payer is the government so taxpayers <hes> everyone would be covered by government issued health insurance and at least in sanders vision private insurance would be basically obliterated which is a big change. I mean there are lots of private. Insurers think aetna cigna blue cross ross whoever you might have your health insurance through and there are lots of people who work for those companies getting rid of those insurers means you have a bunch of workers who would have to find something else to to do as well as probably a bunch of people in hospital billing offices who would have to find something to do and just how many jobs would be lost while we talked to robert pollen he is a distinguished is professor of economics. At the university of massachusetts amherst. He and some colleagues got together in analyze the potential economic effects of medicare for all here's what they found so if you add up the losses in the health insurance industry and among call the administrative staff at providers. We think we're looking. Ah about one point eight million jobs becoming redundant one point eight million now doesn't not a great political bumper sticker right and i wanna be clear upfront here. Robert likes medicare for all he really does. He consulted with the sanders campaign. This election cycle on it and and robert found that one point eight million jobs could be lost if medicare for all his instituted now. Here's why one of the biggest drivers of high healthcare costs in the u._s. is administrative the street of cost. Things like insurance claims billing payments all that studies have shown that we spend in the u._s. Way way more on these things than other advanced economies. Here's one on staggering statistic by one thousand nine estimate for every ten doctors there at that time nearly seven fulltime workers in billing and insurance so so workers who weren't directly improving people's health the savings that robert talks about would largely be driven by getting rid of that bureaucracy to put this in perspective one one point eight million employees. That's more workers than american payrolls have added over the last nine months so three quarters of a year of all those jobs days gone and this is is where we get at one of the big points apollon study that medicare for all would in his estimation be a good thing and that's because in his estimation it would save money and here's what robert means when he talks about savings. He estimated that everyone in the u._s. Altogether spends a little more than three trillion dollars on healthcare every year by his teams math. Even even with everyone insured and using the healthcare system it would still be ten percent cheaper than that three trillion dollars and it would also be a big shift in how that spending ending takes place so take all the spending right now and make it just the government spending the money well the government via tax payers important point and if you did that there their would-be savings but and this is the important point here there are trade-offs. The biggest single source of savings we have to acknowledge is <hes> layoffs of people whose jobs become redundant so to robert one point eight million lost jobs are not exactly good but they are evidence that the plan will have worked and so knowing knowing that those job losses could happen. He told me that he wants to make sure that a single payer proposal plans for those potential losses. I mean the the principal reason why focused i on this was precisely to make sure that as part of the discussion around medicare for all we included just transition process assist for the people whose jobs become redundant in what robert means when he says adjust transition process that would include job retraining a guaranteed pension and and one years wages for displaced workers and we should add that when we reached out to the sanders campaign for comment they said that medicare for all includes five years of funding to provide assistance to displaced workers workers including things like wage support and retraining and here's where we need to stop for a second because first off let's again stress robert and his colleagues estimate of medicare for all his just one one estimate of the potential savings or costs of this plan. We're talking about it to get it. Just how complicated all of this is which is to say that there are also other estimates of savings studies have found a range of possible effects for medicare for all that maybe it could save americans a bunch of money on healthcare or that it could cost americans. Trillions is more. It is very possible that could happen. It's a really important distinction to make so you know plus or minus a few trillion here or there who's counting right so talk about what happens. If medicare for all doesn't save money which might mean it wouldn't cost a lot of jobs. We called katherine baker dean of the harris school of public policy at the university of chicago. Oh and she's less optimistic about medicare for all than robert was. I haven't seen a medicare for all proposal that seems to promise a lot of savings savings or a lot more efficiency in the healthcare system but she does have concerns about medicare for all for example. She doesn't think it would address wasteful health spending or to put put more plainly that it might not draw a line between healthcare services that are cost effective that improve people's health and services that are really expensive but don't for example so help people live longer and of course there's still the question about efficiency you know it might mean a bloated system. That's as inefficient as it is now or it might mean a kind of shifting no more private insurance workers but a lot more healthcare workers and i want to be clear that saving money is not the goal anymore than keeping the number of jobs jobs in healthcare is the goal the goal is to get as many people as possible. My my goal would be to have as many people as possible covered by health insurance plan. That's delivering healthcare in an efficient way. Obviously the loss of lots of jobs in health care would be painful for a lot of workers. That's clearly not the great thing at all but for baker. It's also not great to have a healthcare system. That's expensive and not helping us get healthier if we could employ a lot fewer people people in the healthcare sector without harming health at all that would be a good thing those people could then go work in other sectors and generate other things that improve people's quality polity of life or standard of living to me dr is this isn't just about whether medicare for all is good or not all of this to me is a perfect window into the impossibly difficult job bob of trying to improve the healthcare system and what improving it even means whether it's saving money what it means for jobs whether people are getting healthier not an all of that is such a balancing act bullets zoom out here and be realistic for a second for medicare for all to pass. You'd need democrats to keep the house win the white house win really big in the senate and also for enough of those democratic lawmakers to actually come together and agree on medicare for all plan listen. I refused to make political predictions so i'll say that that's a lot of pieces to fall into place meaning. We might have a lot more time to debate all this. This episode of the indicator was edited by paddy hirsch produced by emily lang and fact check by rachel cohn. I also want to thank larry levitt at the kaiser family foundation who also helped us out in this episode. The indicator is a production of n._p._r. Uh-huh.