There are two things you have to understand about media coverage of Elizabeth Warren. First, her appeal in the Democratic primary race is highly concentrated among educated white progressives. And second, the mainstream media is disproportionately populated by … educated white progressives. This leads to a kind of default credulity in coverage of her statements and proposals. There’s a bit of “one of us” camaraderie that’s entirely natural and human, but good journalists recognize their biases and fight against them.
And that brings us to a fascinating phenomenon I’ve noticed in Warren coverage. Let’s call it the “Wait. What?” narrative. She releases a statement or proposal that purports to own her opposition or advance a progressive goal, she receives favorable initial coverage, and then good journalists take a closer look. That’s when it all falls apart.
The previous perfect example was the coverage of her big reveal of her Native American heritage. Remember that? She made a video. She released the results of DNA testing showing she had some small trace of Native American ancestry, and for about four hours the media responded as if she’d just destroyed Donald Trump. Then they took a closer look, realized that she was basically as white as your average Swede, and realized they’d been had. Ever since then, Warren has been in public apology mode.
History has just repeated itself, on a much more consequential stage. Warren has released her Medicare-for-All financing plan, she blasted out to all the world that she could remake American health care without raising taxes on the middle class, and smart people across the spectrum are responding with a resounding, “Wait. What?”
But that’s not all I’m covering today. Here’s the lineup:
Warren’s financing plan is worse than you think.
Marriage, the most important cultural institution.
Don’t fall for a flawed Trump defense
Oh, and I’m test-driving a newsletter name. This came through Twitter direct message, my wife loves it, and I think it works—the French Press. If you hate it, let me know. Now, on to the substance . . .
Elizabeth Warren’s terrible, horrible, no good, very bad Medicare financing plan
I get the argument for Medicare-for-All. I really do. Its proponents sincerely believe they can replace our hybrid public/private health care industry (an expensive system no one truly loves) with a public-run program that will deliver more health care for less money. Seniors tend to really like Medicare, and extending a popular program to the rest of the nation—while also ensuring that even the poorest Americans have access to “free” high-quality care—is a goal that has real political and moral force behind it.
But then Americans start to think through the sheer magnitude of the social and economic disruption, and the shine comes off the program. More than 150 million Americans are covered by employer-provided health insurance plans, most Americans like their current health plans, millions of jobs depend on the current system, and they’re understandably leery of the greatest peacetime government expansion in American history.
Bernie Sanders responds to these objections with a degree of blunt honesty. Yes, your taxes will go up. No, you won’t keep the insurance you like. But, trust me, most people will pay less overall, and you’ll like what we build.
What about Elizabeth Warren? She just insulted your intelligence. She just unveiled the most transparently absurd campaign pledge since, “I’ll build the wall, and Mexico will pay for it.” When I read her plan, which purports to deliver universal health care coverage without a middle class tax increase, it’s hard to believe intelligent people take it seriously. It’s simply fantastical. It’s a potpourri of absurd assumptions and outright falsehoods.
Let’s start with the assumptions.
Most estimates of the cost of Medicare-for-All put the 10-year tab at more than $30 trillion. Even if the federal government chose to deficit-finance a big chunk of that cost (highly likely when creating new programs), it’s still necessary to raise a massive amount of revenue to avoid a truly disastrous sincrease in the national debt. But hey, what if we simply assume that the cost is much lower? What if we crunch the numbers so that every single debatable question is resolved in a way that makes the program cheaper?
To get a sense of the sheer magnitude of Warren’s assumptions, I refer you not to a gobsmacked conservative website, but rather to Vox’s Ezra Klein. As he explains, Warren takes a respected cost projection from the Urban Institute and modifies it, substantially (the italics are mine):
Private insurers spend about 12.2 percent on administrative costs and profits. Urban assumes that would fall to 6 percent under single-payer, as that’s what Medicare spends now. Warren assumes it will fall to 2.3 percent, as that’s what Medicare’s single-payer program pays now—the higher number includes the private plans in Medicare Advantage and Medicare Part D. That saves $1.8 trillion.
America pays higher prices for the same drugs than other countries. Urban assumes single-payer could cut those costs by about 25-30 percent. Warren proposes cutting payment rates for brand-name drugs by 70 percent. That saves $1.7 trillion.
Medicare pays significantly lower rates to physicians and hospitals than private insurers do. Because providers have built their businesses atop the mix of higher private and lower public prices, the fear is that shifting the system to the lower Medicare rates could lead to widespread hospital closures and physician bankruptcies. Urban assumed that single-payer would pay physicians at Medicare rates but hospitals at 115 percent of Medicare’s rates. Warren takes hospitals down to 110 percent, saving $600 billion.
Warren’s finds more than $2 trillion in savings from scaling a series of Affordable Care Act-era payment reforms across the single-payer system. These are efforts to move health care away from fee-for-service, but the assumptions here are optimistic. Warren’s team projects $1.2 trillion in savings from bundled payments, for instance, but a footnote refers to a Congressional Budget Office paper from before the program began in earnest. A 2018 Commonwealth study found no savings from bundled payments, and Medicare has been backing off the program in recent years.
Health spending tends to grow a lot faster than GDP. The government’s top actuary projects 5.5 percent growth over the next decade. Urban, in its analysis, assumed 4.5 percent. Warren’s team simply asserts that it’ll hold growth to 3.9 percent, which is similar to other developed countries. That adds $1.1 trillion in savings.
Ezra’s doubts are politely expressed, but they’re obvious. He states later in the piece that “[t]here are places where I find Warren’s math or ideas a bit optimistic. I’m skeptical that payment reforms will save trillions.” This is the “Wait. What?” moment. Even an analyst who’s broadly sympathetic to Warren’s progressive goals is unconvinced. In progressive wonk-language, he’s essentially asking, “Who is she kidding?” Her cost assumptions are way, way too aggressive.
But so are her revenue estimates. She builds into the plan revenue gained from achieving a comprehensive immigration reform compromise that hasn’t been achievable in a generation. She also presumes that she can slash defense spending by almost $800 billion over a decade, but unless she can guarantee both permanent progressive governance and a decade of peace, she simply cannot project a decade’s worth of defense budgeting. The defense budget is set year-by-year, and if the Pentagon feels the bite of Warren’s cuts, it’s a safe bet that the next GOP administration will make the Defense Department whole.
That’s hardly the end of the revenue optimism. She claims the IRS can collect an additional $2.3 trillion through stepped-up tax enforcement. This is sheer fantasy. To put this in perspective, she’s claiming that she can get roughly 10 percent of her (unrealistic) revenue target just by better enforcing tax laws.
She’s also assuming she can force states to redirect trillions of dollars in health care spending to the federal government, a mandate that raises serious constitutional concerns. As the Obamacare case reaffirmed, the Constitution places limits on the ability of the federal government to mandate how states spend state tax dollars.
She also of course includes taxes on employers (which could impose costs on middle-class employees), large corporations, and the very wealthy, but even her optimistic projections of revenue from these sources doesn’t come close to covering the costs of her programs. Moreover, destroying the private health insurance system could eliminate roughly 2 million jobs. What’s her plan for that? Here it is:
When she released her funding proposals, I tweeted that it was a perfect example of how smart people deceive the public—with wonky word-salads that most Americans simply can’t decipher. It sounds sophisticated. It looks well-reasoned. And it gives her most partisan supporters talking points to take to cable news. But when the word salad fails, Warren has demonstrated that she can lie just as brazenly as Trump. Here she actually says that only billionaires will pay higher taxes. Extraordinary:
One final note, there are signs that voters may well punish the Democrats if they nominate Elizabeth Warren. She’s running as the disingenuous version of Bernie Sanders, and for now she performs worse than he does in four of six key battleground states:
Just as I can understand the appeal of Medicare-for-All, I can understand—at least on the surface—the progressive appeal of Elizabeth Warren. She’s idealistic. She’s smart. She claims to have a plan for everything. But in practice she’s morphing into a high-energy version of Hillary. She’s untrustworthy. She’s hyper-partisan. Her plans aren’t just too extreme for millions of voters, they’re also unworkable and frequently unconstitutional. Can a candidate who shares traits with both of the failed 2016 Democratic candidates really beat Donald Trump?
Marriage really, really matters.
Here’s research item No. 1—with a hat tip to Tyler Cowen. An enormous amount of ink has been spilled attempting to explain why so many young men have withdrawn from the labor force. One explanation is declining working-class wages have led more men without college educations to withdraw from the workforce. But a new paper posits a different explanation—that changes in the marriage market are also extraordinarily potent. From the abstract:
This paper presents a model in which men invest time in employment to enhance their value as marriage partners. When the marriage market return on this investment declines, young men’s employment declines as well, in preparation for a less favorable marriage market. Taking this prediction to data, I show that fewer young men sought employment after [two] interventions that reduced the value of gender-role-specialization within marriage: i) the adoption of unilateral divorce legislation, and ii) demand-driven improvements in women’s employment opportunities. I then show, using a structural estimation, that half of the employment effect of a labor market shock to men’s wages is determined by endogenous adjustment of the marriage market to the shock.
You can read the entire paper here, but it argues that men participated in the workplace in part to enhance their marriage prospects. They worked to marry. Easy divorce diminishes marriage stability. Changing workplaces and economic trends that have both enhanced women’s economic power and diminished traditionally male workspaces (like factory floors) have made noncollege men less desirable marriage partners and have disrupted the traditional balance of economic power in marriage. Thus, “work is less likely to win a desirable marriage contract,” and the response from many millions of men is “why bother?”
Here’s research item No. 2—with a hat tip to Brad Wilcox and the Institute for Family Studies. It turns out that the epidemic of deaths of despair (drug overdoses, alcohol deaths, suicides) that have tormented white working-class families and have lowered overall American life expectancy disproportionately afflict unmarried men and women. From the abstract:
Although the decline in marriage has been cited as a possible contributor to the “despair” afflicting marginalized White communities, these studies have not directly considered mortality by marital status. This paper uses complete death certificate data from the Mortality Multiple Cause Files with American Community Survey data to examine age-specific mortality rates for married and non-married people from 2007 to 2017. The overall rise in White mortality is limited almost exclusively to those who are not married, for men and women.
The paper does not address the question of “whether changes in family structure are contributing causally to the observed patterns of mortality.” Instead, it argues that “the question is important regardless of the causal relationship.” It makes an additional, critical point—“marriage is increasingly a feature of privileged life in the United States, and mortality is an important component of that pattern.”
A research team headed by Rose McDermott of Brown University analyzed three decades of data on marriage, divorce and remarriage collected from thousands of residents of Framingham, Massachusetts.
McDermott and her colleagues found that study participants were 75% more likely to become divorced if a friend is divorced and 33% more likely to end their marriage if a friend of a friend is divorced.
So divorce is contagious…and you can catch the divorce bug from your friends—even from a friend of a friend?
“Approaching the epidemiology of divorce from the perspective of an epidemic may be apt in more ways than one,” McDermott and her colleagues wrote in a forthcoming article in the journal Social Forces. “The contagion of divorce can spread through a social network like a rumor, affecting friends up to two degrees removed.”
This paper isn’t new. It dates from 2013, but Wilcox rightly tweeted it back to life Monday. It’s a powerful reminder that we don’t live atomized, autonomous lives—that our marriage choices have consequences that can ripple outward into our communities. It turns out that one way to help rebuild and sustain an American marriage culture is as simple as getting married and staying married. Your fidelity and commitment can act as a brake against the “social contagion” of divorce.
I’m not sure how much more evidence we need that a thriving marriage culture is a basic building block of a healthy society (or that marriage bonds are all-too-fragile, especially in marginalized communities), but I’ll keep pushing that evidence into the public square every time I see it.
The president is accountable to Congress for the conduct of his foreign policy.
I like and respect Brit Hume a great deal, but I did not like this tweet:
Or this one:
I get the argument. The president takes the lead in foreign policy, and advisers who express their opinions about that policy in private should salute and follow orders when POTUS exerts his will. The president can’t “subvert” foreign policy when he sets foreign policy, and that means he can certainly overrule any “interagency consensus” when he seeks a different policy.
There are at least two rather important qualifiers to this general rule. First—and most obviously—Congress gets a say in foreign policy as well. When it has appropriated funds for foreign aid, that money must be spent absent a lawful reason to withhold payment. Congress appropriated money for Ukraine. It was not the president’s money to withhold, especially for the purpose of extorting an investigation of a political rival and an investigation of a bizarre conspiracy theory.
That rolls us right into the second qualifier. In a newsletter last week, I observed that Congress was, ultimately, the supreme branch of government. While the president has a degree of default control over the conduct of American foreign policy, Congress can not only check him by statute (through the power of the purse or through other statutes passed over presidential vetoes), it can remove him from office if it believes the president has abused that authority. Constitutionally, Congress should not wash its hands of dangerous, corrupt, or bizarre presidential actions by deferring to whatever policy he chooses to set.
I’ve served in the military—the part of American government most firmly under presidential control—and I can tell you that it is laden with checks and balances designed to thwart corrupt or incompetent commanders. They don’t always work. They frequently fail. But they’re there nonetheless, and many of those checks apply all the way up the chain of command to the commander-in-chief.
So if an anonymous whistleblower believes a president is abusing power and potentially violating the law, he can raise that concern to the relevant congressional committees, and he can raise that concern to the Inspector General. If Congress is sufficiently alarmed, it can investigate, and when it investigates, it can ask even the president’s staff to provide their evaluation of the executive branch’s actions.
As the saying goes, two things can be true at once. It can be true that the president sets policy, and it also can be true that his ability to set policy is subject to congressional oversight. It can be true that subordinates should obey the lawful orders of the president they serve, and it can also be true that they’re honor and duty-bound to report through proper channels potential corruption or evidence of unfitness. And an impeachment inquiry is most definitely a proper channel.
I agree that other presidents have abused their powers. I agree that Congress has deferred far too much to the executive branch—especially on matters of war and peace. But past deference does not mandate present deference, and when a president engages in conduct that is far outside the bounds of propriety or competence, we want to hear from the men and women under his command.
One last thing . . .
I have long suspected that LeBron James is either a superior being from another planet or an augmented human from the future who’s journeyed back in time to demonstrate to us the extraordinary potential of the human body. I’ve looked for proof for years. At last, I’ve found it. In this clip. This is his 17th season in the NBA, and he just did this.
He’s the GOAT. I made the case in 2018, and I get more right every year.