Medicare for All as a Middle Class Entitlement

Like free college and student forgiveness, Medicare for All is a middle class entitlement. It favors the already favored. It does nothing to advance real socialism, as the elites are allowed to keep their property (including the labor power of their workers). It is a better cage.

This is how it is seen and why Sanders has no luck in appealing to Black voters. Let's fix that.

Medicare for All is essentially Medicaid for All. Put another way, every Medicare beneficiary becomes what is called a dual eligible. Without co-payments and premiums, there is no need for a separate needs based health plan for retirees and the disabled. 

The belief on the ground is that M4A will kill private health insurance companies. This is not actually the case. They will retain a role in doing claims processing and in operating managed care systems (which are a feature of Medicaid as well as Medicare Part C). 

What is true is that Medicaid for All takes away the requirement that the family home be sold in order to qualify for long term care in a nursing home. This is where the middle class really makes out, because families can keep their property when they can't take care of their elders at home. It also takes away the need to purchase a reverse mortgage to take care of health care expenses, again, preserving home ownership.

The White Middle Class gets the biggest benefit of this. And so does the Black Middle Class. 

Without M4A, homes are more easily lost to Medicaid liquidation and the pressure to find money for rising health costs. Along with restrictions on predatory lending, both in second mortgages and reverse mortgages (which carry fees that qualify them as usury), the concerted efforts to steal from elderly homeowners, especially among people of Color, will be harder to pull off.

Of course, this will not stop attempts to do so. This raises the question of why redlining and predatory lending exist. It is not a good business model. Helping people succeed helps the community and makes us all richer. Banks are not interested in such things, however. 

Bankers respond to the desires of their best (White) customers who like their segregated enclaves just the way they are. They are the victors who need victims, especially the second generation wealthy, like the Trumps, who carry personal inferiority into the battle.

There is only one way to win this battle. It is to point out that those who would cheat must do so, because they cannot win in a fair fight. The key to claiming equality is to point out that claims of superiority belie deep seated feelings of inferiority. Cheaters should be made to admit that the need to discriminate comes from the inability to win in a fair fight. They must be made to feel less than by their bad behavior. Without extracting such an emotional cost from bad behavior, it will continue.

So how do we pay for M4A. One, stop payroll taxation. Such taxes leave capital income off of the hook. Two, don't rely on a carbon tax. We have enough to do with stopping warming to use the carbon tax on social welfare. Three, don't rely on taxes on the wealthy - indeed, eliminate the Obamacare surtaxes and replace them with a more broad based levy, which leaves us with consumption taxes.

A credit invoice value added tax (I-VAT) gives exporters and their employees an advantage - the same advantage the rest of the developed world takes by funding their systems in this way. 

The other option is an employer-paid subtraction VAT. This method is best (and would not be border adjusted) if employers are allowed to provide continuing health insurance coverage to retirees (and eventually to employees), either through a policy with better benefits for the same price or by employing their own doctors as part of a larger move to a more cooperative workplace. 

Shifting from third party funding or public funding to cooperative purchasing of health care would, in fact, be socialism. Not social democracy, but actual democratic, employee-owned, socialism, with the workers controlling the means of production AND consumption AND finance AND human services (including college education, by the way).

Consumption taxes also kill the benefit of buying life insurance. It's ability as a tax avoidance strategy is ended when the implicit consumption tax buried in income and payroll taxes paid by those who provide goods and services is brought into the light. 

Adding an asset value added tax would entirely end the attractiveness of large dollar life insurance, because when you invest the proceeds in buying assets, a tax must be paid. When such assets generate a return, more taxes must be paid. Also, when property is inherited, the asset VAT must be paid upon sale at market, rather than value added, prices. The only exception to such a tax would be sales to a qualified ESOP or COOP.  Again, real socialism, not the better cage of social democracy. 

The key to making socialism work is making sure it has the best toys. Let's do that, shall we? But until then, pass Medicare for All, highlight it as a way to preserve and create Middle Class assets and portray opposition to it as a form of racism and ageism. This must be part of the bigger fight, not just a benefit for White Millenials and their parents.