
To be fair, as a New York Times reporter, Jackie Calmes probably doesn’t meet many left-leaning economists, so she may not be sure what they look like. (photo: Isaac Brekken/NYT)
With Hillary Clinton ramping up her attacks on Bernie Sanders as a budget-buster—in the February 11 debate, she claimed his proposals would increase the size of government by 40 percent—the New York Times (2/15/16) offered a well-timed intervention in support of her efforts: “Left-Leaning Economists Question Cost of Bernie Sanders’ Plans.”
While the “left-leaning” is no doubt meant to suggest critiques from those who would be inclined to sympathize with Sanders, all the quoted economists have ties to the Democratic establishment. So slight is their leftward lean that it would require very sensitive equipment to measure.
Opinion pieces critical of Sanders often begin with a pledge of allegiance to his “impracticality.” This story, by Times reporter Jackie Calmes, is an “objective,” newsy version of that:
With his expansive plans to increase the size and role of government, Senator Bernie Sanders has provoked a debate not only with his Democratic rival for president, Hillary Clinton, but also with liberal-leaning economists who share his goals but question his numbers and political realism.
Though Sanders wants to increase federal spending on infrastructure, college tuition and childcare, as well as other programs, the bulk of his proposed increase would be for establishing a single-payer healthcare system, and that’s what Calmes’ piece focuses on. It would replace the current mix of multiple forms of public insurance (Medicare, Medicaid, state and local programs) and private insurance with a unitary federal system, much like what Canada has. It would not nationalize doctors and hospitals, as in Britain; only the payment side would be socialized. Sanders refers to it as Medicare for All, which is a simplification, but close enough for politics.
The liberal-leaning economists that Calmes rounds up suggest that Clinton may have been too modest in her accusation that Sanders wants to jack up the size of government by 40 percent. No, Calmes warns that “the increase could exceed 50 percent, some experts suggest, based on an analysis by a respected health economist that Mr. Sanders’ single-payer health plan could cost twice what the senator…asserts.”
As if that wasn’t scary enough, Calmes turns to mockery: “Alluding to one progressive analyst’s criticism of the Sanders agenda as ‘puppies and rainbows,’ Mr. Goolsbee said that after his and others’ further study, ‘they’ve evolved into magic flying puppies with winning Lotto tickets tied to their collars.’”

Paul Krugman illustrated his column (2/16/16) with an image of this tapestry. If in his metaphor a single-payer healthcare system is a unicorn, then presumably the people poking it with spears are establishment journalists.
The theme of magic was further developed in a piece by New York Times op-ed columnist Paul Krugman, “My Magic Unicorn” (2/16/16), in which the word “unicorn” appears six times (not counting the headline). Krugman’s column, which denounces Sanders’ proposals as hopelessly unrealistic, refers to Calmes’ news story for support, a news story that itself reads like an op-ed in disguise.
The “Mr. Goolsbee” quoted in the story is Austan Goolsbee, who was a long-time adviser to Barack Obama before he became president, and then served on Obama’s Council of Economic Advisers. (During the 2008 campaign, Goolsbee was reported as having assured the Canadian government that Obama’s anti-NAFTA talk was “more reflective of political maneuvering than policy”—New York Times, 3/4/08.) Now Goolsbee teaches economics at the University of Chicago’s business school and is a consultant to hedge funds. A very left-leaning resume there.
And the “progressive analyst” who came up with the “puppies and rainbows” line is Ezra Klein, who in mid-January wrote a harshly disparaging piece, “Bernie Sanders’s Single-Payer Plan Isn’t a Plan at All,” on the website he co-founded, Vox (1/17/16). How times change: As long-time FAIR contributor Seth Ackerman showed in an incisive analysis (Jacobin, 1/25/16), Klein was once a strong proponent of a single-payer scheme.
In a 2007 piece for the American Prospect (4/22/07), Klein explored what he called “the best healthcare systems in the world,” including Canada’s, looking for lessons for the US. (Krugman liked the piece enough to put it on a 2012 syllabus for a Princeton class on the welfare state.) Klein’s conclusion, expressed in his opening sentence, was that while medicine is hard, health insurance is simple: We should emulate these other systems that achieve both universal coverage and cost control, like those of Canada, France, Germany and the UK. Though he now holds Sanders’ advocacy of single-payer in disdain, Klein specifically praised Canada’s single-payer system, citing a 2003 paper by Steffie Wooldhandler, Terry Campbell and David Himmelstein in the New England Journal of Medicine (8/21/03) that found that administrative costs were over three times as high in the US than in Canada, mainly because of the inefficiencies of private health insurance. Eliminate private insurance and you enjoy hundreds of billions in savings.
The “respected” health care economist—it’s funny how journalists stick that handle in front of some names and not others—that Calmes cites is Kenneth Thorpe of Emory University, who, as she discloses, “advised the Clintons in the 1990s.” Indeed he did; he served in Bill’s cabinet where, according to his Emory faculty bio, he “coordinated all financial estimates and program impacts of President Clinton’s healthcare reform proposals for the White House.”
Sanders has proposed paying for his single-payer health insurance program mainly by raising taxes on the rich and imposing a 6.2 percent payroll tax on employers and a 2.2 percent income tax on households (while fully exempting lower-income households and partly exempting middle-income ones from the tax). Those tax increases would replace current spending on private insurance, so it would be very wrong to call them new spending.
Thorpe’s paper argues that Sanders underestimates the cost of his single-payer health insurance scheme by close to half. More realistic assumptions would require substantial tax increases across the board and result in lower wages for the presently uninsured as employers compensate for the new payroll tax. Frightening, if true, and Calmes and her headline writer frame the article to persuade us that it is.
Woolhandler and Himmelstein, authors of the 2003 article on administrative costs that Ezra Klein used to like, are not persuaded by Thorpe. In a Huffington Post piece (1/29/16), they find his estimates of administrative savings from a shift to a single-payer system too low and his assumptions of an increase in demand for healthcare too high. He ignores the cost of tax breaks that would disappear under single-payer and assumes no savings on drugs and medical devices, despite the government’s strong bargaining position as the exclusive purchaser. (Calmes alludes to their critique in the piece with a single sentence: “Mr. Thorpe and Sanders aides and allies have been battling online.” The words “battling online” link to the Woolhandler/Himmelstein piece; a print reader would be totally in the dark.)
As Woolhandler and Himmelstein point out, in earlier studies—one done for the state of Missouri, and another for the National Coalition on Health Care—Thorpe projected large savings from single-payer reform. Now this former Clinton adviser finds the opposite.
There’s a political angle to Calmes’ piece as well, which she uses longtime Democratic economist Henry Aaron to deliver. (Aaron is a fellow at the Brookings Institution, a think tank that a congressional staffer once described to me as “a graveyard for conservative Democrats.”) Aaron calls the idea of single-payer a “fairy tale” in the current political climate. Citing the testimony of “other economists in a ‘lefty chat group’ he joins online,” Aaron believes that were Sanders elected, he’d destroy his political capital by fighting such a doomed fight.
I’m familiar with this line of argument from a liberal chat group I used to hang out with online (it takes its off-the-record secrecy with great seriousness)—it may be the same one, but I can’t tell for sure. It goes like this: The right so dominates the present scene that one can do nothing but play defense, hoping to salvage what remains of social spending but never daring to ask for more. Political capital, in this account, can only dwindle when put to work; unlike other forms of capital, it never pays returns. The right never thought that way when it was plotting its ascendancy from the 1950s through the 1970s.
Calmes gave the last word to Thorpe, who concludes from a failed attempt to bring single-payer to Vermont that it would be unworkable on a national scale. Vermont’s plan wasn’t really single-payer; providers would still have had to contend with multiple payers, thereby limiting administrative savings, and the state would have little bargaining power with drug and device manufacturers. The experience of a small state in a big country is hardly conclusive.
What might be more persuasive is the experience of our northern neighbor, a country very much like ours. Canada covers almost all its population at a cost of 10.2 percent of GDP. Even after Obamacare, about a tenth of the US population is uninsured, but that incomplete coverage costs us 16.4 percent of GDP.
Britain’s system costs 8.9 percent of GDP, a little over half what we pay. Both countries have longer life expectancies than we do. But we should be afraid of the unicorns.
Doug Henwood is the author of My Turn: Hillary Clinton Targets the Presidency.
You can send a message to the New York Times at letters@nytimes.com, or write to public editor Margaret Sullivan at public@nytimes.com (Twitter:@NYTimes or @Sulliview). Please remember that respectful communication is the most effective.




People sure do love dishing out their money to for-profit insurance don’t they?
The fat-cat capitalists whisper their lies off-stage to the actors who confront us with the danger presented by these otherwise gentle and beautiful creatures they find so mystical, and then we turn around and do the spear-jabbing.
Wow. It boggles the mind. The jailers could unlock all the cells, leave forever and these people (the die-hard establishment supporters) would not have the courage to walk out into the light. Accept the freedom they have to choose.
Staring them in the face, and they still can’t see this unicorns and fairy mentality is all in their imagination. Where it always was.
Our perpetual global race to the bottom is much alive and well once again this election cycle.
Hello global warming, war, all of it.
Good-bye life on Earth. Meet the New Boss, Same As The Old Boss…
“Left-leaning”
But never standing
Goolsbee, FWIW, is also a Skull & Bonesman (like Bush and Kerry$.
Woolhandler and Himmelfarb are excellent and skilled proponents of single-payer, as is physician and PhD Howard Waitzkin, all of whom have written for Monthly Review, where you can find real left-wing economists. Waitzkin has a forthcoming article in Monthly Review that shows clearly how Obamacare has a thoroughly conservative lineage and is not a step forward at all. Sanders’ website might have noted this, though no doubt this would be impolitic to do. In any case, Sanders’ single-payer plan would be a vast improvement and would empower working people for sure by making them less vulnerable and more secure vis-a-vis their employers. Also, Gerald Friedman, one of Sanders’ economist advisers is a fine economist, and surely doesn’t deserve the barrage of criticism he is facing from Krugman, et. al (including Jared Bernstein, not mentioned in this article, but who sold his soul when he went to work for a quintessential political hack, Joe Biden). One thing that I do wonder about, however, is the growth rate prediction of Friedman if all of Sanders’ economic programs were to be put into practice (he says some of these will be do to the impact of the healthcare plan, as employer healthcare costs fall and as there is a better match between job openings and job seekers, since workers won’t be locked into jobs that provide healthcare). The claim is that the GDP growth rate will be 5.3% and this must surely be a key assumption in terms of the ultimate costs of the Sanders’ program. This seems an unsustainable rate of growth and would be, other things equal, catastrophic for the environment.
Unicorns, like dragons, be mythical.
Too bad for Paul Krugman that in 2008 Rush Limbaugh oft played the “Barack the magic negro” song to the tune of “Puff the Magic Dragon”.
Before taking a prolonged trip to Europe I had an eye problem. Fortunately I was able to see a specialist before I left and had a procedure. I asked what to do if I had a problem during my trip. He said “If you have a problem in London, do NOT go to the public health service; go to Moorfield Eye Hospital and pay out of pocket. If you have a problem in Vienna do NOT go to the public go to Dr. Kruger and pay out of pocket. If you have a problem in Rome, fly back to London.” I can well believe that the AVERAGE of care in other countries is better than in the US — but is it any wonder that I would be reluctant to trade my current healthcare for that in other countries?
Under the Bernie Administration I would expect that the two highest priorities would be to increase life expectance and good health, plus reduce government costs. And as the average American diet is 50% fat, it being the root cause of 95% of illness as it clogs up every internal organ in the body, Bernie I expect would do something grand like require those with a high fat diet to pay all their own medical expenses, which would bankrupt the process food industry, bankrupt the hospital butcher industry and make USA the healthiest nation on earth.
On the other hand, as the two highest priorities for the health industry are maximizing premium payments by keeping our population half-sick and preventing any effort to expose a high fat diet as the root cause of illness.
We are being fed the notion that single-payer, government administered health care is not a reasonable possibility. In fact, the President could set up such a plan and simply make it available. Over time, the drug and insurance industries lose their ability to blackmail the ill.
William Zune, you do realize there are bad eye doctors in the US?
Also, just being in England or the UK doesn’t mean you get to go for eye work in their public systems.
All you’ve conveyed is that there are some questioinable places for eye surgery in the UK and Austria, not that the system doesn’t work on average better than in the USA.
@JohnEllis:
That’s a very simplistic view of most health problems.
What you may be trying to address, badly, is that obesity causes serious health problems and that many in poverty suffer from obesity because of crap food stuffs they are able to afford.
TO — William Zame
“If you have a problem in London,
do NOT go to the public health service”
Rubbish, for England has socialized medicine that is second only to some of the Scandinavian countries.
So, what the well-to-do poster is trying to tell us is that, he is of the 51% most wealthy that hoards all the wealth, the 51% voting majority that keep the lower 49% impoverished for the purpose of economical slavery.
And so, guess who would have to pay for the cost of healthcare for the impoverished laboring-class lower-half of society?
TO — Jay
“That’s a very simplistic view
of most health problems.”
That is the problem, you and most all of your voting majority, you who are the 51% most wealthy and hoard all the wealth, you find it an emotional impossibility to except anything pertaining to class as absolute. For it would just blow your mind with guilt.
So, what is your opinion of 5 year old migrant workers picking all your fruit for starvation wages?
So, what is your opinion of 5 year old
JohnEllis,
You’re not making your case about fat with lines like that.
There has been no left-ish economic discussion in years. This generation so strongly believes in the success of our deregulated capitalism that they think everyone is able to work, there are jobs for all, therefore no need for poverty relief. Who would want to change that?
TO — Jay
“the case about fat”
So which is it, you have no opinion about enriching your self upon the misery of 5 year old migrant workers because you have no conscience, or because your trying to hid a guilty conscience?
So now Austan Goolsbee, Paul Krugman, and Ezra Klein are all going under the bus with Planned Parenthood, John Lewis, Gloria Steinem, Howard Dean, Jimmy Carter, and lord knows who else – all for not being sufficiently worshipful of Bernie Sanders. It might have been worthwhile to point out that usually Krugman and Goolsbee are on the very same side as Reich and Galbraith – and that they ALL were right about 2006-2008 and saw it coming years in advance. But nope. I support Bernie, and, until now, I have been unwilling to attribute to him the idiocy and malice of his small (I thought) cadre of anti-liberal enforcers. But I am about done here. There are facts and figures to discuss here – with highly credible demand-side economists for and against (or maybe for and “more for” would be a more accurate description) both Democrats’ plans. When you fail to point that out in favor of sneering BS, you’re not being FAIR. You’re just being differently biased.
Left out of the cost of US healthcare is the marked loss of physician productivity entailed in wrestling “pre-authorizations” from insurers and, often, losing. Ditch the for-profit middlepeople and the greater healthcare effectiveness would reduce the cost of much avoidable illness.
People goes against the trend. She was on top but at election night. every thing go reverse and Client defeated by Trump in General Elections 2016