Given these results under the last two Democratic administrations, it should not be surprising that the Sanders program--aiming to break emphatically with the neoliberal framework that has dominated economic policy since Reagan--has caught fire among large segments of Democratic and independent voters. Nevertheless, might it still be true, as the critics insist, that the Sanders program is based on flimsy foundations and wishful thinking?
To address these charges seriously, we first need to draw a clear distinction between what might be realistic in political terms versus economic terms. These are separate matters, though the critics consistently confuse them in one big jumble. Presumably, if, as a longshot, Sanders moves into a position to advance his economic program through having won the presidency, that alone will have dramatically recast the country's political dynamic. Yet the more basic question would still remain as to whether the Sanders program is economically feasible even under such highly favorable political circumstances. Let's see how some of his key proposals stand up to this test. Medicare for All
Sanders's critics regularly ridicule his proposal for universal healthcare coverage under a single-payer Medicare-for-all system. For example, two leading liberal healthcare analysts, Paul Starr at Princeton and Kenneth Thorpe at Emory University, have harshly criticized the specific proposal developed by my University of Massachusetts Amherst colleague Gerald Friedman on which the Sanders campaign has drawn. Starr, Thorpe, and other critics may well have some legitimate concerns with respect to the specific proposal drafted by Friedman. This is normal whenever specialists debate the specifics of large, complex policy measures.
Do critics really think its impossible to devise a healthcare system roughly like those in Germany or France?
But the critics are missing the big picture, which is simple: The United States economy currently spends 17.1 percent of GDP on healthcare, while the UK, Australia, Canada, Germany, Japan, and France spend between 9.1 and 11.7 percent, respectively. All of these countries perform better than the United States, according to standard public-health measures such as average life expectancy. Within the context of the current US economy, the difference between spending 10 versus 17 percent of GDP on healthcare amounts to $1.3 trillion. That $1.3 trillion mark-up in US healthcare spending flows mainly into the coffers of big insurance and pharmaceutical companies. Do Sanders's critics truly believe that it is impossible to devise a system whose administrative features roughly approximate those in Germany, Japan, the UK, France, Australia, or Canada? They have not advanced any serious arguments to support such a claim. Indeed, many of Sanders's critics themselves have been proponents of single-payer prior to Sanders's having incorporated it into his platform.