Single-payer health care should be funded by the federal government

Here is my Wednesday news blog post which ends as usual with some music – today some consummate guitar playing. Today, I discuss the dispute about M4A in the US and clear up some misconceptions. Many think that Medicare for All is defunct in the US because the ruling party – the Democrats have essentially rejected the lobbying attempts. Some people who have associated themselves with Modern Monetary Theory have, it seems, been advocating a state-based campaign to get single-payer schemes installed at that level. Is this a violation of MMT principles? Some think so. I do not. It might reflect ignorance of the nature of the sector but it doesn’t amount to a rejection of MMT. Anyway, I am a federalist and I explain why. I also bring attention to some anti-colonial struggles in the Caribbean.

Medicare for All – US

I have received several E-mails about a dispute in the US between activists who are agitating for Medicare for All (M4A) and those who want a single-payer health system installed.

The two pursuits are differentiated, it seems, because the former situates the struggle at the Federal level, correctly observing that the Federal government issues the US dollar and has the financial wherewithal to resource such a system should there be adequate productive resources available or could be diverted from other less desirable activities.

The latter believe, it seems, that there is no hope of securing an M4A system in the US, given the power of big privatised medical lobbies and interests, big pharma and whatever else that is ripping the American consumer off in this area, and so they are pitching their activism at the state level, hoping to pick off a few governors and get a limited system running up at that level.

They believe it is better have one state with a single-payer system than none, which reflects their lack of confidence in the M4A prospect.

Modern Monetary Theory (MMT) has, it seems, become embroiled in the debate.

The state-siders have quoted prominent MMT proponents saying the struggle has to be a state-based struggle.

The federalists have then considered that statement to be a breach of MMT consistency and the dispute between the two camps is very bitter.

Here is what I think.

First, this dispute has very little to do with MMT. It is not a ‘test case’ for MMT. A person can understand MMT and still advocate a state-level, single payer system.

Second, to advance a solution to these progressive activists eating each other up and getting nowhere fast in the process (why does the Left always do that?) there needs to be a study of health economics conducted.


Because the issue is really only to be advanced by understanding where the most effective scale for delivering broad-based, single-payer health care is located.

A cursory blush at what would be found if such a study was conducted would point one in the direction of a federally-funded, built, and organised system or a federally-funded system and built system, where ALL the states sign up to a single standard operational code.

I doubt that an effective scale can be achieved by having 50 different state-based single-payer health systems. Given the federal tax code links all citizens at that level, the administrative transfer to a single-payer system would be best performed at that level.

Further, the states are unlikely to have the muscle to resist the lobbying against a single-payer system from the private vested interests. The opportunity for corruption and captivity is higher at that level I suspect.

Also, progressives should be about equity as well. If all the citizens in California or Washington get a single payer system but the folks in Nevada or Idaho do not, then the idea that all Americans are equal against the law fades into irrelevance.

I know the idea of equity is a dream in a divided, corrupt America. But progressives should at least propose solutions that do not violate that principle.

Third, the matter will only be solved politically. MMT tells us that the federal government can buy all the medical resources available if it chooses whereas a state-level administration cannot. Small states will have worse care than larger states.

But it seems that the current Democrat administration has absolved itself of interest and responsibility at the federal level (that abominable Pelosi woman told the activists to forget any federal action).

Which means the activists think they have more chance getting at least one state over the line.

Is that a better outcome than none, when the activists have essentially given up trying at the (correct) federal level to achieve their aspirations?

I don’t think so.

Once the progressive side of politics bows to the conservative, neoliberals (which includes the Democrats in the US) and surrenders their ambitions such that they pursue something inferior but possible gettable, the battle is lost.

We have seen that surrender over and over again and that is why the Left doesn’t make much progress.

Australian Labor Party – more own goals

The news today is that the ALP, which is in the box seat to win the upcoming federal election in Australia (in May), is once again thumbing its nose to the citizens they are duchessing for votes.

I recently wrote this blog post – The last thing we need is a return to fiscal surpluses and rising household debt (February 21, 2022).

I discussed an Op Ed from a former senior advisor to a previous ALP Prime Minister who was demanding the Labor Party adopt the macroeconomic policies that the conservatives deployed between 1996 and 2007.

Those policies created fiscal surpluses that were only possible because the household sector’s debt went up to 180 odd per cent (from below 100 per cent) as the financial markets loaded up credit on anything that moved.

Those policies saw real wages fall and a massive redistribution of national income to profits.

It was a disastrous period in macroeconomic policy making but the needs of capital were met.

This morning we read that the author of that Op Ed is now going to be parachuted into a Western Sydney seat by central office to contest the next election against the wishes of the branch members of the party.

He is a ‘white, millionaire’ who works in the corporate world, doesn’t live in the electorate – instead lives in a multi-million dollar mansion in one of Sydney’s most salubrious (and expensive) suburbs and is on the extreme Right of the Party.

He doesn’t resemble any of the characteristics of a ‘Labour’ candidate.

And the seat he is being parachuted into is a relatively low-income suburban locality which is heavily multicultural and has several excellent candidates vying for nomination who live and understand the complexity of such an electorate.

The current Labor MP is retiring and comes from the Left of the Party.

It is amazing that the NSW Labor Party (State office) thinks this is a good idea.

I hope they lose the seat and the election as a result of their arrogance and shift to the Right.

The Party is in my view unelectable – which means no-one should vote for them.

Pay the reparations

The British royalty is doing what they often do – swan around the place pretending to love everyone.

At present, Prince William and his wife are on their way to Jamaica. They are not admitting this but they want to head off a growing distaste for the royalty in the Caribbean, which has seen Barbados finally kick the Queen of England out as the head of state and end the last formal vestage of the brutal colonial past.

On November 30, 2021, the island nation became a republic and swore in its first president (Sandra Mason) and the union jack was lowered for the last time – 55 years after first gaining independence from Britain.

Last September, the 300,000 Barbadians elected the new president and end the Queen of England’s tenure.

There are several former British colonies in the region that have now kicked her out as head of state and became fully-fledged republics – Guyana (1970), Trinidad and Tobago (1976), and Dominica (1978).

Jamaica retains the Queen as head of state.

Clearly the Royals are worried that they will be next to declare their republican status.

But the proposed visit is actually setting off new fires that the Royalty would not want to deal with.

A group of prominent Jamaicans (politicians, business leaders, doctors and musicians) have sent an open letter to the monarchy in Britain demand that they pay slavery reparations and apologise for the colonial impacts on the people in Jamaica.

The transcript of the – Open Letter – says among other things that:

We note with great concern your visit to our country Jamaica, during a period when we are still in the throes of a global pandemic and bracing for the full impact of another global crisis associated with the Russian/Ukraine war. Many Jamaicans are unaware of your visit as they struggle to cope with the horrendous fallout of the COVID-19 pandemic, exacerbated by pre-existing social and economic hardships inherited from our colonial past …

We see no reason to celebrate 70 years of the ascension of your grandmother to the British throne because her leadership, and that of her predecessors, have perpetuated the greatest human rights tragedy in the history of humankind. Her ascension to the throne, in February 1952, took place 14 years after the 1938 labour uprisings against inhumane working/living conditions and treatment of workers; painful legacies of plantation slavery, which persist today. During her 70 years on the throne, your grandmother has done nothing to redress and atone for the suffering of our ancestors that took place during her reign and/or during the entire period of British trafficking of Africans, enslavement, indentureship and colonialization.


Read the rest of it and get a sense of despair and anger that exists in these impoverished former British colonies.

Music – Round Midnight

This is what I have been listening to while working this morning.

This is another of my favourite records, which was released in 1959 and always delivers.

The actual track is – Round Midnight – which was recorded and published on the 1959 album – The Wes Montgomery Trio – by the band of the same name.

The players are:

1. Wes Montgomery – guitar.

2. Melvin Rhyne – organ.

3. Paul Parker – drums.

This album really marked the beginning of Wes Montgomery’s career who started out playing in a bar in Indianapolis before moving to New York City.

This bio – Wes Montgomery: The Softer Side of Genius (March 5, 2020) – will fill you in on the life of this great guitarist, especially his struggles with producers who thought they knew better than him about his sound.

Suffice to say, he restyled the concept of playing jazz guitar and has had many imitators since (include me at times).

That is enough for today!

(c) Copyright 2022 William Mitchell. All Rights Reserved.