Medicare for All! "But How Will We Pay for It?"

A view on Monetary Theory and Democratic Socialism

Jan. 2.– Medicare for All has quickly become a principal rallying cry for many progressives and leftists alike. Organizations ranging from Our Revolution, National Nurses United and certain branches of Democratic Socialists of America (DSA) have done much of the day-to-day work to bring single-payer health care to the forefront of political debate. Their efforts have helped push Medicare for All to the floors of the United States Senate and House. Currently, there are 16 senators and 120 Congress people cosponsoring Rep. John Conyers' (D-Michigan) Expanded & Improved Medicare For All Act. 

With greater congressional backing of Conyers' bill and the grassroots surge in democratic socialist politics, questions have moved from the desirability to the viability of programs like Medicare for All. Partisans and opponents of social democracy alike are wondering, "Single-payer health care sounds great, but how can we pay for it? How can we pay for any universalistic program without going bankrupt?" If democratic socialists see social democracy as one of the key stepping stones towards a truly egalitarian society, the issue of how we can sustainably finance such programs is of the utmost importance.

An economic doctrine named Modern Monetary Theory (MMT) is surging in popularity and offering answers. MMT is debunking popular narratives about the harsh necessity of austerity and belt-tightening. It is showing that money is not a finite abstraction, but a limitless public utility that can be used to meet human needs. More than this, however, MMT and its heterodox economic cousins offer a framework to build directly democratic, egalitarian political structures, and thus reimagine and recalibrate the viability of democratic socialism.

What Is MMT? Understanding Neo-Chartalism

One of the theoretical forerunners and bases of MMT is chartalism, an economic theory which argues that money is a creature of the state designed to direct economic activity. The theory has recently been popularized by David Graeber's book Debt: The First 5,000 Years, a wide-ranging work that touches upon issues ranging from gift economies, the linkage between quantification and violence, and the relationship between debt and conceptions of sin. In charting out the history of money, Graeber notes that, despite anthropological evidence to the contrary, economists have long clung to the myth of barter.

However, money does not emerge from barter-based economic activities, but rather from the sovereign's desire to organize economic activity. The state issues currency and then imposes taxes ...

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