Kevin Drum wrote a piece recently that featured a common, but mistaken, criticism of Medicare for All. The criticism is that Medicare for All will increase taxes and government spending so much that there won’t be much fiscal space left to do other things. This criticism is wrong because the amount of fiscal space we have to pay for non-healthcare items is constrained by the level of national health expenditures, not the level of government health expenditures.

Drum’s piece on this is very straightforward. In it, he points out that right now, government spending in the US is around 38 points of GDP. If you add all private health expenditures to that figure, it goes to 46 points of GDP. Thus, according to Drum, Medicare for All would basically tap out the government’s ability to spend:

I don’t know about you, but this is roughly the highest number I’m comfortable with. There are a few countries that spend more, but 46 percent is the EU average and seems like a reasonable ceiling, especially since we’ll almost certainly drift higher than this as health care and retirement costs increase.

So here’s my question: if you want lots of other goodies, there are two choices. First, reduce other spending to make room. Second, don’t worry about that 46 percent total spending number. It’s just centrist rubbish anyway.