Senator Elizabeth Warren has finally issued her answer to the big question of how she proposes to pay for Medicare for All. Some of the responses have been favorable – up to a point. (Paul Krugman: “Did Warren Pass the Medicare Test? I Think So. Her plan is serious, even if it probably won’t happen.”)

The macro math comes down to this. Most OECD countries pay for affordable medical care for all with expenditures of less than 9% of GDP. The US spends 18% and still can’t get it. That’s what happens when the market mechanism is allowed to define what good medical care is.

The US should be able to offer medical care-for-all for under 18% of GDP, which means not more taxes but less money shoveled out to, for just one example, hospital presidents who pay themselves a million bucks a year.

Warren is an academic who knows what the final outcome should be, which is that the government should make available affordable medical care for all.

She is not, however, a politician who strategizes about how we might be able to get there. She is – at least on the surface, and even if only to project a more militant stance – oblivious of the notion of the art of the possible.

That is where Biden, Buttigieg and Klobuchar offer a more realistic and moderate alternative: keeping private insurance plans intact.

Warren should wane by or before South Carolina (Feb 29). Former Vice President Joe Biden is buoyant, but if he slips it is either Pete Buttigieg or Amy Klobuchar.

We may get a surprise showing by Klobuchar in Iowa, the Minnesotan’s neighboring ag state, which is growing tired of Trump trade moves that completely lack strategy or even definition of a desired outcome.

Matt Aizawa, a securities analyst for decades, now watches and comments on markets and politics from the shores of a mountain lake north of Tokyo.