Who Supports Medicare For All?
That's right. The one thing the right-wing Establishment can agree on with the left-wing Establishment is that medicare for all is a terrible idea.
The idea that a single-payer system could be the ultimate goal of progressive politics is so heterodox today that most of the 2020 Democratic presidential hopefuls are afraid to admit they support it.
But that's the case Bernie Sanders made to a crowd of supporters in Washington Square Park on April 17, 2017, in the early stages of his run for president.
“Tonight, we say to the private insurance companies,” he told a crowd of thousands that evening, “take a hike!”
“Let's pass a Medicare-for-all single-payer system.”
The crowd roared.
“Thank you! Thank you,” Bernie said. “I've been waiting to hear those words.”
A few days later, he released a proposal for a Medicare-for-all bill.
Sanders's bill was one of the most detailed, ambitious pieces of legislation in a Democratic primary since, well, Obama's health reform plan in 2008.
And, like Obama, Sanders was quickly attacked for it by his own party.
In the months that followed, Sanders's democratic socialist vision quickly became the most controversial issue in the Democratic primary. At first, the attacks were driven by liberal centrists. But the attacks soon came from the right — from the party's Establishment.
On the day of his bill's release, CNN's Jake Tapper asked the Vermont senator if he could see a scenario where, if he were elected, he would work with Republicans to improve the current Obamacare system rather than pass Medicare for all.
Sanders was unequivocal in his response: “No, I don't see any possibility of any compromise.”
But the very next day, a public option proposal was being floated by Sen. Kamala Harris's nascent presidential campaign.
Days later, Tapper asked Sanders about Harris's bill.
“Kamala Harris is a very good friend of mine,” Sanders said. “She's a great senator. We are going to work together on many issues. We are going to fight on many issues.”
But on that issue, Sanders said, “I've got a real problem with your description.”
He continued: “What that legislation does is say that in America today we're gonna have a public option in 50 states in this country. Medicare is a public option. This is a proposal that says in state after state, we're gonna take on the insurance companies.”
Sanders's was referring to the fact that Harris's bill made it easier for states to set up their own single-payer systems.
But the distinction Sanders hoped to make was lost on the party's leaders.
Over the course of the next few weeks, as the 2020 primary ramped up, they closed ranks.
Right-wing Democrats and centrist Democrats joined forces. Elected officials quietly released a flurry of bills intended to “offer” a public option — in “50 states,” no less — without “compromising” with Sanders.
In fact, the only 2020 candidate who has staked out a clear position on the issue is Sanders.
But more than that, he is the only candidate willing to defend the idea that it could be the goal of progressive politics.
So why are so many Democrats afraid to back single-payer?
It's not hard to understand. After all, in the 2018 midterm elections, the failure of Obamacare was a winning issue for Republicans.
But that's largely because the GOP successfully framed the law as an issue of broken promises rather than broken policy.
Republicans said that Obamacare was supposed to reduce premiums by $2,500, premiums went up.
They said Obamacare was supposed to lower the uninsured rate by 50 percent, the uninsured rate is just 37 percent.
They said Obamacare was supposed to be paid for with new taxes on the rich, the rich got a tax cut.
But it's not hard to see why these attacks have drawn so much resonance. Between 2013 and 2018, premiums increased by an average of 68 percent.
Meanwhile, the number of Americans with health insurance did not increase — it actually decreased by an average of 1 percent.
All of this is true, but it relies on a very tendentious understanding of the law.
The Affordable Care Act is the biggest expansion of government-funded health insurance since the creation of Medicare, which is itself a public option.
So if you think that this is the best model, then you probably shouldn't be surprised that the ACA isn't as far-reaching as you would like it to be.
That is to say, the ACA is not a single-payer system. But it is the closest thing we have ever had to one.
And it's not like we're going to get anywhere closer unless we talk about the issue honestly.
The ACA is not a single-payer system. But it is the closest thing we have ever had to one.
There is an obvious reason that the right-wing Establishment is