Single-payer health care: The new litmus test for Democrats
“The Democratic Party now is, for all intents and purposes, the party of single-payer health insurance,” said Bill Scher in Politico.com. Last week, former Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) introduced the latest version of his revolutionary single-payer health-care system, named the “Medicare for All Act of 2017.” The last time the self-declared democratic socialist introduced such legislation, he didn’t have a single co-sponsor, for the simple reason single payer would require a total transformation of the U.S. health-care system—and a brutal, polarizing national debate. This time, 15 Senate Democrats lined up to put their name on his bill, including likely 2020 presidential contenders Kamala Harris (D-Calif.), Cory Booker (D-N.J.), and Elizabeth Warren (D-Mass.). Bernie’s plan is like the U.K.’s National Health System—but “on steroids,” said Vann R. Newkirk II in TheAtlantic.com. The program would cover everyone and, “well, everything”: doctor visits, drugs, home care, specialty care, and even vision and dental benefits, with “no deductibles, copayments, or coinsurance, whatsoever.” Right now, with Republicans in control of Capitol Hill, “the initiative is almost certainly doomed.” But single payer is now officially a liberal “rallying point”—one firmly at “the center of Democratic policymaking for years to come.”
Bernie’s health-care plan “is a complete joke,” said Philip Klein in WashingtonExaminer.com. It would “add hundreds of millions of people into an already financially strapped program”—lowering the Medicare eligibility age to 55 and insuring all children in the first year, and then expanding the program to include all age groups over the next three years. That could cost an absurd $32 trillion over the next decade, according to the liberal Urban Institute. Yet ask Sanders how he plans to pay for doubling federal spending, said Catherine Rampell in The Washington Post, and the Vermont senator “punts.” His legislation doesn’t include any financing— though Sanders did suggest in a separate white paper raising the top marginal tax rate to 52 percent from today’s 39.6 percent, a new 4 percent health-care tax on households, a 7.5 percent payroll tax on employers, and other taxes. Won’t Americans suffer “sticker shock” over these tax increases? Aren’t they the reason Vermont, California, and New Jersey balked when trying to pass similar single-payer plans? Ask these simple questions of the Sanders camp, and you’ll be branded “a corporate shill or worse.”
Sanders’ plan ignores another “inconvenient truth,” said Matthew Continetti in National Review.com. Some 156 million Americans have employer-based insurance, and the twothirds that are happy with their coverage won’t take kindly to having it “cavalierly” removed in the name of “Sanders’ revolution.” Similarly, don’t forget “the entrenched interests of providers,” said Jonathan Chait in NYMag.com. Doctors, hospitals, and drug companies will fight to the death against the Sanders plan, which seeks to reduce some costs by imposing strict price controls on what providers get paid. If the Democrats’ goal is universal coverage, there are several “boring, incremental” ways to achieve this, including offering Americans without insurance a public option to buy into Medicare. Alas, pragmatism was never Bernie’s forte. In his simplistic worldview, he thinks only “evil” drug companies and corporations would oppose free medicine for all, never realizing that “the most important source of opposition will come from actual American voters concerned about losing their current plan or paying higher taxes.”
Progressives still insisting on “realistic” and “commonsense” health-care reform “are living in the political past,” said Paul Rosenberg in Salon.com. If the old pragmatic assumptions about our politics still existed, Sanders “would never have won a single primary” in 2016, “and Donald Trump certainly wouldn’t be president today.” Americans “demand fundamental change.” Just a few years ago, single payer was a fringe idea; now, a Kaiser Family Foundation poll finds, 53 percent of Americans support it. With Bernie’s plan, Democrats can present voters with a positive, aspirational message in the 2018 midterms and beyond.
Let’s be clear: Medicare for All has “little chance of ever being enacted,” said Ezra Klein in Vox.com. Americans are still far too distrustful of big government and would never accept such massive tax increases. Still, the Vermont senator has done a “remarkable thing.” By making single payer the central legacy of his extraordinary 2016 campaign, he has fundamentally “changed the healthcare debate.” In the future, any Democratic proposal to improve the health-care system will be bolder and further to the left than ever before, moving the country closer to universal coverage. “It’s Sanders who has put them on that path.” ■