ost studies find affordable, high quality health care the #1 issue for voters in 2020. So, it’s only logical that it’s taking center stage as a talking point for Democratic candidates.
And at the same time, it’s predictable that the Democrats are threatening to turn this no-brainer advantage into a huge asset for the GOP by promoting immediate and total Medicare For All.
Here are three key factors opening this self-inflicted wound:
(1) “The Democrats will take away your health care!” There it is—the gift-wrapped talking point that you will hear a million times from Donald Trump and every health care lobbyist from the moment MFA is formally adopted all the way through election eve. It will come non-stop. And it will be effective for the most persuasive of reasons—because it’s true. More than half of Americans get insurance through employer-based plans...which, by definition, would immediately go away. And the damage is not just to coverage--it's also to jobs. Did you know that more people work in health care than any other sector of the U.S. economy? Do those jobs transfer? Will I make just as much money? Where will my office be? Bernie Sanders and Elizabeth Warren say, effectively, “trust us, we’ll figure it out.” But the electorate is in no mood to trust anyone with their health care.
(2) Damage done all the way down the ticket. While the eventual Democratic nominee can earn cheers with MFA from some audiences, the reality is that Congressional candidates (particularly in swing districts) will be plagued by pointed questions they can’t possibly answer. “On what day will this all start?” “How much more will I spend in taxes--or how much will I save?” “Can I keep my doctor and my hospital?”. And most problematic, “why can’t I just keep my current coverage? I like it!” (Right now, 72% say their own coverage is good or excellent.) Where's the argument that convinces them something government-run will make them even happier?
(3) Are you medical "pro-choice"? Obamacare passed largely because it promised (and delivered) more affordable health care costs. But for many, it also represented a choice--something preferable to private insurance plans. Back then, the concept of "choice" worked well for Democrats. But now, with MFA, they threaten to to remove choice. And thus award Republicans with another gold-plated messaging point.
But most annoying is that there are two simple and effective ways this can all play out.
First, declare Medicare-For-All (or some similar plan) as the eventual goal. This is what some contenders are already doing. Allow MFA to enter the market as an option; e.g., “you can keep your employer insurance if you want, or opt for this new MFA. It’s up to you.” This is the way much of Europe plays “socialized medicine”. If single payer is the right answer eventually—which I believe it is—just allow it to win organically. There’s no compelling reason to rush.
Secondly, our emperor now marches on with no clothes, attempting to dismantle the Affordable Care Act through the courts (and perhaps banish the evil Obama from his nightly tremors). The courts should deny Trump; but if they don’t, millions more lose their Obamacare. Those people will not be happy—except to vote for Democrats. There is no alternative GOP plan. That was always a lie. So, we’d be back at square one, trying to construct a replacement—which is the perfect moment to push for MFA.
This all gets easier once everyone agrees that the ultimate goal is not utopia—it’s the White House.
But can the Dems ever agree?
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