By Matthew Continetti
Saturday, September 16, 2017
How rudderless is the Democratic party? Its membership is
so bereft of leadership and policy direction that 16 of its senators have
signed on to a health-care bill sponsored by a self-avowed independent
democratic socialist from Vermont.
The “Medicare for All Act of 2017″ would repeal
Obamacare, along with most other private and public insurance, and replace it
with a government-run, one-size-fits-all, centrally directed system of
reimbursement for medical expenses. Sanders, who honeymooned in the Soviet Union,
holds the same opinion of health insurance as he does antiperspirants: “You
don’t necessarily need a choice of 23 underarm spray deodorants or of 18
different sneakers when children are hungry in this country.”
Senators Harris, Booker, Gillibrand, and Warren, who in
addition to co-sponsoring the bill may soon be fighting each other, as well as
Sanders, for the Democratic nomination, are generals reenacting the last war.
They saw how well Sanders did against Clinton, they have marched in the anti-Trump
“resistance” movement, and they want to inoculate themselves from accusations
of ideological heresy.
Which is why they embrace the thin-skinned and irritable
senator whose wife is under federal investigation. What the copycats forget is
that the future in politics is never a straight-line projection of the present,
much less of the bizarre circumstances surrounding the 2016 Democratic primary.
“Medicare for All” might strike Warren & Co. today as legislation worthy of
support for reasons both moral and self-interested. In time, however, palling
around with Bernie Bros may become a liability.
For one thing, the policy is remarkably vague. “Mr.
Sanders did not say how he would pay for his bill,” writes Robert Pear of the New York Times. “Aides said he would
issue a list of financing options.” The “options” are not included in the bill
— but they are enough to raise the hair on the back of one’s neck.
The experiences of Vermont, whose single-payer system
collapsed several years ago, and of California and New Jersey, whose true-blue
legislatures can’t carry single-payer across the finish line, and of Colorado,
which voted overwhelmingly against a similar plan last year, suggest the tax
increases necessary to sustain expanded coverage frighten even Democrats. Examining
a similar policy introduced by Sanders during the presidential campaign, the
liberal Urban Institute concluded the following:
National health expenditures would
increase by $6.6 trillion between 2017 and 2026, while federal expenditures
would increase by $32 trillion over that period. Sanders’s revenue proposals,
intended to finance all health and non-health spending he proposed, would raise
$15.3 trillion from 2017 to 2026—thus, the proposal taxes are much too low to
fully finance his health plan.
No wonder Sanders wants to avoid the details. He and his
co-sponsors are in a bind. There is no way to pay for the benefits they desire
without a) economy-crushing tax hikes, b) rationing, or c) some combination
thereof. That chases away support.
Nor is that support deep to begin with. Vox, citing research from the Kaiser
Family Foundation, explains that “support for single-payer drops about 20
percent when people who initially said they supported the proposal are told it
would give the government too much control or require Americans to pay higher
taxes.” Universal coverage with no copays sounds nice at first. But both voters
and politicians recoil when they are confronted by the reality of exorbitant
costs and diminished freedoms.
The inconvenient truth of the health debate is this: The
vast majority of Americans are not only insured, they are satisfied with their
insurance. They might grumble about premiums or deductibles or choice of
doctors, but they are not about to embark on systemic change. Two-thirds of the
some 150 million Americans who receive health coverage through their employer
told the Gallup organization they were satisfied in 2016. About three-fourths
of the plurality of Americans who receive coverage from Medicare, Medicaid, or
the VA said the same. Why overthrow those arrangements cavalierly for Sanders’s
revolution?
As President Obama would say: This isn’t my opinion. It’s
the conclusion of liberals who would embrace a single-payer system if they had
to recreate American health care from scratch. “A commitment to universal
health coverage — bringing in the people currently falling through Obamacare’s
cracks — should definitely be a litmus test,” writes Paul Krugman. “But
single-payer, while it has many virtues, isn’t the only way to get there; it
would be much harder politically than its advocates acknowledge; and there are
more important priorities.”
Recall what happened the last time Democrats tackled
health care. The designers of the Affordable Care Act went out of their way to
get buy-in from all the various players in the health-care system. They based
their plan on Mitt Romney’s legacy in Massachusetts. Yet the controversy over
Obamacare’s mandates, taxes, regulations, and panels cost the Democrats the
House, and the negative reaction to the law’s implementation in 2013 and 2014
cost them the Senate. What would be the fallout if Democrats, reduced to their
weakest position in years, took on not only the entirety of the health-care
industry but also the status-quo bias of the American people?
The headlines the Left has generated this week include
single-payer health care, draping a tarp over a statue of Thomas Jefferson on
the University of Virginia campus, the resignation of the mayor of Seattle
after a fifth accusation of child abuse, the Bob Menendez corruption trial, and
Hillary Clinton’s latest sanctimony tour. That man in the Oval Office? He can
only be smiling.
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