By David French
Wednesday, September 13, 2017
Today is single-payer day. Bernie Sanders is introducing
the Medicare for All Act of 2017, and this time he’s no lone socialist crying
in the progressive wilderness. A total of 15 Democratic senators are backing
his bill, including most of the top Democratic contenders for the presidency.
As the Washington Post’s Aaron Blake
observed yesterday, “The dam is breaking.” The
New Republic, among others, is even arguing that single-payer is becoming
the newest “litmus test” for the party’s presidential hopefuls, and given the
speed with which the far Left transforms fringe ideas into moral mandates, I’m
not surprised.
Sober-minded Democrats should be terrified. They just
might be handing Trump two terms. There are three reasons why.
First, and most obviously, single-payer health care comes
with an extraordinary tax bill. The very instant voters saw their take-home pay
plunge — often by an amount that far exceeds their traditional employee
contribution to their employer-provided insurance — they would realize that
“free” health care isn’t free. For now, Sanders is concealing how he’ll pay for
his bag of goodies, but any single-payer plan would be crushingly expensive.
Here’s the Washington Post editorial
board, on June 18 this year, describing the costs:
When Sen. Bernie Sanders (I.,Vt.)
proposed a “Medicare for all” health plan in his presidential campaign, the
nonpartisan Urban Institute figured that it would raise government spending by
$32 trillion over 10 years, requiring a tax increase so huge that even the
democratic socialist Mr. Sanders did not propose anything close to it.
Indeed, Sanders’s 2016 revenue plan was a staggering
$18 trillion short and still
imposed more than $14 trillion in new taxes. To put this in context, the
current total national debt — accumulated over the previous two centuries of
the nation’s existence — is $20 trillion. These numbers are almost too huge for
the human mind to grasp, but the mind can certainly grasp a substantially
smaller paycheck.
Defenders of single-payer, however, claim that their
system will ultimately cost less — pointing to lower costs in other nations.
The Washington Post responds:
The public piece of the American
health-care system has not proven itself to be particularly cost-efficient. On
a per capita basis, U.S. government health programs alone spend more than
Canada, Australia, France, and Britain each do on their entire health systems.
That means the U.S. government spends more per American to cover a slice of the
population than other governments spend per citizen to cover all of theirs.
Simply expanding Medicare to all would not automatically result in a radically
more efficient health-care system. Something else would have to change.
American government health care is more expensive than
European government health care for multiple reasons, but let’s start with this
one: Americans don’t live the same lives as citizens in other countries. We’re
the most obese major developed nation, according to the Organization for
Economic Cooperation and Development’s 2017 “Obesity Update,” and our rates of
drug use, smoking, and alcohol abuse also differ substantially. Different
nations will have different outcomes, and the American experience suggests that
government cost savings will be far more elusive than Sanders supporters hope.
Moreover, voters are “richer, whiter, and older” than
nonvoters. In other words, they’re the people who are most likely to have
stable health plans. Older voters are already on Medicare. Would they want to
pay more taxes for no measurable increase in benefits? Employed voters tend to
enjoy a menu of employer-provided health plans, and they often like the plans they have. With
single-payer, the Democrats couldn’t even pretend that “if you like your plan,
you can keep your plan.” By design, more than 100 million of those plans would
disappear, to be replaced by one of the world’s most immense government
bureaucracies.
But the reasons why the single-payer push helps Trump and
the GOP go well beyond the health-care debate itself. This emerging litmus test
is symptomatic of a larger problem: The Democratic party is increasingly the
wholly owned subsidiary of the progressive base, and the progressive base has
become too radical for widespread electoral success.
Here, the results speak for themselves. President Obama’s
personal popularity obscured the unpopularity of his policies, and the
Democrats have steadily collapsed as a national political party. Its appeal is
concentrated in densely populated coastal urban enclaves, and it keeps
generating political ideas that appeal primarily to this urban base — and no
one else.
That same dense urban concentration yields the groupthink
that very quickly becomes angry intolerance. Debates quickly move to the
extreme, and name-calling substitutes for argument. Don’t think a man can get
pregnant? You’re a bigot. Do you believe that students accused of sexual
assault should enjoy the right to counsel or the right to cross-examine
witnesses? You’re a rape apologist. Are you wary of government-run health care,
and do you believe the free market can deliver better care? Then you’re killing people.
Finally, let’s not forget that many, many Democrats have
always viewed Donald Trump as an opportunity, not a threat. And, incredibly,
they still do. They wanted him to win the nomination, believing he’d be easy to
beat. Then, when they recovered from the seismic shock of Hillary’s loss, they
replaced their electoral confidence with confidence that he’d implode in
office, and the GOP would be utterly discredited. They looked at poll numbers
showing Sanders doing better than Hillary and grew convinced that anyone else
could take him on and win.
So why not double down on the progressive wish list? Why
compromise on, well, anything? After all, Trump’s election isn’t so much a
defeat as it is victory delayed — maybe even victory guaranteed.
They might be right. Trump’s support may well collapse
with the general electorate while he keeps enough of his base to stave off a
primary challenge. He may limp into a general election so damaged that any
Democrat not named Hillary Clinton will win back the Midwest and sweep Trump
out of office. But let’s be clear: The Democratic decision to keep moving left
is minimizing their electoral chances. It’s increasing their risk of loss.
Last November, millions of Americans held their nose and
voted for Donald Trump. With their embrace of single-payer and their continued
migration to the hard, intolerant left, the Democrats seem hell-bent on making
sure those same Americans make the same choice again.
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