“Life, liberty and the pursuit of happiness” is the Jeffersonian trinity of values that stand at the heart of this independent nation. We are now becoming aware that “life” must include universal health care, and every Democratic candidate for president has made that affirmation. The question is not “Should everyone be covered?” but “What is the best way to get it accomplished?”
The philosophical principle called “Occam’s razor” holds that given two or more possible solutions to a problem, the best one will be the least complicated. As I looked at this issue in 2016, I concluded that “Medicare for All” was the simplest solution, and I said so in a column. But as I continue to study the issue, I have had to alter that opinion.
Bernie Sanders wrote the bill calling for “Medicare for All,” and has doubled down on his unqualified support. But he has framed it as an angry broadside against the insurance industry, the pharmaceutical industry, Wall Street and the “one percent.” His plan would also declare illegal the existence of every health insurance company and their policies.
In the recent Democratic debates, Elizabeth Warren and Kamala Harris joined Bernie. The opposing argument to their position is the obvious conclusion that when you obliterate the health insurance companies you cancel every one of their policies. That affects more than 150 million Americans. Advocates of Medicare for All insist they are just offering a less expensive, better alternative without deductibles and co-payments, and assume that Americans will gladly make the exchange.
Advocates, however, fail to recognize the millions who are now happy with their coverage, and the unions that have fought for decades to obtain it for their members. For Democrats to rattle even a minority of union members is a political death wish. Moreover, a significant number of Americans are uneasy about the scope of big government and would see this as just another socialistic takeover of a legitimate capitalist enterprise.
When these issues are raised, the answer comes back, ”Democrats need to stop using Republican talking points.” I have long believed that in any dispute wisdom lies in listening to your opponents and taking seriously what they say, particularly if their appeals are directed at the very independents you need to cultivate.
I have an advantage over America’s political elite. I can consider new evidence and change my mind without being branded a flip-flopper. And change my mind I have. Pushing Medicare for All may simply doom the American people to four more years of Trump. And for that reason alone I believe Medicare for All is a political disaster. Wisdom dictates that candidates unalterably committed to it must be rejected.
Bernie Sanders is locked in. If Elizabeth Warren, who to this point has been my candidate of choice, cannot alter her position, and if she prevails as the party’s candidate, I’m afraid she will lead America into years of the racist, nationalist bigotry only celebrated by America’s right-wingers, including those who shouted, “Jews will never replace us!”
If Medicare for All is not the answer, what might be? Democrats have but a few months to clarify their position, but wherever they come out there are a few guiding principles:
First, the plan must cover everyone.
Second, the plan must provide a choice.
Three, the plan must give people the right to stay with their trusted physician and current plan.
Fourth, the plan must be available to the poorest Americans.
Has any candidate put forward such a proposition? That's unclear, but the idea may start with Mayor Pete’s call: “Medicare for all who want it.” This might come with an alternate government plan built on the Affordable Care Act. In addition, the proposal must guarantee that every American should have the right to seek private coverage or purchase supplemental insurance.
Having watched the latest debates and followed the responses, it appears to me that the overall winner was Donald Trump. So Democrats, before it is too late, step back, take a deep breath and find a better answer to the health insurance issue.
