Medicare for all is a trap

Staff Columnist

Politics & Ideas, by  William A. Galston The Wall Street Journal (Wednesday, February 13, 2019) “If Democrats back single-payer health care,it could assure Trump’s re-election.”

“A political party is asking for trouble when it embraces a position on a high-profile issue that most Americans oppose.

But it isn’t easy to avoid this pitfall when a majority of the party’s own members endorse that position.   As the campaign for the Democratic  presidential nomination heats up, the Medicare for all plan first proposed by Sen. Bernie Sanders risks pushing candidates into this trap.

The stakes are very high: This unforced error could give President Trump his best chance to win re-election in 2020.

A recent Politico/Morning Consult poll found that  endorsing  Medicare for All rather than improvements to the Affordable Care Act did more than any other issue to increase to increase enthusiasm for a prospective nominee among the Democratic rank and file.  Fully 57% of Democrats said they would be more likely to support such a candidate compared with 22% who said they were less likely, and 37% said that they would be ‘much more likely’ to do so.

So it was no surprise that in a town-hall meeting soon after announcing her candidacy, Sen. Kamala Harris vigorously backed Medicare for All. Yet many observers were taken aback when, citing excessive paperwork and delays in the approval process, she went on to say she wanted to get rid of private health insurance altogether.  ‘Lets eliminate all of that,’ she said.  ‘Let’s move on.’

Ms. Harris’s version of  Medicare for All means private insurance for none.  Even if you like your private plan,  you can’t keep it.  And mnay Americans do like their private plans, which is why they find proposals like Ms. Harris’s so troubling.  A Kaiser Family Foundation survey last month found that, while 56% of Americans claimed to favor Medicare for All, support sank to 37% for versions of the proposal that would eliminate private insurance companies.

Some leading Democrats also have doubts about this approach.  Minnesota Sen. Amy Klobuchar, who entered the presidential race last weekend, has declined to endorse Medicare for All.  So has another potential Midwestern candidate, Ohio Sen. Sherrod Brown.Former Colorado Gov. John Hickenlooper, who seems likely to run, staked out his position last year saying ‘I don’t think think we can get to universal coverage as quickly if we try to fight that battle now. . . . The imperative now should be make sure everyone’s covered.’

Colorado Sen.  Michael Bennet, who reportedly is also considering a run, was even blunter on ‘Meet the Press’ last Sunday:  ‘What  Democrats are saying is, ‘If you like your insurance, we’re going to take it sway from you – from 180 million people that get their insurance from their employer and like it.  Where 20 million people who are on Medicare Advantage and love it.That seems like a bad opening offer.’

But here’s the dilemma for Democratic presidential candidates:  As the Atlantic’s Ron Brownstein points out, even when voters who identify as Democrats are told about Medicare for All’s impact on private insurance, a majority continue to favor it.  The same is true after Democrats are told that it would require most Americans to pay more in taxes,’ a consequence that only 37% of the electorate is willing to accept.”

More from Galston: ”It seems that Democratic candidates face a stark choice between pleasing Democrats during the primaries or the entire electorate in the general election.  But there’s a way out of the trap.  By a margin of 51% to 39%, rank and file Democrats want the new Democratic majority in the House to  focus on improving and protecting the ACA rather than passing Medicare for All.

In addition, several versions of Medicare expansion enjoy overwhelming support.  Seventy-seven percent of Americans favor allowing  people 50 to 64 to buy health insurance through Medicare.  Seventy-four percent support a broader plan called ‘Medicare Open to All,’which would enable everyone to buy into Medicare if they chose but would let people keep their private coverage if they are satisfied with it, as most are.  Forty-nine percent ‘strongly  back this approach, and Democrats prefer it to Ms. Harris’s plan by 10 percentage points.

So there’s a way for Democratic candidates to square the circle.  First, support improvements to the ACA, such as protecting people with health insurance from high out-of-network medical bills without advance warning, along with strengthening restraints on prescription-drug costs.  Second, endorse Medicare Open to All.  And finally, during the primary debates unapologetically explain why you oppose forcing people to give up private insurance and pay higher taxes.”

Concluding:  “Candidates who can’t win this debate should find another line of work, and a party that ends up on the wrong side of it could forfeit a winnable presidential campaign in 2020.”

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