The Washington PostDemocracy Dies in Darkness

Kamala Harris should be commended for retreating from Medicare-for-all. Here’s why.

There are good policy and political reasons to eschew the costly concept

By
August 22, 2019 at 12:02 p.m. EDT

The meme, pushed by President Trump, that the Democrats have all gone far left turns out to be, in the words of former vice president Joe Biden, a moderate who still leads the presidential primary race, a “bunch of malarkey.” The Post reports:

“I don’t think it was any secret that I was not entirely comfortable — that’s an understatement,” [Sen. Kamala D.] Harris said, holding a to-go cup from a Mexican restaurant at a recent stop. “I finally was like, ‘I can’t make this circle fit into a square.’ I said: ‘We’re going to take hits. People are going to say she’s waffling. It’s going to be awful.’ ” But, she said, she decided it was worth it.

The Democratic senator from California is hardly alone. The idea of Medicare-for-all — a unified government health program that would take over the basic function of private insurance — became a liberal litmus test at the outset of the presidential campaign, distinguishing Democratic contenders who cast themselves as bold visionaries from more moderate pragmatists.

Well, the only ones who seem to be pushing for it as a litmus test are Trump, who wants to define the Democrats as socialists; the self-described socialist Sen. Bernie Sanders (I-Vt.); and Sen. Elizabeth Warren (D-Mass.), who every now and then sounds like she has room for a step-by-step approach.

Medicare-for-all would help pay for long-term care. Why don’t more people know that?

Harris and others who have decided against full-blown Medicare-for-all should be commended, not ridiculed as “small thinkers” for eschewing an enormously costly and choice-averse concept at a time Americans want discrete, concrete things (e.g., low drug prices). By listening to experts and voters, watching poll numbers and thinking strategically about how to beat Trump, Harris likely made the best political decision, long-term, for her campaign. There are good policy and political reasons to wind up where she did.

Second, Sanders and Warren have yet to grapple fully with the cost. Shouldn’t someone with a revolutionary plan to change the face of health insurance tell us in detail how much it will cost and who is going to pay? This is not simply a quaint affection for fiscal sobriety. If the price is outlandishly high, then the idea is never going to happen, supporters should fess up. Moreover, the bigger the price tag, the more obvious it is how many people will have taxes raised. Who exactly? By how much? It seems highly unusual that Warren, who’s got a well-thought out proposal for everything, hasn’t thought through the full ramifications of her most controversial proposal.

Democrats back off once-fervent embrace of Medicare-for-all

On the political front, Warren and Sanders are now wrestling for the votes of the most progressive voters. Biden’s poll numbers to date, however, suggest a candidate aiming for a wider ideological coalition in the primary can do just fine, and quite possibly win. That becomes even more true as the race gets down to the final three to five candidates. Why try to out-Sanders and out-Warren the two Medicare-for-all proponents when the winner could very well be Biden or the person prepared to scoop up Biden voters if and when he falters?

Plenty of voters are tired of gigantic, unfulfilled promises to reinvent the Affordable Care Act, which they’ve finally figured out and like. (Thanks to Trump, the ACA still draws close to majority support.) You shift the health-care debate back where it should be: Trump tried to take away health care once; if reelected, is there any doubt he’ll do it?

This opinion piece originally appeared in The Washington Post.