Democrats should stop talking themselves out of Medicare for All

Photo: Bill Clark/CQ Roll Call

The Medicare for All movement has again pushed major, progressive health reform to the forefront of Democratic politics. Now supporters need to resist the watered-down compromises being pushed in response.

Colorado Gov. John Hickenlooper stood with some of his fellow governors at the National Press Club on Friday and announced his plan to fix the nation’s broken health system: more of the same, but slightly different.

The “Bipartisan Governors Blueprint for Healthcare,” an updated version of the proposal pushed last year by Hickenlooper and Ohio Gov. John Kasich, is exactly as exciting as it sounds. It’s a mishmash of token market-based reforms and inscrutable platitudes — like the need, the two governors write in a joint Time Magazine op-ed, to “give patients the tools they need to make value-conscious choices.”

Their “blueprint” comes a day after the liberal Center for American Progress (CAP) released what it calls “Medicare Extra for All,” a proposal with its sights set considerably higher. It would create a new public insurance program, Medicare Extra, into which many Americans would be automatically enrolled over time.

While certainly bolder than Hickenlooper’s plan, Medicare Extra still stops well short of Medicare for All, the full single-payer overhaul favored by much of the Democratic base and endorsed by 17 Senate Democrats last year. But rest assured that if you’re a left-leaning voter in search of a health care reform proposal to get behind, there are still plenty of other options out there.

There’s Medicare-X, a much narrower public option being pitched by Colorado Sen. Michael Bennet, who shares a distaste for ambitious policy with his former boss. There’s AmeriCare, an old proposal touted by Vox last year as “a public option on steroids.” There’s United States of Care, an advocacy group founded by several Obama alums, which wants to…well, no one really knows.

It’s a positive sign, to be sure, that major, progressive health care reform is again becoming a nonnegotiable plank in the Democratic platform, just a few years after conventional wisdom held that the essential structure of the Affordable Care Act must be preserved and only incremental fixes could be made within it. In that context, the vision and scope of something like CAP’s Medicare Extra is welcome news.

But it’s not enough — not as policy, and certainly not as a political rallying cry. The plan would preserve the existence of private insurance companies, which are fundamentally, inescapably driven to prioritize profit over the provision of care. And unlike Medicare for All, it would not guarantee care that is free at the point of service, instead relying on a cumbersome, means-tested fee schedule to “set deductibles, copayments, and out-of-pocket limits that would vary by income.”

Even if you believe, however, that such concessions to the status quo will eventually need to be made, proposals like Medicare Extra are a bad political miscalculation. With Democrats many years and a great deal of electoral work away from being in a position to enact new reforms, these half-measures achieve little but to dilute the galvanizing potential of the Medicare for All movement and bargain the left’s own demands down before we’ve even gotten to the table.

As many as 57 percent of Americans now support a Medicare-for-All-style system — a number that would surely only grow if the full institutional weight of Democratic Party were placed firmly behind it. Even after Obamacare’s valuable reforms, American health care is still in crisis; costs are as high as ever, insurers are still making us miserable, and tens of millions lack any coverage at all. People are ready for sweeping, even radical change — something that future Democratic presidential hopefuls recognized when nearly all of them signed on to Medicare for All legislation last year.

The instinct to blunt this leftward momentum with more moderate proposals like Medicare Extra or Bennet’s Medicare-X is a perfect storm of many of the Democratic Party’s longest-held hatngups and neuroses. There’s the wonk-industrial complex’s urge to graft unnecessary layers of technocratic complexity onto straightforward, universal ideas. There’s the empirically proven tendency of Democratic politicians and consultants to believe the electorate is much more conservative than it really is.

And, of course, there’s the simple, uncomfortable fact of the influence wielded by the deep-pocketed corporations that, in the case of health care, must be not only reformed but dismantled. Getting on board with Medicare for All requires telling private insurance conglomerates with a long history of writing checks to Democratic candidates that they should no longer exist.

These forces can be overcome — and to a great extent they already have been, by a nationwide movement of left activists who have pushed the urgent necessity of guaranteeing health care as a human right to the forefront of Democratic politics. With so much ground already gained, Democrats who support this movement shouldn’t settle for watered-down compromises — they should keep pushing. It’s working.