The Denver Post has a story up today that is worth reading, despite a headline that some of our more aggressively liberal Democrats might find a bit incendiary–“At town hall that focused on health care, [Sen.] Michael Bennet says single-payer system isn’t best option.”
In a dialogue this week largely focused on defeating efforts to repeal and replace the Affordable Care Act, U.S. Sen. Michael Bennet dismissed another system elsewhere along the ideological spectrum: government-sponsored, or single-payer, health care.
Bennet, speaking Monday night at a town hall in Greeley, said the existing system should be the focus.
“I think we should have a discussion about how to expand Medicare, so that more people can be part of it or maybe be able to buy it and how to do the same with Medicaid.”
Bennet emphasized that his Democratic colleagues frequently debate a single-payer health care system, but that he was “in the early days of this, myself”. The senator also said he hoped the topic “won’t turn into a litmus test” for Democratic candidates.
Creating an option for individuals regardless of their income or age to buy into government-managed health insurance programs would restore one of the central objectives of the 2010 Affordable Care Act, one lost in the vain attempt to win Republican support for the bill: a “public option” that would regulate the cost of private insurance by forcing it to compete with a nonprofit model. There are good arguments for Democrats adopting a “Medicare for all” platform as part of a broader counterattack on health care leading into the 2018 elections–in addition to this being a way to build on the Affordable Care Act’s success in expanding coverage instead of trying to tear the existing law down.
At the same time, there is a significant percentage of voters on the left who have much more expansive designs for health care reform than reviving a public option, to include a single-payer model like the one proposed in Colorado last year via Amendment 69. This pressure comes despite the fact that Amendment 69 failed by nearly 80% of the vote.
There are a number of reasons why Amendment 69 failed as badly as it did, and not all of them have to do with a lack of support for single-payer health care in the abstract. Many Colorado Democrats who support going beyond the scope of Obamacare to address access to care in America still couldn’t support Amendment 69, believing that a nationwide solution was the only viable path forward–as other states who started down this road themselves discovered. There were also specific problems with the proposal as written that hadn’t been accounted for, costing it support from would-be allies. When you combine soft support on the left with the total wall of opposition from conservatives to anything that can be remotely considered “government health care,” Amendment 69’s fate was sealed. So much so, in fact, that it was more useful to Republicans as a wedge to drive within the Democratic coalition than as a rallying point for Democratic candidates in 2016.
And it has to be said: a radical change to health care like moving the entire nation to a single-payer system is politically no more viable a prospect today than it was in Colorado last year. Where the broader adoption of something Americans know and trust like Medicare could attract enough support to pass–especially after a big Democratic win in 2018–there remains a far too vast ideological chasm between the right and left to achieve more than that right now. Progressives face a years-long task of unwinding pervasive conservative messaging on this and so many other issues. They faced the same challenge in 2010, too, and the total blockade of Democratic policy priorities by Republicans since the passage of the Affordable Care Act raises legitimate questions about whether the highly compromised Affordable Care Act was worth the collateral damage. The combined objectives of policy gains and legislative majorities, in a nation that is as deeply divided as ours, makes this a far more difficult question than impatient ideologues want to admit.
The political reality of this is tough medicine for a left newly emboldened in opposition to President Trump, but it’s critical that Democrats understand the limits of their own political capital. In 2004, Colorado Democrats retook majorities in the state legislature not by proposing far-reaching “Hail Mary” progressive policy goals. They won by pledging to be more competent with the government the voters already knew.
That’s where it has to start today, too.