Democrats: Keep it simple – Medicare-for-All

As Republicans recklessly move forward in doing damage to health care in America, it’s important for Democrats to have a clear vision for the alternative: Medicare-for-All. Democrats must communicate that their goal is straight-forward: to provide complete and affordable health care for all Americans. It’s basic economics. You want to ensure that the demand for goods and services is met by suppliers who are properly remunerated.

The demand for health care is always in flux. Each day, new Americans contract illnesses or are injured. At the same time, Americans are recovering from what had set them back. We as individuals, we as a society, are only as good as we are healthy. It is in everyone’s best interest for us to have a system in which health care is available in a timely and convenient fashion. To those who are taking care of us, it is important for them to be properly paid and to perform their duties in the best of working conditions.

There is nothing engraved in stone that says that insurance companies should be involved with how we do health care. Insurance is legalized gambling, on both the part of the suppliers and the purchasers. That may be acceptable if you go to the race track or a local casino. However, it is far too casual and unreliable to use as an approach to deal with our physical and mental well-being. In insurance, there are winners and losers. When it comes to our wellness, we need “win-win” solutions.

What Republicans are currently doing for insurance companies is not to expand the market as the Affordable Care Act has done. Rather Republicans are minimizing risk by essentially allowing the companies to either not insure people who may require the costliest procedures or to price individuals out of the market. But what Republicans are doing through their approach to health care is not just taking care of insurance companies with whom they are cozy. They are acting in a way that it consistent with one of their basic political, and even psychological, goals: to simply be mean to people about whom they care the least.

At last look, the Congressional Budget Office estimated that the Republican plan will cause twenty-four million Americans to lose health care.  Eight years ago, under President Obama, our nation talked about how low we could make the number of people who did not have access to health care. With Donald Trump and the Republicans, it’s how many we can remove from our health care system.

Why do they do this? Some, like House Speaker Paul Ryan, would say that it is to be responsible overseers of our federal budget. But it looks and smells much more like overseers of people who they want to keep subservient.

If Republicans really care about balancing the federal budget, as they say, why do they want to balance the budget? The conventional answer is that they care about deficits and deficits cause inflation. Take a look at the two charts below to see how specious this argument is:

As you can see above, the federal debt has grown, almost exponentially, since 1980. But below, you see that inflation has topped 5% only once during that period. Over thirty-five years of recent history clearly shows that running federal deficits has little or nothing to do with inflation [the real factor is what percentage of the GNP is the deficit, but Republicans don’t talk about that.]

So why is it that Republicans constantly harp on wanting to balance the budget? First, by supporting the reduction of federal expenditures, they put themselves in a position to support tax cuts for the wealthy. That’s something they clearly like.

Second, and this is more psychological than political, we have to recognize that there are some people in our society who are just plain mean when it comes to public policy. They almost seem to lack an empathy gene and they don’t care about the suffering of others, particularly if those people are not like them. Why else would you support a health care bill that would reduce $800 billion of taxes on the wealthy while denying twenty-four million people access to health care?

It’s not that Republicans are mean; it’s that those among us who are mean tend to be Republicans1. Psychologically and politically, there is very little that Democrats and others can do about changing that. But what it does mean is that those who have more of a sense of empathy can try to fashion public policy that provides the greatest amount of good for the greatest number of people. When it comes to health care, that is clearly Medicare-for-All.

So Democrats, please don’t get bogged down in the details of the Republican policies. Don’t worry about giving a fair shake to the insurance companies? Our goal for those in the health insurance industry should be to help them find gainful employment in the future, just as it is for coal miners.

Not only is Medicare-for-All sound policy, it is good politics. Let’s face it, the American people don’t like complexity. That’s why neither the Republican plan nor the Affordable Care Act are popular.

Keep it simple, when you can. The message and the policy should be Medicare-for-All.


1 Many of these people are very cordial and thoughtful towards those who they know. But when it comes to fashioning public policy that serves the common good, they are just plain mean.