Bernie Sanders introduced his Senate “Medicare for All” bill on Wednesday with 16 of his Senate colleagues co-sponsoring the bill. Sanders and many of the bill’s co-sponsors appeared at an event on Capitol Hill Wednesday to unveil the “Medicare for All” bill, with Sanders repeating his familiar refrain that “healthcare is a right.”
These 16 Democrats see the writing on the wall: “Medicare for All” has now become a litmus test for Democrats hoping for future electoral success, whether that be in elections to maintain seats they hold now or elections for more ambitious positions, such as President of the United States. In fact, many of the 16 co-sponsors, such as California Senator Kamala Harris and Oregon Senator Jeff Merkley, have been named as possible contenders for the honor of representing the Democratic Party in the 2020 presidential election. Bernie Sanders himself is seen by many as the current frontrunner in a hypothetical 2020 race, due in part to his status as the most popular politician in the United States, according to a Harvard/Harris poll from August.
While it’s safe to say that a majority of Democrat voters and independent voters who lean Democrat will not withhold votes from a politician simply because they are not a “Medicare for All” proponent, especially in a hypothetical 2020 race against Donald Trump, the number of those who have drawn a line in the sand on the issue has now reached a critical mass and momentum is clearly on the side of expanding Medicare to cover all Americans. Democrats who choose to oppose “Medicare for All” will be forced to contend with an energized and vocal contingent of progressive Democrats and independents who see it as an issue on which they will not compromise, even if that means victories for Republican candidates. More moderate Democrats can try, as they might, to argue that this strategy is foolish or self-defeating, but their efforts would be in vain. The line has been drawn.
According to CNBC, recent polling conducted by the Kaiser Family Foundation suggests that 53 percent of Americans now support the idea of a single-payer healthcare system like the one Bernie Sanders is proposing with his “Medicare for All” bill. Other polls suggest as many as two-thirds of Americans support single-payer. The concept of a single-payer healthcare system is not some wild Marxist idea espoused by radicals. In most of the developed world, it has been implemented with great success, with single-payer healthcare systems typically being rated higher than the for-profit system we have in the United States.
Expanding Medicare to cover all Americans is not only the right thing to do, it also makes sense economically. According to the World Bank, the United States spends roughly $10,000 per capita on healthcare expenditures. Canada, a country with a single-payer system in place, spends around $5000 per capita. Australia, a country with a hybrid public and private system, spends around $6000 per capita.
Opposition to a single-payer healthcare system remains strong among conservatives and centrist liberals. The primary argument against such a system revolves around the idea that the free market is more efficient and/or ideologically preferable. The efficiency argument can be easily dismissed by studying healthcare systems around the world. According to the Guardian, the U.S. system fairs poorly in comparison to countries that have some form of a single-payer system or hybrid system. Given that so much of our healthcare spending goes toward large salaries for insurance company executives, insurance company and shareholder profits, administrative costs associated with running a for-profit entity, and advertising costs, it’s hard to take seriously the argument that such a system is efficient. It’s an efficient way for some people to make money, but not really the most economically efficient way to get care to those who need it.
The other argument against a single-payer system is wholly ideological. Some people reject the idea that income should be redistributed via a system of taxation and spending. This argument falls flat in three distinct ways.
First, taxation does not directly fund government spending. Our federal government spends by way of a pre-distributionist model, not a re-distributionist model. In other words, spending decisions are made independently of the amount of money the government is taking in by way of taxation. For proof of this, simply look at the ease with which our government spends huge amounts of dollars on war. It’s never a matter of “can we afford this” with war or funds allocated to buy weapons from defense contractors. It’s assumed first that we will afford it, and budgetary considerations come later. This is, of course, complicated, because taxation does have a relationship to spending, but the argument “my tax dollars shouldn’t pay for that other guy’s medicine” is woefully simplistic and inaccurate.
Second, for-profit health insurance operates on the fundamental principle of income redistribution based on profit and risk. The idea that a corporation taking and distributing money for a product with the underlying motive being profit is fundamentally “better” than a public system is purely ideological and should be pointed out as such.
Third, this argument prioritizes one ethical consideration over the other. The arguments for “we should take care of people” and “we shouldn’t tax people to take care of other people” are both essentially ethical arguments. To choose one or the other, one has to make a moral and ethical decision that directly impacts other people. Right wing libertarians and free market absolutists like to pretend that their arguments against income redistribution by way of taxes are some concrete law of nature, but at every turn, they’re making a choice to prioritize one ethical concern over another.
Proponents of “Medicare for All” are not going to relent. Democrats who currently hold or are seeking public office would be wise to accept that reality and get on board now. At some point, their obstinance will come back to haunt them.
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