So I’m normally more enthusiastic when health care policy gets as much spotlight as did last night during the Democratic debate, but like many a wayward left-dude I was distracted by things people wrote on the internet. Maybe that’s because I’ve grown less wonk-centered as we move forward into this post-Affordable Care Act landscape, more radical in my overall beliefs, and exceedingly concerned with organizing and coalition issues that ever before. I don’t know, and don’t particular care because my motivations are an extraneous aspect of the response to Bernie Sander’s basic outline for single-payer health care.
I don’t want to undercut how pleased I was that the candidates spent as much time as they did on the subject, because Hillary Clinton was right to say that the project of expanding health insurance coverage is a time-honored Democratic Party tradition that’s worth celebrating—when it’s been accomplished and where it genuinely works. This is an important subject to continue debating various merits, goals, and visions.
In the absence of these kinds of specifics, Sanders has offered a puppies-and-rainbows approach to single-payer — he promises his plan will cover everything while costing the average family almost nothing. This is what Republicans fear liberals truly believe: that they can deliver expansive, unlimited benefits to the vast majority of Americans by stacking increasingly implausible, and economically harmful, taxes on the rich. Sanders is proving them right.
This is an overly-eager-to-eviserate wonk critique from Klein that gets bogged down in demanding too many details. To be sure a lot of these questions are good in the abstract, and in the event of legislative reality these would be critical inquiries into the transformation of a fundamentally flawed (still) health care system. But this isn’t 2010. This is an election primary.
Klein is right that the mechanics of the plan are critical, and I probably should have done more than shrug that off as something that we’d get to later. Still, I think his criticism goes way too far. This is a campaign document. It’s obviously aspirational, and asking a presidential candidate to go into deep detail about the drawbacks of his policy is a little much. […]
But my take is that Sanders was trying to accomplish something specific: he wanted to show that universal health care was affordable, and he wanted to stake out a position that Democrats should at least be dedicated to the idea of universal health care. I’d say he accomplished that in credible style. It’s fine to hold Sanders to a high standard, but it’s unfair to hold him to an Olympian standard that no presidential candidate in history has ever met.
Look. Questions about what type of effects such a transition would have on existing stakeholders, including health care providers and companies etc etc are worth exploring. Folks like Ezra and others are welcome to continue those conversations but some contexts are less relevant than others. This is one of those contexts. I figure Ezra knows this, yet like many a good self-styled wonk sometimes we just can’t help ourselves.
The far greater critique of Sanders isn’t about technical policy but securing the necessary power to enact anything on his agenda. He can’t do these things on his own and to my knowledge his most substantive rejoinder to the issue is describe a fifty-state revolution. That’s not good enough by far and I believe it’s the candidate-centric issue that he should be most-pressed to expound upon. A broad outline for single-payer has it’s purpose but what about a white paper for organizing the legitimate control to see it actualized? This is a tougher bit to answer. I hope someone goes down that rabbit-hole.