I’m not sure if Bernie Sanders actually graduated from the Hogwarts Academy of Political Enchantment and Necromancy, but his level of magical thinking certainly puts him in Dumbledore cogitation territory. He seems to be thoroughly convinced that he can conjure up an American Denmark out of the Republic’s potions book. Um, yeah. Good luck with that.
Now, it’s possible that Bernie actually does know the location of some secret political Platform Nine and Three Quarters, a place where a solar-powered liberal locomotive will arrive complete with an organic treats trolley, the populace will happily pile on, and from thence be steamed off to some progressive Elysium while munching fair trade chocolate frogs. That makes about as much sense as some of Bernie’s policy proposals, proposals that grown-ups who should know better are starting to take way too seriously.
Case in point is Bernie’s current drive to implement a single-payer, universal healthcare system (you can watch him giving the basic pitch here). He’s tried this several times before. He supported the 1993 American Health Security Act, which was basically state-based universal health care coverage (you can read the full text of the bill here), and he went whole hog for socialized medicine in the American Health Care Security Act, a bill he introduced into the Senate in 2013 (actually the bill got pretty watered down, but if you want to see where he was coming from you can read his original proposal here ).
None of those efforts made much noise. In between torpedoing the Clinton administration’s healthcare reform efforts and sucking the soul out of Obamacare, partisan Dementors sent Bernie’s healthcare plans off to the congressional equivalent of Azkaban. Not this time. Bernie has roughly a third of the Democrats in the Senate signing on as co-sponsors of his new bill–including pretty much everyone being seriously considered as a 2020 presidential aspirant. The bill is the Medicare for All Act, the thrust of which is to, well, put everyone on Medicare. In a nutshell, the basic idea is for all of us to have the same basic health insurance plan, which will be provided by the United States government. None of that Obamacare shilly-shally, it’s on to that geezer pleaser, the doc-for-the-vox-populi plan for the lot of us.
How will that work? How much will it cost? Who’s going to foot the bill? What about Big Pharma, Big Med, and Big Insurance, won’t they have a big problem with it? Will the GOP make some political hay out of this and might it, perchance, cause some problems for the Democrats? In order, here are the answers: dunno, dunno, dunno, affirmative-roger-bingo, and, you bet your sweet bippy.
The dunnos are standard Bernie-gram policy communication. He is not known for letting irritating practical details get in the way of forcefully advocating sweeping reform. He is super-keen on loudly insisting government do something, but whispers inaudibly about all the practical particulars necessary to transform wish into reality. Indeed, he gets kind of snippy when people pester him with vexatious queries like, “How’s that gonna that work?” In this case, the plan seems to be that Congress declares health care a human right and everyone signs up for Medicare. And then … well, something, I guess. Maybe Bernie mutters a sotto voce incantation of “wingardium leviosa”, gives a swish of one of Mr. Olivander’s best wands, and yada, yada, yada, ol’ Doc Potter is standing by to write free prescriptions for the migraine I feel coming on.
Now a single-payer system is, in theory, not a bad idea. Actually, it’s a pretty good one. It can mean everyone gets basic health care coverage, and no one gets sent to the poor house, even when the doc takes a look at those lab results and diagnoses it as a virulent case of “cha-ching!” It’s not the idea that’s bad–I’m actually down with it. Nor is it the philosophical issue Bernie-types like to bang on about. In other words, the arguments over whether health care should be a human right, a universal privilege bestowed on all by a benevolent state out of noblesse oblige, or something like tacos and underpants, a good you purchase on your lonesome without tax-backed subsidies. Who cares as long as you can get reasonable access to healthcare services without risking penury? That, said, if Bernie does get this through, I wouldn’t be surprised to see him proposing free taco trucks on every corner and nationalizing Fruit of the Loom.
The real problem is not conceptual or philosophical, but practical. In a technical sense, how do you make it happen? In a political sense, how can you make this feasible? Answering the first question means figuring out how to blow up a sixth of the American economy and radically restructure it in a way that leaves everyone with decent healthcare. That’s tough. Real tough. It’ll require pols and policy wonks to put on their big boy pants and hammer out deals with the healthcare industry that many are not going to like. Other countries have managed it, though, so surely with a skosh of Yankee ingenuity and can-do grit we can figure something out. I suspect an answer to the second question, though, is simply out of reach. I just don’t see how this works politically.
Let’s take just one screamingly obvious political issue this proposal creates. Roughly 150 million Americans get their health insurance through their employers. And by all that Nate Silver calls holy, they seem to like those plans. The Bernie Bros—and remember, this now includes a big chunk of supposedly grownup Democratic senators—seem to think you can go out on the campaign trail and tell these people, “we’ve got this ace idea to take away your healthcare plans and put you all on Medicare! But don’t worry, your healthcare will be better. Or not. We’ll get back to you on that. But you definitely will pay less. Unless you pay more. Anyway, it’s a fabbo idea, so remember to vote for us!”
There is no doubt that huge numbers of sitting legislators are willing to go out into the 2018 midterms and hit that message hard, loud and relentlessly. And they are almost all Republicans. From a GOP perspective, this won’t cure the electoral damage of the Great Obamacare Repeal and Replace Fiasco and Masacree of 2017. But it might make it sting a bit less, or at least provide a reasonable campaign trail dodge to the effect that Republicans aren’t the only ones proposing to blow up the healthcare system without carefully thinking through details.
Let’s face it, Bernie hasn’t exactly been good for the Democratic Party. He winged Hillary Clinton’s presidential campaign pretty good, and looks set to put a lesser, but still potentially painful, burn on the Democrats with this healthcare push. But then again, I can’t fathom why anyone would think he might be good for the Democratic Party because, well, he’s not a Democrat. Granted, he plays one when it suits the purpose (Politifact says, at best, he’s an unenthusiastic, reluctant and inconstant Democrat ). Near as I can figure, he’s an independent/Socialist who doesn’t like political parties, but is happy to take advantage of them. He likes to sit outside the system and rail at it and demand it should change. The problem is that while he’s pretty good at saying what he wants changed, he’s lousy at providing any realistic path to getting there. He just seems to think it will happen if only enough people want it to. What’s worrisome is that people who should know better are starting to take that whole idea seriously.
The click-your-heels-and-wish-real-hard school of politics, though, rarely achieves much. And until an Owl comes down your chimney with Medicare enrollment papers, I wouldn’t put too much faith in Bernie’s magical thinking.