I love the fact that Bernie Sanders is running for president. Unlike most Democratic politicians he is not embarrassed to be called a liberal. Heck, he’s not even embarrassed to be called a socialist (even though he technically isn’t one). Like some Republican politicians he speaks his mind and doesn’t mince words, and unlike those same politicians he doesn’t completely ignore reality.
Except in one area. Paul Krugman published an opinion piece recently, and I realized that some of the reasons why I love Bernie Sanders are the same reasons I don’t think he will make a great president.
The title is “Health Reform Realities”, and Krugman’s main point is that Sanders is ignoring political reality in this country when he says he wants to replace the ACA (Obamacare) with a single-payer, Medicare-for-all system.
It isn’t that I don’t believe that a single payer system is superior. I just don’t think it will ever happen. As Krugman points out, do we really want to re-litigate one of the biggest political successes in a half a century?
Indeed, another article points out that in Vermont, the home state of Sanders, he was unsuccessful at setting up a single-payer system just a few years ago. This, despite the fact that the governor, legislature, and even many hospitals and businesses were solidly behind the effort.
As recently as early 2014, everyone assumed that Vermont was going to get a single-payer system. I remember reading about it. But by the end of that year, they completely gave up on it.
Was it because of conservative opposition? No, it was because budget analysts figured out that it would require $2.5 billion in additional revenue, which would require raising the payroll tax by 11.5% and the income tax by 9% (essentially doubling state taxes).
Of course, many Americans would ultimately save money, because the increased taxes would be more than offset by the savings in health insurance premiums (which would drop to zero). But other people would have to pay more, which would likely cause a huge political backlash.
Part of the reason other countries have been able to set up single-payer systems is because they have kept health care prices down. Most countries do this by keeping the salaries of doctors and other health care professionals much lower than they are here. Imagine what would happen here if you suddenly slashed the income of all the doctors and nurses in the US!
Then imagine if you also slashed revenues for hospitals, pharmaceutical companies, medical equipment companies, etc. All hell would break loose. It was a big enough problem that Vermont simply gave up on their single-payer system.
And that’s ignoring the problems of getting a national single-payer system past a Republican congress. Good luck with that. It is hard enough to keep them from dismantling Medicare and Social Security.
What bothers me is that Sanders is being an ideologue, instead of a pragmatist. I would much prefer it if Sanders were coming up with popular ways to modify Obamacare in order to push us (slowly) toward a single payer system. For example, he could be proposing that we bring back the “public option” in the health insurance exchanges (which Republicans removed from the ACA). Nobody would be forced to choose that option, but it would be there competing with private health insurance, and if it turns out to be competitive and people like it, then it would grow. It gives people more choices and provides more competition.
Such a proposal has a much higher chance of success than ramming a single-payer system (like the one in Vermont) down everyone’s throats. And I think in the long run, it would have a significantly better chance of leading us to a single-payer system, if that is indeed a good way for us to go.
Finally, Electoral Vote has a good post on why even if Sanders is able to win the Democratic primary (which itself is highly unlikely), he has pretty much zero chance of winning the general election. His popularity now has more to do with the fact that the Republicans are not smearing him (like they did with John Kerry); instead they are actually currently helping him to try to hurt Clinton. Donald Trump is even claiming that he is responsible for Sanders rising in the polls.
I am happy to have Sanders playing the role of pushing Clinton to the more progressive end of the spectrum, but nominating him would be a big mistake for the Democrats.
I’m sure many of you disagree. Tell me why I’m wrong.
