Wednesday, July 26, 2017

Democrats And The Single-Payer Trap

Right now, the Republicans own the health-care issue. Let them keep it.


By Albert R. Hunt
The Bloomberg View
July 26, 2017

Democrats relish the Republicans' inability to pass even a pathetic alternative to Obamacare.

For seven and a half years, Republicans have campaigned and voted to replace the Affordable Health Care Act. When given a real chance at success, with governing control, they were impeded by a president who's ignorant on the issue. Then, after Republican senators slipped behind closed doors to come up with their own plans, they provided products that voters, even some Trump supporters, overwhelmingly spotted as frauds.

As justified as the Democrats' ridicule is of this, it's also creating a trap for them: They overreach if they think they can now push for a single-payer, government-run system. Such a course threatens to be a problem in the 2018 midterm election cycle and certainly would be in 2020.

Turning to a single-payer system, instead of trying to improve the Affordable Care Act, maybe with a public option, is a loser on the politics and policy -- "a fool's errand," says Ezekiel Emanuel, a leading Democratic health-care expert who helped craft Obamacare.

The pressure on Democrats is building, as conversations with several members of Congress suggest. Senators Elizabeth Warren and Bernie Sanders, leaders of the influential left wing, are pushing a single-payer system. In the House, 115 members have sponsored this initiative, and more state and county Democratic Party committees are embracing it.

On single payer, says U.S. Representative Rick Nolan of Minnesota, rank-and-file Democrats "are energized in a way I have not witnessed in a long, long time." He's a veteran liberal who wins in the populist Iron Range district of Minnesota that Donald Trump also carried.

But this won't play out well for Democrats. If the U.S. were starting anew on health care, perhaps it would have been better to enact something like the systems in Canada or Australia, praised by Trump. But to try a radical overhaul, throwing out the entire system with a new one funded by federal taxes, would be a humongous jolt.

Changing one-sixth of the American economy would be traumatic for the system and the public. Look at the fallout from the far milder Obamacare changes or the agony the Republicans are currently enduring.

A public option for those people in the federal exchanges would be resisted by the insurance industry and most all Republicans. But it's far less radical, and potentially more feasible, than a single-payer system that nationalizes coverage for everyone.

To their dismay, Republicans now own health care, whether they try to repeal and/or replace the Affordable Care Act or let the issue wither away. Obamacare today is far more popular with voters than any alternative Congress has suggested.

But Republicans could lighten the load of their albatross if Democrats also propose to repeal Obamacare and instead spend trillions of federal tax dollars on a government-run system. That debate might energize a depressed Republican electorate and turn off a lot of swing voters.

It's worth reprising the wisdom of one of America's great pollsters, the late Bob Teeter, a Republican, who two decades ago foresaw that the political party that owns health care will suffer.


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