Friday, November 22, 2019

The Not-So-Secret Secret

It was discouraging, albeit unsurprising, when Kristen Welker at the Democratic presidential debate in Atlanta asked (beginning at 19:05 of the video below)

Senator Warren, you are running on Medicare for all. Democrats have been winning elections even in red states with a very different message on health care: protecting Obamacare. Democrats are divided on this issue. What do you say to voters who are worried that your position on Medicare for all could cost you critical votes in the general election?

It was discouraging, albeit unsurprising, when after Warren's reponse Welker asked

I want to ask you the question this way, Senator Sanders. You described your campaign, including your plans for Medicare for all, as a political revolution... President Obama explicitly said the country is, quote, "less revolutionary than it is interested in improvement. The average American doesn't think we have to completely tear down the system and remake it," end quote. Is President Obama wrong?

Sanders began his answer with "no, he's right" because the answer to every "is President Obama wrong" question during the primary campaign must be "no, he's right." And of course Warren answered the loaded question posed to her by explaining her program rather than responding to the "why are you advocating a policy people are against?"

Sanders did add "now is the time" to "take on the pharmaceutical industry." That, sans detail, is as much as we can expect from any candidate now that, according to Slate's Jordan Weissman

Recent polling by other organizations has shown even lower levels of support for a single-payer system. An NBC/Wall Street Journal survey last month found just 41 percent said they backed one, with 56 percent against, while a Fox News poll found 46 percent in favor and 48 percent against. But polling results on health care can be extremely sensitive to how the question is phrased. What makes the Kaiser Family Foundation survey interesting is that it’s been asking the public the same version of its question for more than two years now—“Do you favor or oppose having a national health plan, sometimes called Medicare-for-all, in which all Americans would get their insurance from a single government plan?”—giving us a picture of how public opinion has evolved. And it suggests that as single payer has become a more contentious political topic during the presidential campaign, it has lost a bit of its shine....

None of this is especially surprising. The phrase “Medicare for All” tended to poll well early on, but its popularity tended to drop once respondents were told it would require them to give up their private insurance. That specific issue has been front and center during the Democratic debates and may have eroded some enthusiasm for the concept. Pure partisanship has probably kicked in a bit as well; as the primary campaign has worn on, Republicans and Republican-leaning independents may have come to associate the idea with Democratic candidates, leading them to reject it.

This was written 5-6 weeks ago and I suspect that recognition of the need to eliminate private health insurance has not grown since then. As their remarks would indicate, both Sanders (though evidently not his ardent supporters) and Warren well recognize this phenomenon.

Joe Biden's approval numbers remain high among Democrats, especially in crucial South Carolina. Pete Buttigieg reportedly has surged to the top of the pack in Iowa and Amy Klobuchar has become at least a little viable. We can only hope that the hostility to single-payer among their these candidates has not contributed to their strength among Democratic primary voters.

Even if it has not, however, the framing of the questions posed to the two progressives, the Vermont and Massachusetts senators, suggests that the notion of procuring health care without a private company as intermediary has lost popularity. Kristen Welker, as network correspondent a straight-news reporter, framed the two questions to reflect conventional opinion and not only her view of reform, assuming that is what it is.

The acceptance of even Democratic, presumably left-liberal, voters of the continued dominance of the insurance industry in health care is one of the 6,000 pound elephants in the room. (A bigger elephant is the decision of President Obama not to endorse former Vice-President Biden for the nomination.)

Either Sanders or Warren, or both, must find a way to slay that elephant (though in such a way PETA won't object, which probably would be determinative in a Democratic primary). Alternatively, they can continue to skirt around the issue, hoping that this phobia declines or doesn't impede their road to the nomination. However, if one chooses the latter path and somehow manages to be nominated and elected, it does not bode well for implementation of comprehensive reform in the President's first term.

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