Reading the Tealeaves

I don’t think that William Galston is reading the tealeaves quite correctly in his recent Wall Street Journal column when it comes to “Medicare for All”. He says it’s a trap for Democrats:

A political party is asking for trouble when it embraces a position on a high-profile issue that most Americans oppose. But it isn’t easy to avoid this pitfall when a majority of the party’s own members endorse that position. As the campaign for the Democratic presidential nomination heats up, the Medicare for All plan first proposed by Sen. Bernie Sanders risks pushing candidates into this trap.

The stakes are very high: This unforced error could give President Trump his best chance to win re-election in 2020.

A recent Politico/Morning Consult poll found that endorsing Medicare for All rather than improvements to the Affordable Care Act did more than any other issue to increase enthusiasm for a prospective nominee among the Democratic rank and file. Fully 57% of Democrats said they would be more likely to support such a candidate compared with 22% who said they were less likely, and 37% said that they would be “much more likely” to do so.

So it was no surprise that in a town-hall meeting soon after announcing her candidacy, Sen. Kamala Harris vigorously backed Medicare for All. Yet many observers were taken aback when, citing excessive paperwork and delays in the approval process, she went on to say she wanted to get rid of private health insurance altogether. “Let’s eliminate all of that,” she said. “Let’s move on.”

Ms. Harris’s version of Medicare for All means private insurance for none. Even if you like your private plan, you can’t keep it. And many Americans do like their private plans, which is why they find proposals like Ms. Harris’s so troubling. A Kaiser Family Foundation survey last month found that, while 56% of Americans claimed to favor Medicare for All, support sank to 37% for versions of the proposal that would eliminate private insurance companies.

Some leading Democrats also have doubts about this approach. Minnesota Sen. Amy Klobuchar, who entered the presidential race last weekend, has declined to endorse Medicare for All. So has another potential Midwestern candidate, Ohio Sen. Sherrod Brown. Former Colorado Gov. John Hickenlooper, who seems likely to run, staked out his position last year, saying “I don’t think we can get to universal coverage as quickly if we try to fight that battle now. . . . The imperative now should be to make sure everyone’s covered.”

Colorado Sen. Michael Bennet, who reportedly is also considering a run, was even blunter on “Meet the Press” last Sunday: “What Democrats are saying is, ‘If you like your insurance, we’re going to take it away from you’—from 180 million people that get their insurance from their employer and like it, where 20 million Americans who are on Medicare Advantage and love it. That seems like a bad opening offer.”

How do you reconcile those apparently conflicting opinions? That 70% of people support “Medicare for All” but they also want to keep their present insurance? I think the answer is that most Americans don’t pay all of their health care expenses out of pocket, want to keep it that way, and see M4A as a way of maintaining that.

At least to me that suggests a framing of the issue that would lead to M4A being a net positive for Democrats at the polls.