Democrats Are Still Twisting Themselves Into Knots Trying To Explain Health Insurance And Other Progressive Initiatives To Voters

"Look," no one serious ever said, "we can't put the Mob out of business because it will throw so many people out of work." It's true. If the Mob were shut down, all kinds of people doing work that, in varying degree, is anti-social. Insurance companies are also doing work that is anti-societal. Yet it is widely thought that if they are phased out as an anachronism for another, more effective means of paying for healthcare, too many people will be unemployed. Writing for This Week last week, Ryan Cooper pointed out that Democrats need to get over their fear of disrupting private health insurance. "About half the population is insured with private, employer-based coverage," wrote Cooper, "leading liberals to adopt a defensive posture. 'A lot of people love having their employer-based insurance,' says Nancy Pelosi." Yeah, I did too-- when I was president of a division of Time-Warner and had the best private sector insurance money could buy. The I turned 65 and got on Medicare and realized private health insurance absolutely sucks. Medicare is MUCH better-- other than Medicare Part D, Republican Medicare-- than anything available on the private market. People who say they love their employer-based coverage are just ignorant, like I was. A good leader would trying showing them why.

Cooper noted that Pelosi's reasoning leaves aside an important fact-- the private insurance system is itself constantly knocking people off their insurance. There is no way to reform the system in a way that will simultaneously preserve private insurance and not be blamed for people losing their coverage, because the private system is so inherently unstable.

While ObamaCare was being discussed and negotiated, Democrats twisted themselves into knots trying not to fuss with the private insurance system too much. Thus during the 2008 campaign and afterwards, Barack Obama said some version of "if you like your insurance, you can keep it" dozens and dozens of times.

This line blew up in his face spectacularly. One of the objectives of ObamaCare was to clean up employer-based insurance. This made perfect sense, in the context of the ObamaCare approach-- before the law, there was a substantial market in absolute garbage policies that didn't really cover anything (which are coming back thanks to Trump, by the way), and lot more with gaps in their coverage. New regulations on guaranteed coverage standards, the medical loss ratio, and so on made employer-based insurance considerably better-- but also required substantial restructuring of the market, which destroyed a lot of policies.

Conservatives and the mainstream media had a screaming fit-- especially so-called fact-checkers, who are always on the lookout for liberal flubs to give them nonpartisan cred (PolitiFact labeled Obama's claim as "lie of the year" in 2013).

But critically, the freakout was given major strength by the background condition of people being constantly kicked off their insurance. People switch jobs often, and employers routinely shop around for different or cheaper coverage. As Matt Bruenig details, a Michigan study shows that fully 28 percent of people on an employer-sponsored plan were not on the same plan a year later. About half of the population-- or 160 million people-- is on private insurance. If that's a representative study (and it's surely in the right ballpark), that means about 45 million insurance loss events annually, or 3.7 million per month.

Obama didn't get in trouble over his broken promise because people are deeply in love with their (increasingly crummy and expensive) private insurance. He got in trouble because it was a stupid promise that was logically impossible to fulfill, and he couldn't have avoided sounding like an outright liar. No matter what health-care reform passes, so long as private insurance exists conservatives will always be able to point to millions of people losing their existing coverage and blame it on the reform.

As an aside, it's also worth noting that the ObamaCare exchanges also require people to shop for new insurance every year as a matter of design-- and anytime an insurer withdraws from the exchange, which happens all the time, everyone on its plans gets kicked off. Bit of an odd choice from people who are supposedly obsessed with the backlash problem.

At any rate, all this demonstrates the only way around the backlash hurdle-- be honest with the public, and hold out the promise of good coverage that is actually permanent, like Medicare-for-all. Yes, if you have private coverage, you will lose it-- but in return you'll get something really good that will stay with you for life. No more worrying that losing your job means your whole family losing their coverage, and possibly being driven into bankruptcy, or staying in a lousy job just because you need the insurance. (Medicare also has the advantage of being widely understood already, so fear of the unknown is reduced.)

Conversely, trying to design a health-care reform that preserves private insurance is inescapably vulnerable to backlash, because constant insurance loss is built into the private system. Moderates trying to tiptoe around the backlash problem end up being deceptive about what their plans would do, just like Obama did, which only fuels the backlash-- for instance, Medicare-for-some proposals described as letting "people keep employment-based insurance" would absolutely kick millions off their coverage.

Indeed, if framed properly, this could be a powerful argument for universal Medicare. As Bruenig writes, "Critics of Medicare-for-all are right to point out that losing your insurance sucks. But the only way to stop that from happening to people is to create a seamless system where people do not constantly churn on and off of insurance." If we want good coverage that everyone can really keep forever, simply scrap the stupid, inefficient private system and sweep the whole population onto the same high-quality program. As usual, good old Big Government is the best way to go.

Meanwhile, Pramila Jayapal's new-and-improved Medicare-For-All (H.R. 1384)-- which has been expanded to include, among other things, dental and vision care, prescription drugs, long-term care and mental health-- has 108 co-sponsors, fewer than the less robust Conyers proposal last session (124 co-sponsors). Why? Frightened freshmen. Only 16 are co-sponsors so far:

• Veronica Escobar (TX)
• Chuy Garcia (IL)
• Debra Haaland (NM)
• Jahana Hayes (CT)
• Mike Levin (CA)
• Andy Levin (MI)
• Joe Neguse (CO)
• Alexandria Ocasio-Cortez (NY)
• Ayanna Pressley (MA)
• Rashida Tlaib (MI)
• Lori Trahan (MA)
• Katie Hill (CA)
• Ilhan Omar (MN)
• Susan Wild (PA)
• Jared Golden (ME)
• Josh Harder (CA)

45 freshmen have not signed on as co-sponsors. Before progressives can hope to persuade Republicans and before they can take their case to the public, they really should try persuading their colleagues. If not hardcore Blue Dogs, how about some of the freshmen in the Progressive Caucus aren't there yet, like Angie Craig (MN), Gil Cisneros (CA), Sylvia Garcia (TX), Steven Horsford (NV), Andy Kim (NJ), Joseph Morelle (NY), Madeleine Dean (PA) and Mary Gay Scanlon (PA)?

The Republican wing of the party-- the Blue Dogs, New Dems, the corrupt careerists-- aren't embracing progressive initiatives unless they're forced to by voters, but with DCCC chair Cheri Bustos (who is all of the above-- a Blue Dog, a New Dem and a corrupt careerist) outlawing primaries against right-of-center incumbents like herself, there is no way to effectively pressure anti-progressive Democrats in blue districts.



Last month Bob Borasage penned a piece for The Nation, Centrists Are Using Calls for Civility to Silence the Left, that makes it clear how "[m]any members of the civility police come from the beleaguered center-right of the party, and their calls for unity are often just forewarning progressives to lower their sights and curb their tongues. The chiding often comes with shots at Senator Bernie Sanders specifically or the left more generally. The civility police assert that Trump will pounce on any weakness of the Democratic nominee that gets exposed in the primaries. Michael Tomasky argued that the 'one terrible and unforgivable thing the Democratic contenders can do to one another' is to 'expose that Achilles heel and worsen it.' 'This is what Sanders did with respect to Clinton in 2016,' he claimed, by setting up 'Trump’s Crooked Hillary line of attack.' Really? Donald Trump has a canny and ruthless instinct for the jugular. He didn’t need Sanders to prey on Clinton’s self-inflicted vulnerabilities."

“We should not eat our own,” cautioned David Brock, which is rich coming from a professional hatchet man servicing both sides of the aisle at different points in his career. In reality, the ones doing the eating are primarily centrist pundits using high minded postures to skewer Bernie. Sanders has been assailed by a former Clinton staffer for using private planes while stumping for Hillary in 2016. He’s been attacked for hiring David Sirota, a respected left-leaning journalist who got his start in Sanders’s House office twenty years ago. (Sirota was raked over last week for supposedly hiding his conflict of interest while at The Guardian, a claim that turned out to be simply false). Tomasky presumptuously issued a “personal plea” to Bernie to rein in his supporters, while saying nothing about the Clinton advisers publicly vowing to unleash their oppo research from 2016 on Sanders.

The civility police call for a debate over policy and ideas, not personal attacks, which is surely right. The question, however, is what is a personal attack? Biden insider and Washington lobbyist Ron Klain argued that “a debate about ideas is healthy, a debate about motives is not. The Democrats should hash out their differences in 2020 without slashing up one another-- not casting aspersions on each other’s integrity, motivation or intentions.”

Clinton and her supporters consider Sanders’s repeated criticism of the hundreds of thousands she pocketed for speeches to Goldman Sachs and other banks an “aspersion” on her integrity. But the corruption of big-money politics and the unholy alliance with the financial sector is at the center of the failure of the establishment of both parties. Trump made the corruption of politicians-- Republican and Democratic alike-- the central theme of his campaign in 2016. The Democratic primary debate would be foolish to rule airing the issue out of bounds.

...This concern about unity too often masks the real concern of centrists: their belief that only a “moderate” candidate who offers “realistic” reforms can win. Politico trotted out Stuart Eizenstat, Jimmy Carter’s former policy adviser, to make the case explicitly. “Maximalist ideology is a prescription for division and defeat,” he wrote, adding that Medicare for All may be a “useful campaign slogan,” but a “totally government run program is not a solution.” The answer to climate change is “not a Green New Deal… but ‘market based incentives.’” He believes that if progressives want to win, they’ll join a “united front” around a centrist candidate.

In the name of unity, Eizenstat calls for robust debate in which progressives defer to the responsible center. Democrats ran an experienced centrist with moderate policies against Trump in 2016 and got beat. Democrats won twice with a charismatic center-left candidate in Barack Obama, and Sanders’s agenda has gained ever more adherents. Most of the top-tier candidates-- from Sanders to Warren to Senator Kamala Harris-- are making the case for bolder ideas and politics.

Eizenstat might be more on target were he focused on cautioning centrists on the need for unity behind a progressive nominee. Jonathan Chait’s dyspeptic article-- “Will Bernie Sanders Split the Democratic Party in 2020?”—exposes just how savage and embittered centrists are. Chait is simply deranged about Sanders, accusing him of running a “factional splinter campaign” in 2016, hiring aides committed to “left-wing factionalism,” espousing “hard-core socialist politics” and “vaguely Marxist concepts, by which he means “describing most issues as being driven by an economic divide between the people and ‘the billionaire class.’” This would apply also to Obama in his rhetorically populist 2012 reelection campaign). Chait scorned Sanders’s followers as an “irrational cult,” packed with “schismatic Bernie diehards.” He accused them of not realizing that the primary contest should be viewed as a question of “which Democrat can beat Trump,” as opposed to a battle of ideas and direction. Sanders, he argued, has to choose whether he is a “partisan Democrat” or a “schismatic leftist using the Democratic Party.”

This ugly rant reflects the venom of those who fear losing control. In reality, Sanders is now part of the leadership of the Senate Democratic caucus. He ran and won on both the independent and the Democratic line for the Senate in Vermont. He ran a powerful 2016 campaign for the presidency in the Democratic primaries-- and then helped fashion the party’s platform, while endorsing its nominee, and working harder for her election than virtually any other ally. He now is the most popular senator in America, trailing only Joe Biden in the polls of Democratic voters. He’s already pledged to work for whoever wins the Democratic nomination, arguing that beating Trump is imperative. He’s vowed to run-- as he always does-- focused on issues, not on personal attacks. He’s pledged not to run a negative ad. He’s issued statements urging his followers not to engage in personal attacks on other primary contenders.



Running with a bold agenda, fueled by small contributions, opposed by the establishment of the party and legions of embittered Clinton devotees, facing a skeptical mainstream media, he will have a difficult road to the nomination. Were he to win it, he could be well suited to expose Trump’s betrayal of working people and take him down.

Democrats are remarkably united about basic propositions: Beating Trump is vital, and unity behind the eventual nominee is essential. Democrats should not allow a bitter primary to divide them. Yet even these commonsense propositions are being wielded to mug the left.

The civility police suggest that the differences between Democrats are relatively insignificant as opposed to those with Trump and Republicans. This somehow coexists with the argument that if Democrats embrace candidates espousing bold reforms that Eizenstat scorns as “demanding the moon,” or Chait poisonously labels “hard-core socialist politics,” the party will crash and burn.

The reality is that Democrats are in the midst of a fundamental argument about the future in the wake of the abject failure-- in policy and in politics-- of the established center of the party. The differences between candidates calling for a return to Obama and those who seek a fundamental change in course are significant and should spark a fierce debate. The difference between those financed by big-money contributions and those relying on small donations goes to the heart of our politics. If they are serious, the civility police should start focusing their attention and concern on the center, which is losing its hold, not the left, which is rising.