An Electoral Strategy For Democratic Activists... But NOT For The Faint Of Heart

Rep. X is in this photo of Republicans pretending to be Democrats

I was invited to join a conference call yesterday with a group of committed activists in a red district with an ultra-right-wing Democratic congressmember, who I will refer to as X, so as not to give anything away I was asked to not write about yet. X, a freshman, immediately joined the Blue Dog and New Dems and has a ghastly (F) voting record already. X opposes everything progressive, period. The only case to be made for X is that X is better than a Republican-- in other words, the DCCC's very favorite strategy: vote for the lesser of two evils.

X is heavily supported by the county Democratic parties in the district, who are all just delighted to have someone on Team Blue in the house. The progressive activists I spoke with yesterday, on the other hand, are willing to see X defeated... by a Republican if necessary. One of them has all but decided to run as an independent and take on X and whichever garbage the NRCC fields, from the left, campaigning on the Green New Deal (which X opposes), Medicare-For-All (which X opposes), free public college (which X opposes), lower drug prices (which X opposes), etc. The idea is to show how similar X and the Republican are.

X won by less than 3% last time. It was very close and the Republican was lazy and arrogant and never even thought there was a chance of being defeated. This time the NRCC has targeted X and the Republicans will go all out in this district which Trump won by double-digits.

An independent candidate on the left isn't likely to win-- but is guaranteed to take away enough votes from X that the Republican will win. Inevitably local and state Democrats will beg the independent to get out of the race. When all else fails, Steny Hoyer will step in with a job offer. At that point, the independent will agree to drop out, not for the job, but in return for X publicly signing an agreement to fully support the Green New Deal and Medicare-For-All. X will be expected to do just what Ben Ray Luján did when he realized a progressive primary opponent was going to kick his ass-- co-sponsor Alexandria Ocasio-Cortez's Green New Deal resolution. The independent will drop out of the race and endorse X for reelection when X goes on TV and explains why Medicare-For-All is crucial and why Pramila Jayapal can count on X to voter it and fight for it.

If you read Paul Waldman's column in the Washington Post yesterday, "The Campaign To Destroy Medicare-For-All Has Already Begun," you know how angry X's fellow Blue Dogs are going to be. The Blue Dogs' corporately-funded think tank, Center Forward, is putting everything it has into defeating Medicare-For-All. "In fact," wrote Waldman, "they’ve already begun to put together what will no doubt be a spectacularly well-funded campaign to crush Medicare-for-all or any other ambitious reform that Democrats come up with."

Like us, he cited Lee Fang's Intercept exposé on Center Forward and the PhRMA lobbyists. "[I]t shows," he wrote, "how the groundwork is already being laid to defeat Medicare-For-All long before there’s a Democratic nominee with a proposal that he or she is promising to pursue, let alone legislation that stands a chance of becoming law. Now let’s take a moment to talk about the Partnership for America’s Health Care Future. If you go to their web site you can read their inspiring mission statement":

The Partnership for America’s Health Care Future’s (PAHCF) mission is to improve what’s working in health care and fix what’s not. We support building on the strength of employer-provided health coverage and preserving Medicare, Medicaid, and other programs that so many Americans depend on, so we can deliver affordability, expand options, improve access, and foster innovation.

Affordability, options, access, innovation-- all that sounds great! And you can watch this video the group produced, which for the first minute and a half seems like a friendly Vox explainer on how the American health insurance system works, but then takes a dark turn to to saying how Medicare-for-all will destroy everything good about health care, full of Republican talking points.

“Health care decisions would be shifted from patients and their doctors to politicians and bureaucrats,” it says, as opposed to the paradise we live in now, where insurance company bureaucrats have absolutely no role in health care decisions.

PAHCF, which was formed last year, is a coalition that includes pretty much every industry with a financial interest in keeping medical costs high and avoiding more government oversight: the pharmaceutical industry, the health insurance industry, the hospital industry, the biotech industry, and the American Medical Association, among others. If we were to actually bring down the prices that make American health care by far the most expensive in the world, they’d all suffer.

PAHCF is only getting started, by doing such things as placing op-eds; in March, Libby Watson wrote a revealing article for Splinter on how the “ordinary Americans" writing those op-eds and getting quoted on the partnership’s behalf all turn out to PR executives with insurance-company clients, people in the insurance industry, Republican officials, and the like. Scroll through its Twitter feed and you’ll see that it contains almost nothing about improving the health-care system; it’s virtually all attacks on Medicare-for-all.

If there’s a Democrat elected next year and health-care reform looks like a real possibility, they’ll kick their campaign of lobbying and public persuasion into high gear. They have essentially limitless resources; they could easily spend hundreds of millions of dollars to defeat Medicare-for-all, given what they stand to lose.

That will be just one part of the anti-Medicare-for-all effort. It’s also important to understand that these interests are not just going to fight against a full-on single-payer system of the kind that Sen. Bernie Sanders (I-VT) advocates. They’ll fight just as hard against what I call “Medicare for anyone,” or plans that allow anyone to join a government program but don’t mandate it. In fact, they’ll fight against pretty much any serious expansion of the federal government’s role in health care, because it could all wind up in the same place: cutting their profits.

And the truth is they stand an excellent chance of winning that fight. This is a classic collective-action problem, as Mancur Olson explained half a century ago. You have a group of concentrated interests with a great deal to lose on one side, and a much larger group of diffuse interests on the other side. Many of the people in that group with diffuse interests-- that would be the American public-- have a lot to gain from a universal system, but they’re more difficult to organize than a small group of drug companies, insurers and doctors willing to pour millions upon millions of dollars into the effort.

They also have fear and loss aversion on their side as they set out to destroy Medicare-for-all, which is why they’re arguing that if Medicare-for-all passes, you’ll be left with nothing. And if you say, “They can’t say that, it’s transparently bogus,” you obviously weren’t around the last time we debated health reform.

Which is why the Obama administration decided in 2009 that the only way to pass the Affordable Care Act was not to fight those interests but to co-opt them, convincing them that there was enough in it for them in the ACA that they shouldn’t oppose it. And it worked.

Democrats haven’t yet figured out how they’re going to defeat the moneyed interests that will be working with Republican to fight the next version of health-care reform, and I wish I could say I knew exactly how to do it. But if those Democrats don’t come up with some kind of plan, they’re almost guaranteed to fail.

So... I'll do whatever I can to help the local activists force Rep. X see the light or... whatever. Saving X's miserable career isn't high on my agenda; saving Medicare-For-All from X's colleagues is. Not to mention the Green New Deal. If Rep. X is determined to vote like a Republican, X can expect to be treated like a Republican.