Democrats have spent the 2020 campaign talking about health. So what happened to Medicare for All?

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Does anyone remember “Medicare for All”?

The question seems to have disappeared from the mainstream political discourse. Those of us who still care may feel like George Orwell characters 1984 who could swear they remember a time when Oceania was allied with Eastasia in a war with Eurasia and not the other way around. Wasn’t everyone fair talking about health insurance for all?

Progressives have dreamed of instituting some kind of “single-payer” or “Canadian-style” health care system in the United States for many decades, but Senator Bernie Sanders popularized the proposal under the label “Medicare for All” during of his run against former Secretary of State Hillary Clinton for the 2016 Democratic presidential nomination.

Secretary Clinton fired it like a unserious socialist fantasybut the idea continued to gain momentum over the following years.

As hard as it may be to remember, arguments about medicare for all dominated the race for the 2020 Democratic Nomination. Early in the cycle, several strong candidates said they supported Medicare for All.

Senses. Sanders, Elizabeth Warren and (for a brief moment) Kamala Harris have all said they want to completely nationalize the health insurance industry. The idea was in the air. Sanders even managed to win over the crowd during a Fox News Town Hallconvincing them of the interest of giving up their private insurance plans for a universal public plan.

The more moderate candidates with a real shot at the nomination, Joe Biden and former South Bend Mayor Pete Buttigieg, split the difference, saying they wanted “a public option” (Biden) or “Medicare for All Who Want It” (Buttigieg).

2020 Democratic Candidates Debate.

Win McNameeWin McNamee/Getty Images

Warren finally decided she wanted to split the difference, with a confusing two-phase plan to achieve the ultimate goal of a single-payer system.

The senses. Cory Booker and Kirsten Gillibrand, Representatives Tulsi Gabbard and Tim Ryan, former HUD Secretary Julian Castro and Andrew Yang all sided with Biden and Buttigieg in wanting to preserve some role for private insurers, but they all at least started by branding their proposals simply as Health insurance for all. (Harris also eventually recalibrated and joined the Centrists.)

In 2020, meeting Bernie-ism halfway was the moderate position.

Various combinations of these candidates were put together for what at the time looked like 100,000 hours of televised debates. And, time and time again, a significant portion of the evening was spent battling it out on issues such as how long the transition from the status quo to some type of state-backed universal coverage system should take, and whether private health insurance companies should exist at all.

“Joe Biden stated unambiguously in a section of his campaign website that has never been reviewed that “[w]Whether you’re covered by your employer, buy insurance on your own, or aren’t fully covered, Biden will give you the choice to buy a public health insurance option like Medicare.”

Everyone insisted that of cours there should be a legal guarantee that every man, woman and child in the United States would be covered by a health insurance plan – and of cours they didn’t think anyone, anywhere should have to deal with Aetna or Blue Cross Blue Shield if they preferred to be federally insured.

Joe Biden unambiguously stated in a section of his campaign website which has only ever been revised”[w]Whether you’re covered by your employer, buy insurance on your own, or aren’t fully covered, Biden will give you the choice to buy a public health insurance option like Medicare.

Before the Never Bernie mob settled on Biden, their big centrist hope was Pete Buttigieg – and according to his plan, people would be “completely cover-free” automatically registered to the public plan without having to do anything to buy it.

State after state, no matter who won a given primary or caucus, Democratic voters told pollsters they just wanted to replace the private insurance system with a single government plan.

I argued back when the differences between “Medicare for All” and “Medicare for All Who Want It” were greater than they might appear to a casual observer, and I still believe that – but the common ground of all Democratic plans were supposed to be that no one should be unwittingly denied government-provided health insurance. So now that one of those candidates is President of the United States, another is Vice President, a third is Cabinet Secretary, and several more are back in the Senate… what the hell happened?

Last year, Politics generously rated Biden’s campaign promise of a public health insurance option is “blocked” rather than broken. But even that is exaggerated. As Politics notes it himself, there has never been a attempt to put a public option in a reconciliation bill. (It’s hard to argue that putting tens of millions of Americans – and this is only a conservative estimate – on a government-provided insurance plan wouldn’t have the required “non-accidental” budget consequences. for bypassing the Senate filibuster.)

Although no major figure has taken up the idea, there is also a creative legal argument that Joe Biden could unilaterally give every American at risk of exposure to COVID-19 — that is, every American — access to Medicare through a broad interpretation of Section 1881A of the Social Security Act.

Perhaps none of these maneuvers would work. But questions about parliamentary tactics are the least of it. Which cannot be blamed on Democratic Sens centrists. Joe Manchin and Kyrsten Sinema, Senate Rules, or how the courts might interpret Section 1881A, is the simple fact that Biden and (almost) all other 2020 contestants have I just stopped talking about it.

At a time when the Democrats face the very real prospect medium-term catastrophe, it is far from clear that this choice makes sense, even in cynical political terms. Medicare for All a long time well soundedand it’s hard to see how loudly and proudly fighting to give health care to all could make Democrats’ electoral situation worse.

More importantly, ensure the 31 million people who have no health insurance at all, while providing public insurance to the much larger number who face often inadequate coverage from private, for-profit insurance companies, is a moral imperative urgent. The same goes for the release of all people who to have good health insurance, provided by their employer or their spouse’s employer – and who end up being trap into bad jobs or even bad marriages as a result.

The United States has a shorter life expectancy, higher infant mortality, and a higher rate of “health care-attributable mortality” (i.e. statistics for people who die because they have not seen a doctor in time) than culturally and economically comparable countries, such as Canada and UK. Life expectancy in the United States varies greatly from postcode to postcode.

Democrats have claimed to care about these grim facts in 2020. But how can we take this seriously if they leave the subject aside until next year, when they have to run against each other to the nomination of their party?

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