Bernie Sanders unveiled his Medicare for All bill this week, and 16 Democratic senators signed on as cosponsors. The last time he introduced a bill like it, not one senator was willing to join him. They considered the idea impossible, utopian.
Times have changed.
The senators who shared a podium with Sanders understand this bill won’t pass in today’s Republican-dominated Congress. They signed on because it’s a good idea, and because they recognize that by doing so they can both reflect and reshape a shifting political landscape.
They’re aware that Sanders’ presidential campaign triggered a wave of energy and activism that continues today. They recognize that this nascent political movement is a powerful political engine, and its diverse millennial base makes it the Democratic engine of the future.
They understand how change happens: as an ongoing dance between street-level activism and electoral politics.
A declaration of principles
With this bill, 17 senators – nearly one-third of the Senate’s Democrats, including several presidential prospects – are saying health care is a human right and a public good. That’s a declaration of principle.
They are also defending the principle of progressive taxation. The program would be funded through higher taxes on the wealthy, eliminating special tax breaks, a one-time tax on offshore profits, and a fee levied against big banks.
Their cosponsorship is a declaration of principle in another way, too. Not one of the bill’s 16 cosponsors describes her- or himself as a “democratic socialist,” as Sanders does. But this bill shows us how government can make our lives better, as it already does through programs like Medicare and Social Security.
Democrats have too often been reluctant to proclaim the value of government in recent years. They’ve kept government at an embarrassed arm’s length, like a parent at a junior high dance. These Democrats, on the other hand, are embracing an unabashedly pro-government idea. No embarrassment, just pride.
The bill has no chance of passage in the current Congress. In that sense it’s symbolic, a flag. But flags have value. They give people something to rally around, and they can be used to point the way forward.
Democrats could use a few more flags these days.
For too long, “centrist” Dems made the mistake of elevating process over principle. Process is important, of course. But elections are won and lost on principle, on flags. Democrats who speak of “the art of the possible” in the context of a Republican-dominated Congress are on a fool’s errand. They’ll accomplish little or nothing of value.
The goal must be to take over Congress, not surrender to a hostile one, so that the “possible” is redefined. This bill can help make that happen.
These senators are being active rather than reactive. Instead of complaining about Donald Trump, they’ve provoked Trump into complaining about them. White House Press Secretary Sarah Huckabee Sanders said that the president thinks this bill is a “horrible idea.”
That’s how you win elections – by framing the terms of the debate. Let the Republicans tell the American people why they don’t think health care is a human right. Let them tell voters why they’re defending the runaway greed of insurance companies and Big Pharma.
Dollar by dollar, life by life
The bill includes a transitional phase-in period. That’s important. Healthcare in the United States is a $3.4 trillion economy, so it will take some time to ensure a smooth transition. And, as Harold Meyerson notes, the bill’s gradualism is also “designed to make it progressively easier for legislators to support and progressively more difficult for such entrenched interests as the insurance and pharmaceutical industries to defeat.”
There is entrenched resistance to single-payer health care. It’s easier for a politician to defend a health care program for a defined population – children under 19, for example – than it is to defend something that can be abstracted away as “socialized medicine.”
It should also be noted that somewhere between one-third and one-fourth of all U.S. health spending is already government-funded. In that sense, any new government health care proposal should be considered “gradualist.”
This bill lays out the long-term goal, but its phased-in approach gives breathing space for other forms of health-related activism in the meantime. They include the fight to defend current government health care programs, and the battle for Medicaid expansion in states like Texas and Florida.
Medicare For All can be the flag for all of these health activism fronts, and all of them can be pursued with a single, unifying goal in mind: Dollar by dollar, life by life, public health insurance must be defended and expanded until it is available to everyone.
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