On Monday, the Trump administration's months-long effort to repeal the Affordable Care Act and replace it — whether with the House's American Health Care Act, or the Senate's Better Care Reconciliation Act ― appeared to collapse under its own weight. Massively unpopular with the American public, negotiated largely in secret and rushed along at a breakneck pace as it was, the bill's failure may have opened up a golden opportunity for the progressive left that shouldn't be ignored.
Namely: Democrats should start running on single-payer health care now, because if things go their way in the 2018 midterms, the party has a genuinely historic opportunity on their hands.
First things first, support among the American public for a single-payer, government-guaranteed health care system is ascendant, with a full 33 percent of respondents to a Pew poll in June supporting such a system. While that's still far from a majority, the figure represents a five-point increase since February, and a 12-point increase since late 2015.
Secondly: The Democratic Party is facing an ongoing, and potentially serious, problem with the public's perception of it. A Washington Post-ABC News poll this week found that amid the chaos of the still-young Trump administration, less than 40 percent of voters believe the party stands for something, and a narrow majority of believe it's nothing more than anti-Trump. And as the 2016 election demonstrated in the most vivid and irreversible way, simply being anti-Trump isn't good enough.
Single-payer could serve as an instant panacea to this bleeding political wound. It's the sort of clear, unambiguous, line-drawing policy proposal that screams out belief in a core set of principles, ones that dovetail perfectly with the arguments Democrats have already been making for months in defense of the ACA.
One of the most powerful and effective cases opponents of the Republican health care plan have made is its cruelty and capriciousness, pointing out that it'll cost literally millions of Americans their health insurance over the next ten years, and in the process lead to tens of thousands of preventable deaths each year. This threat has sparked widespread protests and demonstrations, including dramatic demonstrations on Capitol Hill by disabled activists.
But that argument cuts both ways, and Democrats are playing with fire to ignore that. It's easy to argue that a bill which negatively affects the status quo, costing tens of thousands of lives, is a disaster and a moral disgrace. But implicit in that argument is the belief that the goal of health care policy should be maximizing life-saving and life-enriching medical care. Not just some market-centric notion of "access" to health care, in which the system is still convoluted and expensive enough to discourage, depress, and price-out the neediest and poorest, but the real thing.
It's not as though such a system would be free, of course. That's something that multiple democracies throughout Europe have capably tackled through taxation policy, and contrary to the protests of the free market-loving political class and the health insurance industry, it can be done here too.
And, of course, there's the fact that the Republican president sitting in the White House has been a proponent of single-payer for years — it's literally one of the few policy views Donald Trump coherently stated throughout his adult life.
Trump took heat for this during the Republican primary, with Texas Sen. Ted Cruz attacking him as a supporter of socialized medicine, and it's true ― President Trump has praised single-payer systems in Canada and Scotland, to the chagrin of the conservative establishment. In fact, in the midst of his own party's health care negotiations, he even commented that Australia has a better health care system than we do, another nation that guarantees it as a right of all citizens.
So, suppose for a moment that the Democratic Party wins back both the House and Senate in the 2018 midterms. It would require a very strong performance, especially given a difficult Senate map, but it's by no means impossible. Much less if left-wing grassroots enthusiasm and turnout were fueled by the party actually standing for something as simple, unambiguous, and principled as health care being a basic human right, rather than an earned benefit.
Then, suppose the party advances a Medicare-for-all bill through both houses, of the sort the Vermont Sen. Bernie Sanders has been championing for years. Again, this would not be an effortless process even with narrow Democratic majorities, thanks to the resistance of conservative Democrats and the significant money and influence of the health insurance industry. But it'd be the best, most realistic opportunity for such a bill to pass in recent history, and it's the direction progressive health care policy is heading.
All the more so if the Democrats start running on it now, rather than throwing their weight behind bipartisan half-measures like the Center for American Progress' "Market Stability and Premium Reduction Act." Which again, by the moral premises the party's been using to attack the GOP plan, would be far less humane, life-saving, and health-enabling than finally cleaving apart American health care from free-market capitalism, and guaranteeing health care ― not merely health coverage ― for all.
If this scenario were to unfold, and the Democrats sent off a crisp, shiny piece of health care legislation to Trump's desk? Considering he plainly wanted to notch a "win" by any means necessarily throughout GOP's health care push, despite demonstrating little to no knowledge of what was in it? And considering the plan would be a comparatively simple concept that he actually understands, and has previously praised as being better than the current system?
And after he watched the Republicans try and fail to come through for him, unable to pass their own plan after seven years of sabre-rattling, spending months of his time only to come up short? It's really not hard to imagine Trump bucking his own party's establishment and signing the bill. Amid all the different things that would need to fall into place, in fact, it doesn't even sound like the unlikeliest part.
Simply put, the Democratic Party is a strong midterm wave and a little intra-party soul-searching away from a chance at finally fulfilling the left's greatest health care dream — and unlike the GOP's health care dream, it would actually help millions rather than hurt them. While it might not be easy, or entirely without risk, it's at the very least an issue worth fighting for. And, with Democrats desperately needing to prove they stand for guiding principles beyond just party and legacy, one that's worth letting the public see them fight for.