Opinion | Warren’s Very Good Transition Plan
Warren’s Very Good Transition Plan
By
David Leonhardt
Nov. 19, 2019
If only she’d started with it.
Senator Elizabeth Warren, Democrat of Massachusetts and 2020 presidential candidate, spoke at a town hall in North Las Vegas on Sunday.Joe Buglewicz for The New York Times
This article is part of David Leonhardt’s newsletter. You can sign up here to receive it each weekday.
Health care is a great political issue for Democrats — or at least it should be. Many Americans are
anxious about medical costs, and yet Republicans have spent years
pushing plans that would increase costs for most families. For Democrats, the playbook should be simple enough: Promise to make health care more affordable.
The plan that Elizabeth Warren
released last week takes this approach. It would, among many other things, use the 1980 Bayh-Dole Act to push down the price of drugs that were developed with government funding. It would also create low-cost federal insurance coverage, like Medicare, that anyone could purchase. Warren’s plan,
Larry Levitt of the Kaiser Family Foundation says, “would provide cost relief to a lot of people.”
My one major criticism is that Warren should have started with this plan, rather than first
committing herself to a Medicare for All plan that would abolish private insurance. The plan she released last week lays out a two-year transition period that would include immediate changes, before she would ask Congress to pass Medicare for All. Her hope is that the transition plan — especially a universal Medicare buy-in — would make Americans more supportive of abolishing private insurance.
[Listen to “The Argument” podcast every Thursday morning, with Ross Douthat, Michelle Goldberg and David Leonhardt.]
That’s clearly a gamble, because she is trying to win a presidential election before a universal buy-in exists. And mandatory Medicare for All is one of the few ways for Democrats to get on the wrong side of the politics of health care.
Supporters of Medicare for All like to claim otherwise, by citing polls with
favorably worded questions, but there is abundant evidence that it is unpopular.
Multiple polls show that most Americans oppose abolishing private insurance. More telling, in 2018, Democratic House candidates who supported Medicare for All “performed worse than those who did not, even when controlling for other factors,”
Alan Abramowitz recently wrote for Sabato’s Crystal Ball. For the Democrats who simply talked about reducing costs, by contrast, health care was a
highly effective issue.
Warren’s larger economic agenda is the most ambitious plan from any current presidential candidate for improving the living standards of most Americans, as I’ve
written before, and I wish she had taken a different approach on health care. She could have said that Medicare for All was her ultimate goal but emphasized measures like the one she proposed last week.
Once she made that mistake, though, she did about as good of a job minimizing the damage as she could have. The question now is whether she can spend less time talking about a proposal that scares many voters — Medicare for All — and more time talking about the popular and achievable ideas in her transition plan.
Even progressives who are committed to Medicare for All should favor that approach. It’s the only plausible way the United States is going to make such a radical change to its health care system.
For more …
- Trying to create a full single-payer Medicare system from Day One has two problems, Paul Krugman writes: It would be “a liability in the general election,” and it would “almost certainly fail to pass even a Democratic Senate.” He adds: “So all or nothing would, in practice, mean nothing.”
- Warren’s transition would address many of the weaknesses in Obamacare and substantially reduce medical costs for families, as Levitt of the Kaiser Family Foundation explains.
- In The Times, Margot Sanger-Katz breaks down Warren’s transition plan, while Shane Goldmacher, Sarah Kliff and Thomas Kaplan explain how Warren came to believe in Medicare for All.
- “She’s finally admitting that moving to Medicare for All will require at least two separate pieces of legislation, spaced several years apart,” writes Charles Gaba, a health care expert.
- Dylan Scott, Vox: “If there is one place that Democrats do all agree on health care, it’s that they think Americans, if given the chance to have government health care, will really come to like it. Sanders says that’s why people will ultimately be happy to give up their private plan and why Pete Buttigieg says he believes a buy-in can be the start of the path to single-payer.”
If you are not a subscriber to this newsletter, you can subscribe here. You can also join me on Twitter (@DLeonhardt) and Facebook.
