The Republicans who now control the White House and both houses of Congress have a problem, and it is the job of progressives in particular, and the Democratic Party as well, if they will only accept the challenge, to make that problem worse for them. The Republican Party as now constituted is dedicated to the proposition that government can only do harm, and never do anything good. The Affordable Care Act, or Obamacare, flies in the face of that proposition, which is why from the beginning the Republicans set out to sabotage the ACA once they understood that they could not stop it. It was also necessary to amplify every problem that occurred during the rollout of the ACA, to promote the idea that the ACA overall was bad. One defense the Democrats pursued was to challenge the Republicans by asking what their alternative was. Now we know: it is the monstrosity known as the American Health Care Act, which I prefer to call Ryancare. At this point, it is not Trumpcare, because Trump had no apparent hand in shaping it, but he has said that he will try to sell it.
In trying to “repeal and replace” the ACA, Republicans ran into sharp opposition from their own constituents at emotional town halls. It turns out that people are discovering, when faced with the prospect of losing the ACA, that they really like and need it. Oddly, Ryancare is also opposed by the most extreme members of the Republican Party, who object to the fact that it fails to completely repeal the ACA. So it would seem that progressives would have nothing to worry about, because the Republicans will not be able to find the votes to pass Ryancare. This assumption, however, fails to take into account the extraordinary sales skills of Donald Trump. This is a man who could sell sand in the Sahara Desert. The last time we underestimated him, he became president. The Democratic Party is being too complacent at the moment, and not listening to their own advice. It is not enough to defend the status quo, to insist that the ACA must remain in place. Despite the exaggerations and outright lies of the right wing, there are real problems with the ACA that created the opening for Trump’s victory in the first place. For many, lack of insurance has been replaced by insurance that people can not afford to use. So, in order to make sure that Ryancare fails, The Democrats need to offer up their own plan, just as they insisted the Republicans do. Let me offer my idea of what that plan should be, and how to sell it.
The purpose here is to offer up a plan that highlights the inadequacies of Ryancare and the harm it will do. We also need to undercut Trump’s efforts to get it passed. So we need a plan that really does deliver on a promise that Donald Trump made, that he would deliver a plan that would save money and deliver better care than the ACA. That plan is universal health care. I have talked before about how and why Democrats have failed to sell it to the American people, but I want to go into more detail now about how to win this battle. Hillary Clinton tried to get universal healthcare in 1993, but her instincts are always to find a consensus solution to any problem. There is no consensus solution here, because there is no way around the fact that you are destroying a vital part of the insurance industry, taking them out of the very lucrative health care business entirely. Done properly, universal health care also hurts the pharmaceutical industry, because you should insist that the government has the right to negotiate for the best prices. So you need to stand up to some powerful lobbies to pass universal health care. That is why the best time to do it is during a severe economic crisis. Barack Obama had that opportunity in 2009, but he too was intent on government by consensus, so we got the ACA instead. Last year, Bernie Sanders tried a different approach, insisting that universal health care was a right, a moral imperative. It is, but Hillary Clinton was able to get him bogged down in the details of how to pay for it. She made him lose the same battle she had lost thirteen years earlier, and also managed to make him look unprepared to govern while she was at it. I believe this was a major reason why Sanders lost the primaries. Ironically, the answer to how to sell universal healthcare was at Sanders’ fingertips the whole time, but he never effectively put the whole package together for the voters.
Universal health care would give the American people cash to spend on other things, so it would provide a major boost to consumer spending. Money that now gets deducted from paychecks for premiums, or spent on copays and deductibles, would instead go directly into the economy, leading to a major boost in job creation. It would also make American companies more competitive, by reducing the cost of hiring, and freeing companies from the expense of providing retiree health benefits. To pay for it, we must first recognize that the current cost of the ACA and other government health programs would no longer be needed, so those funds would go here instead. On top of that, companies currently deduct $260 billion for employee health benefits. Add in increased revenue from all of those new jobs I mentioned. And then there is the kicker. Pair universal healthcare with a measure that costs the government nothing, and you suddenly need very little in the way of new taxes to pay for it all. That measure is an immediate increase in the minimum wage to $15, indexed to inflation. Right wingers like to make the disputed claim that increasing the minimum wage is a job killer, but pair it with the job creating aspects of universal healthcare and that problem disappears. Over time, the minimum wage increase promotes consumer spending, which also means more jobs, and more revenue to pay for healthcare. Bernie Sanders erred in failing to realize the powerful synergy between his two proposals. It even gets better. All those new jobs, plus increased pay for existing jobs, means a sharp reduction in the number of the working poor, meaning funds that had been spent on public assistance programs such as food stamps can be used to pay for universal healthcare instead. I am not an economist, but I think it is possible that this proposal could be sold as being revenue neutral. At the worst, it should be possible to claim convincingly that the only new taxes needed would be on the wealthy.
I am a realist. I understand that there is no chance that a Republican-controlled Congress would ever pass this. Even if they did, you can be sure that Donald Trump would veto the measure. But that is not the point. By offering up this proposal and selling it properly, the Democrats would guarantee the failure of Ryancare, and expose the callousness of the Republican Party for all to see. If anything, the fact that this proposal would not pass should help reluctant Democrats to rally around it, knowing that they would have to answer to their constituents in redder states only for an idea, but not a law that would be vilified in the right wing media. The minimum wage increase is a popular idea, and so is universal healthcare if the public can be made to accept that their taxes do not need to rise to pay for it. The Democrats need to show that they are better than the Republicans who could not come up with an alternative to the ACA for eight years, and this is how to do it.
OK, I admit the song this time is a stretch, but I couldn’t resist:
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