The approval of ACA may seem preordained in 2017, but it certainly didn’t look like it at the time. Even with 60 Democrats in the Senate, every day was a crisis: if it wasn’t Joe Lieberman demanding the elimination of the public option, it was Ben Nelson and the “Cornhusker Kickback.” Legislation based on GOP ideas about health care ultimately passed by the skin of its teeth.
Notwithstanding that, Bernie Sanders is proposing to sell us a Lexus without telling us how much it will cost, which makes no sense in a world in which the GOP has come within a few votes of eliminating the more limited health care legislation we already have. Single-payer has absolutely no chance of being approved in the foreseeable future, because:
- Can you see the Democrats getting 60 votes in the Senate again? Me, neither.
- The drug and insurance companies would mobilize all possible support against it. Hillary Clinton will be happy to tell you what that means.
- More to the point, the legislation would threaten the livelihoods of tens of millions of health care providers. If it doesn’t, it won’t do anything to control costs, and it will be useless. Bernie only talks about taking on drug and insurance companies; he doesn’t have the guts to extend the battle to the vastly more popular doctors and nurses.
- And, of course, he would be replacing the benefits already enjoyed by over a hundred million Americans with a promise. Will they go for it? I doubt it.
Sanders surely knows that single-payer isn’t going to become law in his lifetime. One assumes that his rationale for the bill has something to do with playing the long game; a proposal that seems unrealistic at any given time can be viewed as common sense a decade later. But what about the current problems? For them, he has no solution.
To me, this looks like the left-wing version of the PBPs using Reactionaries to get votes for tax cuts, while providing nothing but lip service in return. The backlash that we are experiencing today was inevitable. The same thing will happen if the Democrats win elections on the promise of single-payer and then can’t deliver.