By all rights, the 2020 election should be a referendum on Donald Trump. Based on his poll ratings and the outcome of the midterms, if there are no major unforeseen changes (an unlikely event, to be sure), a generic Democrat should be a solid favorite to win. The Democrats, however, will nominate an actual flesh and blood person, not a generic candidate.
If, as seems likely, the chosen one supports a single-payer program, the GOP will attempt to change the terms of the debate by focusing on the costs and risks of making a dramatic change to an industry that represents, I believe, about 17 percent of our GDP. You can anticipate a blizzard of commercials from both medical providers and the Trump campaign that will make Harry and Louise look like kindergarten. Here are the likely messages and targets:
- Insurance company employees: You’re losing your job. Duh.
- Health providers: Your income is going to be cut dramatically in exchange for a small reduction in paperwork. Is it really worth it?
- The elderly: You worked hard all your life to build up a Medicare “nest egg.” Now the program is in danger of being diluted in favor of shiftless younger people who didn’t contribute as much to the system as you did all those years. The Democrats say the new program will be better, but do you really trust the government to improve anything? And oh, by the way, DEATH PANELS! DEATH PANELS!
- Workers with employment-based insurance: You’re going to be giving up perfectly good insurance, and paying higher taxes, in return for a promise that your wages will go up and your costs will go down. Do you really trust either the government or your employer on such an important matter?
- Every consumer: RATIONING! LONG LINES! LOSING YOUR DOCTOR! SOCIALISM! And don’t forget DEATH PANELS!
Hillarycare died in the face of insurance industry opposition. Obamacare barely survived opposition from the GOP, under much better political conditions; it got through the Senate with no margin of error. In light of that, is it really wise to make an extreme form of single-payer the focal point of a campaign? Do the Democrats really want to make 2020 about that issue, and not about Trump’s shortcomings?