In Single-Payer, Who Really Pays?

by Jim Geraghty

Making the click-through worthwhile: the not-so-solid public support for single-payer, the inconvenient details behind the boast that Hillary Clinton “made history,” a stunningly low percentage of Americans can answer basic questions about how our government works, and the former Democratic nominee’s odd interepretation of classic literature.

The Public Preference for Single-Payer Is Oh So Fragile

I’m headed up to New York City today, appearing on CNN to discuss Senator Bernie Sanders’ latest proposal for “single-payer” health care and on CNN International to discuss – well, something, possibly the Sanders proposal, perhaps something else.

The coverage of health care rarely suggests that public support for single payer is a mile wide but an inch deep. But this Kaiser poll from July is usefully illustrative. It found that a majority (55 percent) supports “single-payer,” but when respondents hear the argument that it would give the government “too much control,” then 61 percent oppose it.

When you mention the tax increases, 60 percent oppose single-payer. This concept does not enjoy ironclad support from the masses.

People hear “single payer” and think “ah, that’s nice, somebody else will pay.” Once they realize that they’re the ones paying, they’re reticent, and once they realize that the government will get to make the decisions about what procedures they deem cost-effective and which ones aren’t, the notion doesn’t look quite as appealing against the status quo as it did before.

Put another way, Bernie Sanders wants all Americans to enjoy the speedy, compassionate care that our men and women in uniform enjoyed from the Phoenix offices of the Department of Veterans Affairs.

What will be intriguing about the coming year is how much Democrats pretend that 2009-2010 is ancient history, and that no one remembers how Obamacare was supposed to provide affordable care to all Americans. It didn’t live up to its promises for many Americans — they didn’t get to keep their plan, they didn’t get to keep their doctor, and they didn’t see a dramatic drop in their premiums.

There’s no way for Democrats to tout their current bold promises about affordable health care without acknowledging their failure to keep their last round of bold promises about affordable health care. Writing at the Huffington Post, Jonathan Cohn acknowledges the obvious facts that many Obamacare fans prefer to ignore:

Millions of Americans still don’t have insurance. Millions who do are stuck with high premiums or out-of-pocket expenses. The new system seems to have particular trouble in more rural parts of the country, where sparse populations make it difficult for private insurance markets to thrive. That’s why Republicans have been able to get as far as they have with their repeal effort — and why even Democrats are talking about how they’d like to improve the system.

Cohn’s also pretty honest about the costs and trade-offs from single payer:

Suddenly introducing sharply lower prices, however justified on paper, would be a severe shock to the health ecosystem. Some combination of job losses and care shortages would likely follow, as hospitals, drug- and device-makers, and other parts of the industry scrambled to readjust their business models.

 . . . [Single-payer supporters] would also need to sketch out a plausible political scenario for overcoming the inevitable political resistance ― again, not just among familiar rogues in the health care industry, like drug companies, but also among the millions of Americans who are pretty happy with the insurance they have today.

If you like your plan . . .   you’re part of the problem now.

What Kind of History Did Hillary Clinton Make?

Hillary Clinton is on her book tour, and you’re still hearing a lot of damning-with-faint-praise plaudits that salute her for “making history” — in the Boston Globe, Glamour, Democrats speaking to RealClearPolitics, and elsewhere.

Yes, Clinton was indeed the first woman to win a major party’s presidential nomination in American history. But the “SHE MADE HISTORY!” rallying cry is a lot of hand-waving to distract from not merely her defeat, but that she had perhaps the easiest path to winning that nomination of any presidential candidate in recent memory, other than Al Gore in 2000. There’s a strong argument that Hillary Clinton was the Democratic party’s presidential nominee-in-waiting since spring of 2008 when she lost the nomination to Barack Obama. If she didn’t have the nomination quite handed to her by the party, she didn’t need to yank it away from anyone else, either.

She was the heaviest of favorites in the primary from the beginning. Back in 2012, 86 percent of Democrats said they had a favorable opinion of her, and 61 percent said they wanted her to be the party’s nominee; the next closest was Vice President Joe Biden with 12 percent. That’s about as big an advantage as one can imagine in this era.

Her primary win would be more impressive if she had defeated Biden, but the vice president chose not to run, in large part because of unforeseen family tragedies. The rest of the field was a freak-show: Jim Webb running for the nomination of a hawkish rural Democratic party that didn’t exist anymore; bland, forgettable Martin O’Malley, neither centrist nor leftist but just kind of there; weird and awkward Lincoln Chafee, pledging to convert America to the metric system. Not even boxing promoter Don King ever lined up a bunch of tomato cans like this.

That left Bernie Sanders, the 75-year-old socialist with little name ID who resembled Larry David and came from a state with three electoral votes. Even then, in late October 2015, Clinton led Sanders in national polling, 62 percent to 31 percent. She headed into the primary fight with way more money, the endorsement of just about every major figure in the Democratic party, and the widespread perception that the Democratic National Committee was attempting to grease the skids for her. The Democratic Party’s “super-delegates” — elected officials whose votes are the equivalent of many, many primary voters — preferred her, 570 to 44.

That’s a huge set of institutional advantages, and yet she still almost bobbled the nomination away! In hindsight, her difficulty in putting away Sanders week after week should have been a screaming klaxon of her deficiencies as a presidential candidate. Sanders campaign manager Jeff Weaver was prophetic when he wrote in May, “the Democratic Party must decide if they want the candidate with the momentum who is best positioned to beat Trump or if they are willing to roll the dice and court disaster simply to protect the status quo for the political and financial establishment of this country.” Democrats chose to roll the dice, and came up snake-eyes.

“Hillary made history by winning the nomination” is another way of saying “Hillary made history by managing not to lose the nomination with institutional advantages that no other candidate is likely to enjoy for the next few decades.”

And then she headed into a general election with another slew of institutional advantages: her campaign spent twice as much as Trump’s did, the media detested Trump, and the Republican nominee stumbled from one mess to another. Many prominent Republicans skipped their party’s convention in Cleveland while the Democrats’ gathering in Philadelphia went off without a hitch. Clinton may complain about FBI Director James Comey’s last minute reopening (and re-closing!) of the  bureau’s investigation of her, but it’s not like Trump had a smooth final month with the revelation of the Access Hollywood tape in early October. Sure, the first line of Hillary’s obituary will mention she was the first woman to win a major party’s presidential nomination. But it’s likely to continue, “and the loser in the most shocking upset in American political history.”

Americans’ Dwindling Interest in Self-Government

Think of these poll results the next time someone laments that voter turnout is low in the United States. A disturbingly high percentage of Americans can’t name the three branches of government and basically don’t know anything about how their government works.

That’s nearly three-quarters of the American population that can’t cough up “legislative, executive, judicial” on demand and fully 60 percent that can’t name *more than one* of those . . . 

Nearly half of those surveyed (48 percent) say that freedom of speech is a right guaranteed by the First Amendment. But, unprompted, 37 percent could not name any First Amendment rights. And far fewer people could name the other First Amendment rights: 15 percent of respondents say freedom of religion; 14 percent say freedom of the press; 10 percent say the right of assembly; and only 3 percent say the right to petition the government . . . 

Another 53 percent believe that illegal immigrants have no rights under the U.S. Constitution.

If you don’t know anything about how the government works, what it does, what it’s supposed to do, or what rights you and your fellow citizens have . . .  I’m fine with you not voting.

ADDENDA: James Heartfield reads Hillary Clinton’s new memoir, What Happened, and finds an astounding passage where she concludes the lesson of George Orwell’s 1984 is the need to “trust our leaders, the press, and experts who seek to guide public policy based on evidence.”

Does she think Brave New World is an endorsement of pharmaceutical products, too?

The Morning Jolt

By Jim Geraghty