The political momentum on the left for Medicare for All, fueled by Republicans’ dramatic failure to repeal Obamacare, has been tempered lately by an attack of the piecemeals. Some liberals are warning that the political hurdles for government-provided health care cannot be surmounted at once—that advances must ushered in slowly and incrementally, to minimize disruption.
Joshua Holland argued in The Nation earlier this month that, “from a policy standpoint, Medicare-for-All is probably the hardest way to get” to universal health care. Moving to single-payer within a year or two “would cause serious shocks to the system,” and “compelling the entire population to move into Medicare, especially over a relatively short period of time, would invite a massive backlash.” The New York Times’ Paul Krugman, meanwhile, wrote last week that single-payer “would be much harder politically than its advocates acknowledge; and there are more important priorities.” He recommended “improving the A.C.A., not ripping it up and starting over…”
Holland and Krugman endorse a public option, a government-run competitor to private insurance that individuals or employers can purchase. Several Senate Democrats have introduced a bill that would allow people aged 55-64 to buy into Medicare. Gradual access, the theory goes, can flower into one of the various program designs that industrialized nations use to provide universal health care to their citizens. But why is increased access to Medicare, which is solid but inadequate, the obvious first step? If the plan is to transition to something like Medicare for All, shouldn’t the strategy begin with making Medicare great?
– New Republic