Wednesday, January 13, 2016

Clinton attacks Sanders on single-payer health plan

Here's the essence of the difference between the two Democratic candidates on health insurance (from Paul Waldman at the Washington Post/Plum Line).

... the basic divide between the two is that Sanders wants to remake the health insurance system, while Clinton wants to build incrementally on the ACA. But in the context of a Democratic primary, her attack on single-payer insurance is a little strange.

While there are certainly liberals who disagree with this line of thinking [expounded by Obama in arguing for the ACA], nobody would be surprised, insulted, or appalled if Hillary Clinton adopted it. If she said, “Look, single-payer might be a good idea, but it’s just not realistic at this point in history, so let’s focus on what we can accomplish in the next few years,” it wouldn’t be controversial and it wouldn’t drive away any Democrats who weren’t already firmly in Sanders’ camp.

But that’s not her argument. She’s making a second kind of argument, that single-payer is itself a bad idea — not that we might like to do it but we can’t, but that it fails on the merits.

It really is a strange line of attack because single payer is so popular and works so well in other countries. Clinton must know both these things.

And single-payer is a hugely popular idea among Democrats. Depending on how you phrase the question, you can see support as high as 80 percent or more. To take just one recent example, a Kaiser Health Tracking poll from December asked whether respondents favored “having a national health plan in which all Americans would get their insurance through an expanded, universal form of Medicare-for all.” Eighty-one percent of Democrats said they favored it, with 52 percent favoring it strongly.

So why would Clinton be attacking single-payer in the way she is — on the cost issue before, and now on this state issue — when there’s a less risky way to frame her objections to Sanders’ idea? ...

Waldman offers some possible answers but none make a lot of sense to him (nor to me).

I can’t say what the answer is. But if Clinton and Sanders keep arguing about this issue, eventually we may be able to figure it out.

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