Thread by @JewhadiTM

Kamala Harris' Medicare for All Problem Is the Democratic Party's Medicare for All Problem

The California senator's history of flip-flops reveal the emptiness of her campaign—and looming problems for her party.

reason.com/2019/08/20/kam… via @reason

Sen. Kamala Harris' (D–Calif.) health care flip-flops are, first and foremost, a referendum on Kamala Harris, the candidate, and the fundamental emptiness of her presidential campaign.

Harris views health care through an exclusively political lens, wanting to be seen as a supporter of Medicare for All and its popular promises without reckoning with the trade-offs that a real single-payer health care system of the sort proposed by Sen. Bernie Sanders.

Sanders may be in it for the revolution, but Harris is in it for the optics.

Harris reportedly told a group of supporters at a fundraiser that she was "uncomfortable" with Sanders' Medicare for All plan,that would eliminate virtually all private health coverage in four years.

That’s the same Medicare for All plan that Harris co-sponsored all the way back in 2017, the same plan that she came out swinging for when she launched her presidential bid in January, the same plan she was listed as backing as recently as April of this year.

Harris has backtracked on health care multiple times over the course of the year, but it's hard to believe she was genuinely uncomfortable with a plan she so prominently backed.

What's more likely is that Harris was uncomfortable not with the plan itself, but with the unpleasant political position it put her in—having to defend not only the substantial cost of the plan but its swift elimination of private coverage and the disruption that would cause.

Which is why her own plan, released earlier this summer, is best understood not as a health care plan, but as a campaign messaging document that allows her to say she supports both Medicare for All and some allowance for private health insurance.

Notably, her plan contained no cost estimates and pushed the transition back 10 years—conveniently ensuring not only that it wouldn't happen during a Harris administration, but wouldn't show the full cost of implementation.

It's a plan that hides its least popular elements beyond the scope of a conventional legislative price tag, and past the political accountability of a two-term president.

Yet her plan, which allows private insurance only if is essentially designed by the government, would still lead to the elimination of employer-sponsored coverage as we know it, disrupting coverage for tens of millions of people in the process.

And while the party's left flank has stood by the “Medicare for All" plan and its essential radicalism, it's not clear that much of the rest of the party even agrees on what it means.

That's why both "Medicare for All" and copycat labels like Medicare for All Who Want It have regularly been deployed by those who favor something less than full-fledged single-payer, but still want to seem like they support the same basic goals.

So while it's true that Harris' chief rivals for the Democratic nomination—Biden, Warren, and Sanders—have clearer individual visions when it comes to health policy, it remains the case that the party as a whole is both divided and muddled in its thinking.

Any Democratic candidate who won the nomination would face the same challenge of reconciling those conflicting impulses, and then defending and explaining them to the voting public at large.