Let us get the requisite hunk of cynical reality out of the way right here at the top. Absent the kind of national landslide that killed off the Whigs and Federalists, or a sudden discovery within the Republicans of a vestigial collective conscience, no Democrat's healthcare plan will get through to the president's desk out of a Senate led by Mitch McConnell. Therefore, any debate on the topic within the Democratic primary process is largely aspirational. (After all, only Joe Biden has publicly endorsed the actual existence of that mythical beast: The Republican Who Can Be Reasoned With.)
Not that there's anything wrong with that. It's good to aspire to things. It's good to throw the cap over the wall. It also helps if your plan is as carefully constructed and precisely reasoned as the one Senator Professor Warren put out there on Friday, the one that so thoroughly answers the question, "How're you gonna pay for it?" that people should be embarrassed to ask it again. Dave Dayen at The American Prospect has as good a summary of the 9,300 pages as you can find. (Dayen shrewdly points out that single-payer plans are generally held to a ludicrously high standard by politicians and pundits.) And he makes one magnificent catch: the Warren plan re-institutes a systemic risk fee that was eliminated in the negotiations over the Dodd-Frank financial reform bill at the request of...wait for it...Scott Brown. SPW has a plan. She also has a memory.
There are three elements of the new plan worth studying right off the top. First of all, it is designed as a mechanism for universal coverage. Long ago, in 2003, I was riding around Iowa with Howard Dean when he still was the only person running for president—George W. Bush hadn't yet announced for re-election—and he emphasized that the primary goal of any overhaul of the healthcare system should be universal coverage and not necessarily cost controls. Warren's plan does that.
Second, it is perfectly consonant with the anti-corruption, anti-monopoly power theme of her entire campaign. The plan aims to bring antitrust enforcement to the healthcare sector.
And third, it factors into its calculations a cut in the defense budget, which used to be a big deal for Democrats, but which hasn't been a top-line item in presidential campaigns for a while. And, again, this is premised on the same principles on which is premised her campaign—that the money power has paralyzed self-government to the point at which it is not capable of doing much of anything, a situation with which the money power is more than content. Defense-industry corporations are just as avaricious and just as blind to the public interest as corporations generally are, if not more so. If it does nothing else, the new plan integrates healthcare into a general criticism of economic inequality and disadvantage. It connects healthcare to dozens of other economic "kitchen-table" issues that have arisen since the nation's wealth began its headlong flight upwards in the 1980s.
It is a sucker's question to ask how she plans to get this plan through a Republican Senate. Given the likely state of things in January 2021, she probably can't, any more than Presidents Sanders or Buttigieg could get theirs through. Ask yourself, though, what the proper parameters are for a progressive debate on healthcare. If it does nothing else, Senator Professor Warren's plan sets out clearly what she believes those parameters should be, and they are wide and generous. Let the rest of the field explain why their ambitions are more limited.
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