Single-Payer or Bust: The Democrats Need to Give Us Something to Vote For

“Since when do Democrats attack one another on universal health care? I thought we were trying to realize Harry Truman’s dream. I thought this campaign finally gave us an opportunity to put together a coalition to achieve universal health care.”

That was Hillary Clinton, in the heat of her 2008 primary battle with then-Senator Barack Obama.

Obama, Clinton suggested, was committing a shameful act of friendly fire by sending around fliers that misled voters on health care and other topics around which Democrats should seek to unify.

“This is wrong and every Democrat should be outraged because this is the kind of attack that not only undermines core Democratic values,” Clinton said, “but gives aid and comfort to the very special interests and their allies in the Republican Party who are against doing what we want to do for America.”

How quickly things change.

In 2016, confronting yet another unexpected challenge in the person of Vermont Senator Bernie Sanders, Clinton trampled on what appeared, in February of 2008, to be a statement of principle.

Previously an outspoken proponent of single-payer health care, Clinton, speaking at a campaign rally early last year, painted Sanders’ “Medicare for all” proposal as pie in the sky.

“I wish that we could elect a Democrat who could wave a magic wand and say, ‘we shall do this and we shall do that.’ That ain’t the real world we’re living in!” Clinton said.

But the former Secretary of State didn’t stop at dismissing Sanders’ proposal as unrealistic; she insisted that, if it was enacted, it would dismantle the progress made by Obamacare and “send health insurance to the states, turning over your and my health insurance to governors.”

Chelsea Clinton, adding to the concentrated barrage of attacks, pursued a similar line during a speech in New Hampshire, arguing that Sanders’ plan to replace the Affordable Care Act with a single-payer program could “strip millions and millions and millions of people of their health insurance.”

These claims, as everyone who examined them at the time recognized, amounted to little more than the smears Clinton decried eight years prior.

Contributing one last disingenuous item to a mountain of misinformation, Clinton said, “I don’t know where [Sanders] was when I was trying to get health care in ‘93 and ‘94.”

A response came swiftly: He was literally right behind her.

Fast-forward to the present, and we have a rather different health care fight on our hands: Republicans are attempting to make good on their longstanding promise to repeal the Affordable Care Act and replace it with something, in the words of President Donald Trump, “really great.”

Predictably, the plan put forth by House Republicans, led by the supposed policy wonk Paul Ryan, was a craven mess that would’ve stripped millions of their insurance while—of course—giving massive tax breaks to the wealthiest Americans. The plan was, as Vox’s Dylan Matthews recently put it, “an act of class warfare by the rich against the poor.”

As such, Democrats forcefully aligned against it.

Bernie Sanders, an independent, entered the fray as well, but from a different angle than most Democrats. Being the party of no is not sufficient, Sanders insists; Democrats must articulate an alternative just as forcefully as they have articulated their opposition to GOP-care.

“Never lose sight of the fact that our ultimate goal is not just playing defense,” Sanders recently tweeted. “Our goal is a Medicare-for-all, single payer system.”

He was almost instantly derided, most prominently by the liberal columnist Paul Waldman, who scoffed in response to Sanders’ tweet: “Like saying ‘Never lose sight of the fact that our goal is to remodel the kitchen’ when there are arsonists pouring gasoline on your porch.”

The sentiment is not unfamiliar: Not now, says the Sober Liberal, not now. We can save the Utopian ideas for the future; at present, we must beat back the barbarians currently attempting to breach the gate.

But if the 2016 election results have taught us anything, it is that saying “the other side is bad” is not nearly enough. People are eager for something to organize around and to vote for.

Contra Waldman, it is possible to resist Republican efforts to dismantle the current health care order while also articulating the need to move beyond it, to something better.

In fact, to resist most effectively, we must do precisely that; insisting that “Obamacare is already great” won’t do.

“The American health care system is such a hideously complicated tangle of institutions,” The Week’s Ryan Cooper noted back in January. “The fact that ObamaCare—a reasonably good-faith effort to make the system better—did not stop the vicious cruelty of medical billing, and in many ways only added to the system’s psychotic complexity, ought to weigh on us all.”

And it ought to weigh most heavily on Democrats.

In January of this year, a poll conducted by the Pew Research Center found that “60% of Americans say the government should be responsible for ensuring health care coverage for all Americans.”

Democrats casting about for issues that will consolidate their base and inspire progressives at the grassroots level have been granted a remarkable opportunity by their Republican opponents.

What better program to unify around, particularly given the present circumstances, than one that guarantees health care to all Americans as Republicans scramble to take it away from millions as a sop to the rich?

In 2008, Hillary Clinton believed she sensed “an opportunity to put together a coalition to achieve universal health care.”

Today, if they choose to take it, Democrats have that opportunity once more. This time, they cannot afford to blow it by smearing those who insist upon Medicare for all.

From their position of powerlessness, Democrats can begin to feed off of the demands for universal coverage by constructing an ambitious and stark contrast to the disaster that is GOP-care, thus laying the groundwork for future electoral victories.

If not now, when?

Jake Johnson is a freelance writer. Follow him on Twitter: @johnsonjakep.