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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe Genius of Bernies Gradualism
http://prospect.org/article/genius-bernies-gradualismThe Genius of Bernies Gradualism
Harold Meyerson
September 13, 2017
Sanderss Medicare for All bill is built on the understanding that revolutions take time.
snip//
But by far the most strategically savvy aspect of the bill is its gradualism. Sanders, its important to recognize, has not made and does not make the perfect the enemy of the good. During the Republicans war on the ACA, he more actively defended that legislationwhile at the same time making the case for going beyond itthan most of his peers, touring the country to rally the opposition to the GOPs attacks. Likewise, the bill he just introduced, composed as it is of several time-specific steps, is designed to make it progressively easier for legislators to support and progressively more difficult for such entrenched interests as the insurance and pharmaceutical industries to defeat.
Suppose, as will likely be the case, that a legislative majority for the bills first trancheexpanding Medicare to Americans under 19 and over 49emerges first, before theres a majority willing to enact the entire package. Politically, its far less of a heavy lift to support a universal entitlement for children (who also incur low medical expenses) and for a slice of the population thats worked for many years and is finding it more difficult to find remunerative employment in our brave new economy. Thats a debate that single-payer advocates should welcome, and that Big Pharma and the insurance companies should feel somewhat nervous about. I suspect the bills 17 sponsors would see it as a victory if that first tranche were enacted as a separated-out piece of legislation, with the understanding that theyd keep trying to secure majorities for the other tranches.
As the scope of Medicares clientele expands and as that of the private insurers contracts, the financial and political heft of the private insurers would contract with it. The fight to lower the age of eligibility to 45, then 35, then to make Medicare truly universal, would be one in which private insurers would have progressively fewer arrows in their quivers. An industry that provides insurance to 60 million Americans, and then 40 million Americans, has smaller profits and less clout in Congress than one that provides insurance to 150 million Americans.
It may not be Sanderss intent to disassemble his bill into age-and-time-specific pieces of legislation. But the bills very design certainly makes that possible if its politically necessary, and Sanderss own inclinations not to make the perfect the enemy of the good, and his understanding of the complexities of social change, suggest that he at least understands this may be the course that getting to single payer will take.
None of this is to suggest that enacting just the first tranche will be easyit will, of course, require substantial Democratic majorities in both houses of Congress and a Democratic president. Compelling pharmaceutical companies to negotiate prices and simply expanding the populations covered by Medicare will provoke a massive opposition campaign from Big Pharma and insurance companies, and other forces that thrive under the health care status quo. But its easier to overcome those forces when the debate centers on the right to health care of children and longtime workers than it is to win an all-or-nothing battle that some on the left have advocated.
The gradualist approach in Sanderss bill also permits Democrats and progressives to have a more flexible approach to their own elected officials and candidates. A liberal or center-left Democrat in a red state may face electoral extinction if she endorses single-payer. She may well be strengthened at the polls, however, if she backs Medicare for kids and the middle-aged. Rather than encouraging some on the left to create a single standard for candidate supportto wit, whether that candidate backs single-payer nowthe Sanders bill creates a continuum that affords candidates the ability to position themselves on a sliding scale of support, depending on the politics of their state or district. Some on the left clearly want to cast elected officials who dont or politically cant support the entire package now into the eternal darkness; little Lenins at the Finland Station we certainly have with us. But Sanders himself has made no such argument, and his bill clearly invites the partial endorsement of Democrats who feel constrained from backing it in its entirety.
Besides, revolutions take time. Theyre a process, not an overnight transformation. Bernie understands that; so should the left.
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The Genius of Bernies Gradualism (Original Post)
babylonsister
Sep 2017
OP
'Sanders . . . has not made and does not make the perfect the enemy of the good. . .
elleng
Sep 2017
#1
elleng
(130,773 posts)1. 'Sanders . . . has not made and does not make the perfect the enemy of the good. . .
Besides, revolutions take time. Theyre a process, not an overnight transformation. Bernie understands that; so should the left.'
Pugster
(229 posts)2. The first part would "require substantial Democratic majorities in both houses of Congress"
When will that happen?
samnsara
(17,606 posts)3. we are almost out of time
beam me up scottie
(57,349 posts)4. K & R!
LexVegas
(6,031 posts)5. Heh. nt
delisen
(6,042 posts)7. So now its the Evolution Revolution