Fiorella Beccaglia Opinion Editor
Last Wednesday, April 10, 2019, Bernie Sanders released the newest version of his “Medicare for all” plan, which would establish a federally funded, single-payer system where the government taxes its citizens to finance healthcare for everyone in the United States. This latest version of the plan does not have many significant differences to previous ones, except that this version is backed by many of Sanders’s rivals for the Democratic 2020 presidential nomination.
Rather than simply mocking him—like many Republicans nominees have—they should take a minute to learn from what Mr. Sanders has accomplished and how. You don’t have to support single-payer to see that he has been very successful as a policy entrepreneur.
Sanders has moved a seemingly radical idea into the mainstream of Democratic policy-making. In doing so, he has modeled a certain kind of persistent political leadership by using the Senate and his presidential campaigns as platforms to advance a major policy idea. Sanders has been able to sale groundbreaking ideas without initial backing from any party leadership. Quite few, if any, legislators on the right are attempting anything comparable, even though they could. The strategies Mr. Sanders employed would be available to any Republican or independent willing to do something like this.
First, and most importantly, he has a clear vision and has relentlessly made the case for that vision and the benefits he believes it will provide: coverage for everyone, no co-payments, no hassle of insurance paperwork. That persistence is another of Mr. Sanders’ strengths as a presidential candidate. The latest version of his Medicare for All is the fifth, a sign of his commitment. Building on the democratic-socialist politics of his youth, he has been pushing for federal universal healthcare for years, even in the face of considerable resistance from many Democrats.
That also accounts for some of his success. Bernie Sanders has not been afraid to work outside of traditional partisan power structures and oppose Democratic Party leadership. Rather, he has built his own base of political power as a greatly successful independent politician (probably the most successful in the country), including the Congressional Progressive Caucus, a group for liberal legislators that he helped found and led in the 1990s. The idea of single-payer has long been seen as a drawback, but Mr. Sanders has used it to his advantage. He has paired his radicalism with transparency and a willingness, at least up to a point, to talk about some of the trade-offs his plan would require. He has been blunt about the fact that his plan would largely remove private insurance and has argued that this is both necessary and good. In my opinion, although I completely agree with Sanders, this is very unlikely to happen anytime in the future since these are billion-dollar companies that basically run the country.
At the same time, he has left some of the most difficult policy questions open for discussion, in particular the problem of how to finance the significant increase in government spending that Medicare for all would entail. In the end, it may still not be enough. A single-payer system full Sanders’ style is almost certainly too disruptive, too fiscally troublesome, too big a political lift, at least for the foreseeable future. Sanders’s brand of democratic socialism would also pose real risks if he were to become president, where he would be expected to manage and govern instead of just campaign. Yet even if he lost the election, he is likely to come out ahead. Democrats may not follow his exact plans, but the party is now chasing his vision.
I wish one day universal healthcare will become a reality in the U.S. like it is in the majority of Europe. Perhaps not in our time nor on Bernie Sanders’ terms, but I think it is totally possible. Out of the 33 developed countries in the world, 32 have universal health care. The only one left to achieve this is the United States. We have to stop seeing healthcare as a business.