The critical point that Paul Waldman highlights, perhaps unwittingly, about the healthcare debate between Clinton and Sanders
Back when I was in college, a professor in one of the science courses I took in order to fulfill the Liberal Arts Science requirement made the point—maybe specifically in refutation of Creationists, although I don’t remember—that it is scientists, not those who contest and try to interfere with scientific discoveries, who will ultimately prove or disprove scientific theory.
A blog post this morning by Paul Waldman in the Washington Post about the healthcare insurance debate between Clinton and Sanders, which I just read, reminded me of that professor’s observation. Waldman says:
Clinton’s theory of change is practical, realistic and born of hard experience. But it’s also not particularly inspiring. It takes opposition from Republicans as a given and seeks to avoid direct confrontation with certain powerful interests. It’s essentially the same theory Obama operated on in 2009, when his administration set about to co-opt the insurance and pharmaceutical industries instead of fighting them. And it worked — after half a century of Democratic failure on health care, they passed sweeping reform.
Sanders’s theory of change starts from the unspoken presumption that the ACA was in its own way a failure, because it didn’t change the system enough — there are still people left out, and though costs have been reined in, we still spend far more than countries with single-payer systems, and always will as long as we have a system based in private insurance. The problem with Sanders’s theory, however, is that it’s vague on getting from where we are to where he wants to go. He talks about the need to “stand up” to special interests and create a “revolution,” but standing up isn’t a plan.
Lest any of my friends supporting Sanders call me a squish, I’d note that I’ve been touting the benefits of single payer for years. In various forms it has been tried and worked far better than our system in every other advanced country in the world. In places like France or Germany or Japan, everyone is covered, the quality of care is as good or better than what Americans get, and it costs dramatically less than our bloated, inefficient system. But — and it’s a big “but” — moving from our current system to a single-payer system would be an extremely complicated endeavor, both practically and politically. If you tried to do it all at once, the opposition from both Republicans and the affected industries would make the fights over Bill Clinton’s and Barack Obama’s health-care plans look like nap time at the preschool.
But that doesn’t mean Sanders’s ideas about health care should just be dismissed. It’s no accident that he’s getting the support of millions of idealistic Democrats. He’s a radical, in the traditional sense of the word as one who gets to the root of things.
A real primary debate needs the elements that both Sanders and Clinton provide: on one hand, a fundamental examination of what drives the system and a vision that speaks to the party’s essential values, and on the other hand, a realistic assessment of what the next president can accomplish. That’s why even though they have a profound disagreement on health care, both of them are right.
Sanders, though, isn’t really vague that major restructuring of how political campaigns are financed in this country is a prerequisite to enactment of a single-payer, Medicare-for-all system, and that a prerequisite to that in turn is massive involvement in our electoral system by people who want these.
But Waldman’s post illustrates exquisitely that the point my long-ago professor made about scientists is true also about Bernie Sanders’s candidacy.
I’m not a scientist, man. But I applaud and support them. As I do, now, Bernie Sanders. For similar reasons.