Allow me to spoil the 2020 election for you: We’re not getting Medicare for All.
Elizabeth Warren’s gigantic, single-payer, death-to-private-insurance plan will not become law.
The only question is whether it doesn’t become law because it’s un-passable, even with full Democratic control of government. Or because she loses an election.
But just for the sake of argument, let’s pretend that one year from now Warren is elected president. Let’s further pretend that Democrats hold the House and regain narrow control of the Senate. These are rosy scenarios for the Dems, but not out of the realm of the possible.
What happens next?
Well, go take a gander at the Axios readout.
Warren proposes to remake the entire healthcare sector. Which means that there would be built-in opposition from many, many vectors. For instance:
- Warren’s plan proposes to override drug patents in order to drive down prices. Which would play havoc with the financial incentives for research.
- Doctors and hospitals will see their reimbursements drop dramatically. Which would put enormous financial pressure on front-line providers.
- The healthcare insurance industry—which employs some 600,000 people—would disappear. Which means that a big block of workers would have their livelihoods endangered.
- Because Warren is trying to hide the football on taxes, she proposes to pass the costs on to employers under the assumption that they’ll then push wages down. But we have no idea what the downstream effects of this scheme would be on jobs and wages—especially for people at the lower end of the wage scale.
Please understand that I’m not making a subjective argument about whether Warren’s M4A plan is a good thing. I’m talking solely about the politics of passage and pointing out that her plan triggers immediate, Armageddon-level opposition from a whole bunch of different groups, not all of whom are mustache-twirling villains.
And who are the constituent groups who will be willing to die on the M4A hill?
- Voters without insurance
- Super-progressives on Twitter
Just as a matter of politics, this is unpassable. It’s dead on arrival. Especially because a compromise version—something close to the Biden or Buttigieg model—will be sitting right there, on the shelf. You are never—never—going to get the people in Congress to walk the plank on something this sweeping, with this much built-in opposition, when there’s an alternative available that gives you 90 percent of the benefits for 10 percent of the political cost.
Now maybe Warren supporters will argue that she doesn’t need to get everything, that by going big, she’s just setting herself up to pass something good even if it’s not perfect in the end.
And maybe that’s true!
But just so long as we all understand that Elizabeth Warren’s Medicare for All is, at best, the progressive version of Donald Trump’s Wall That Mexico Will Pay For.
Speaking of things that aren’t going to happen, Charlie Sykes has a great post mortem on Beto that you should absolutely read. It’s here. (Gretchen, ,stop trying to make Beto happen. It’s not going to happen.)
I have a slightly different view of why Beto collapsed, because unlike Charlie, I’m not convinced that it was obvious he couldn’t win the nomination.
In order to win a presidential nomination, normally two things need to happen:
(1) The candidate needs to have a clearly-defined understanding of what he or she is selling, and
(2) What you’re selling has to be exactly what the primary voters decide they want to buy.
This isn’t universally true. Dole ’96 was not a case of Bob Dole homing in on his product like Steve Jobs and hitting his targets square on the chest. That campaign was about the raw power of institutional momentum and establishment machinery.
But in general, it’s true. In 2016, for instance, there were a handful of Republican candidates who had very clear ideas about what they were selling:
- Marco Rubio: A new future for the Republican party in the age of American hyperpower
- Ted Cruz: Pure, uncut, small government, constitutional conservatism
- Chris Christie: Tough, no-nonsense, austerity and fiscal reform
- Rand Paul: Ron Paul 2.0
Each of those candidates really understood what they were proposing and could make a convincing case that their product was what Republican voters really wanted.
But along came Donald Trump, who also had a very clear idea of what he was selling. The Trump campaign was basically arranged around a single proposition: We should keep brown people out because they’re making the country different and we don’t like it.
And Republican voters were basically like Stifler in Old School:
Anyway, back to Beto.
Beto’s proposal to Democratic voters was, “It’s time to turn the page on Boomer politics and move America to a new generational order.”
Democratic voters were like, “Nah, we good.” And then they made a trio of septuagenarians their front-runners.
Faced with the realization that the Democratic electorate was not interested in generational change, Beto pivoted toward trying to win the woke primary. But it turns out that there just aren’t many voters in that pool.
There was one other candidate selling the same product: Pete Buttigieg. And when Mayor Pete realized that his product was a bad fit for the market, he also retooled.
But like the good McKinsey guy he is, Buttigieg chose more wisely and decided to pivot his pitch as the other pragmatic alternative to Elizabeth Warren.
Buttigieg’s new market position pre-supposes a Biden collapse. Maybe that will happen and maybe it won’t.
But it’s a better bet than Beto’s.
In the end, the Beto 2020 campaign failed not because of poor organization, or a dearth of money, or a lack of focus, but because Democratic voters understood what he was offering and didn’t want it.
The question which no one can answer yet—seemingly not even the Democratic voters themselves—is what do they want?