some notes on that Chait article
First, most people who have employer-based coverage like it and don’t want to change
Do people "like" it in the sense of "I really like filing claims with Blue Cross Blue Shield, it's the best! I love getting bills in the mail two weeks after my last visit to cover a hospital fee I didn't know about", or do people "like" it because of actual specific coverage details that takes care of them when they're sick (which would be better for pretty much everyone under what I've seen of this plan, and also has the benefit of not being tied to your job, and also the likely benefit of being cheaper out of pocket). Those are two very different things. Obviously, there's the psychological aspect of people reacting negatively to something being "taken away", even if it's immediately replaced with something far better...but that's an argument for not framing the policy
that way and instead emphasizing all the good shit that makes the negatives seem trivial in comparison
, rather than an argument against the policy itself (since again, no one would lose actual coverage for their health issues, and they're still going to the same doctors)
And unlike when Republicans do shit like name their fossil fuel giveaway "The Clean Air and Freedom Act", the actual policy
would improve the vast majority of people's lives in this case.
Second, higher taxes are unpopular. Yes, in an imaginary, rational world, people could be reassured that Medicare will be as good as what they have, and the taxes will merely replace the premiums they’re already paying. In reality, people are deeply loss-averse and distrustful of politicians.
Racism is super popular also, and tough to change people's mind, I guess we better not fight racism. And racism has a far greater psychological hold on people than their "love" of private insurance companies. Yes, people can be irrational. So you construct a bold policy message, organize, put in the work, get people on your side, grind it out and gain political power so that you can change that. That's
what politics is, not just sitting around pretending like people can never respond to outside pressure, and only crafting policies based on a single unchanging snapshot of the political mood, and hoping people just magically fall in line because you're being "reasonable".
Asked by Vox about the difficulty of switching people out of employer-based insurance, he scoffs, “It’s not a question of switching plans,” and then segues into a generalized riff about the merits of universal insurance. (In real politics, you can’t answer people’s concerns by denying they’re concerns.) Asked by the Washington Post about the taxes needed to finance his plan, he insists that we have no idea how much it would cost because the only studies so far have been faked by big pharma and the insurance industry: “The truth is, embarrassingly, that on this enormously important issue, there has not been the kind of research and study that we need. You’ve got think tanks, in many cases funded by the drug companies and the insurance companies, telling us how terribly expensive it’s going to be.”
we do have an idea of what it would cost (we had a primary last year where those costs were debated! other countries have existed for years with examples of costs!). We also know for the vast majority of people, they would pay far less out of pocket. We also know that the US is an incredibly wealthy country overall. It's not like these are completely unanswered questions, the whole point of this initial salvo is to reframe the debate around values and material needs (since that's what actually motivates people to fight for a policy, as opposed to whether the tax rate is increased 1.2% vs. 2.5% ). And on a party politics level, it gives Democrats something far more specific to actually rally around, rather than just some even more vague concepts like "improve access", or "defend the ACA".
Evil corporations are the only impediment he acknowledges. At no point does he grant that the most important source of opposition will come from actual American voters concerned about losing their current plan or paying higher taxes.
But people's concerns are largely influenced by those same "evil corporations". That's the whole reason why they spend billions of dollars lobbying and advertising!
This is also why you don't make your message "Sorry Americans, you will all lose your plans and pay high taxes, ya got me. Please clap though." while ignoring the benefits. That's the whole point of emphasizing "you will have everything covered, and all the shit you hate like deductibles will be gone, and you will pay less than you do now". All of that is true, even if you technically "lose your current plan" and "pay higher taxes".
It's like going to Apple and complaining that they don't address the high cost of their phones. Of course not, since that's a flaw, so why would they make that a giant part of their messaging? They just emphasize all the good shit their phones actually do to the point that the flaws don't really matter as much anymore.
Sanders is not a details person, though. He prefers to act as though the important barrier is the abstract notion of government-run insurance, turning every question about specifics into a question about values
That's because specifics are handled in legislative meetings and debates and the less exciting parts of CSpan. Values are a major
part of politics when trying to mobilize a mass base of support, which is how major changes actually get done. And it's not like it's some completely mystery about how it would be funded. In one breath, Chait's criticism is that this is funded by higher taxes that will scare people away, and in the other breath he says he absolutely needs to know how this will be funded, or else this will worry people. Which is it?
(sidenote: I agree with pigeon on something else as well, that although I understand this is a Senate bill, it would be nice to hear more acknowledgement in general of HR 676 from Conyers, which is even more radical than Sanders' proposal.)