Here's the good news when it comes to access to health care: Americans are ready for change. Every serious Democratic candidate for president has embraced some form of Medicare for All, and Speaker of the House Nancy Pelosi has proposed holding hearings on the many different bills that Democrats have proposed. Even more promising, the stigma around single-payer has dropped over the years, with broad majorities across party affiliation supporting the idea of more governmental support to improve more Americans' access to health care. The bad news is that the private insurance industry isn't going down without a fight, and its pockets are deep.
Last week, the Kaiser Family Foundation released its monthly tracking poll. The data is striking. Fifty-six percent of all Americans support a nationalized health insurance plan. Seventy-seven percent support increased buy-in options to Medicare or Medicaid, including majorities of Republicans. On the other hand, the data shows that such support plummets when poll recipients are presented with generic counter-arguments: Under Medicare for All, taxes might go up, patients might experience delays, the current private health-care and Medicare systems might change.
Taken as a whole, the message is clear that Americans across the political spectrum are longing for changes in health care, but are worried about what those changes might mean.
Industry leaders recently lamented to Paige Cunningham at the Washington Post that "There is no pushback against those calling for Medicare-for-All," and say they intend to change that dynamic. Their weapon: lots and lots of money. Enter the United States Chamber of Commerce. Earlier in January, Tom Donohue, chief executive officer of the lobbying group, vowed "to respond to calls for government-run, single-payer health care, because it just doesn't work." According to the non-profit Open Secrets, the U.S. Chamber of Commerce routinely ranks among the highest-spending lobbying groups in Washington. Its ranks are staffed with former government employees. Open Secrets notes that the Chamber of Commerce poured $6 million into positive advertising for Republicans, and $0 for Democrats during the 2018 election cycle.
The Chamber isn't alone. Last November, The Intercept published leaked industry documents detailing the formation of the Partnership for America's Health Care Future, "an ad hoc alliance of private health interests, to curb support for expanding Medicare." One of the partnership's strategies is to convince centrist Democrats to support improving the Affordable Care Act instead of supporting a broad overhaul into a single-payer system. The group is preparing an advertising blitz about the "horrors of single payer," much as industry groups did back in 2009, when they helped centrist Democrats such as Joe Lieberman and Max Baucus kill any attempt to even hold hearings around single-payer health care. Some of the same players from that era are involved in this new alliance.
In the end, this fight will be about information and messaging as much as anything else. Take taxes as a vehicle for funding health care, for example, which at least some analysts believe will emerge as the core issue. Right-wing pollster Frank Luntz responded to the Kaiser poll by tweeting, "Support for Medicare For All: 56% support [and] 44% oppose. Support for Medicare For All when you tell people it requires higher taxes: 37% support [and] 60% oppose." But higher taxes on whom? And how might individual expenditures on health care go drastically down, resulting in a significant individual net gain? The Kaiser poll doesn't drill down to those kinds of nitty gritty questions.
Presidential candidate and Massachusetts Senator Elizabeth Warren also made news last week by proposing a "wealth tax" that would levy a 2 percent tax on people with assets over $50 million. It would raise around $2.75 trillion over 10 years. Combine that with Alexandria Ocasio-Cortez's proposal to raise taxes on income (not wealth) over $10 million, and we'd be starting to see some serious revenue pour in from just a tiny fraction of American taxpayers. The latest analysis of the cost of Medicare for All from the Political Economy Research Institute at the University of Massachusetts–Amherst finds that the government would need an additional $1.05 trillion a year to balance the books on universal health care. I think we can make this math work out.