Friday, December 6, 2013

It's Time to Ask: Why not Medicare for All?

As noted in the Washington Spectator, every liberal recognizes that Obamacare is a conservative solution, so why do the Democrats beat their heads against a wall trying to convince conservatives that a conservative solution is right for the country, despite their hostile opposition?

There is one situation—and one situation only—in which Republicans support market-based health care reforms—but ONLY when government-based solutions are on the table—such as when single-payer programs look possible.

So every time a Republican yells: "Repeal and replace Obamacare!" —we should shout back: "We're with you! Let's expand Medicare for everyone!"

Imagine the Democratic members of Congress actually having a response to Republican attacks on Obamacare. It might sound like this:

"There've been some early issues with the Affordable Care Act. We're committed to making it better, but if it doesn't work, we have proven alternatives. One is Medicare. I'm introducing a bill in the Senate this week to expand Medicare to everyone."

Conservative think tank strategies makes heavy use of a concept called the Overton Window:

Wiki: The Overton window is a political theory that describes as a narrow "window" the range of ideas the public will accept. On this theory, an idea's political viability depends mainly on whether it falls within that window rather than on politicians' individual preferences. It is named for its originator, Joseph P. Overton, a former vice president of the Mackinac Center for Public Policy, a "free market" think tank. At any given moment, the “window” includes a range of policies considered politically acceptable in the current climate of public opinion, which a politician can recommend without being considered too extreme to gain or keep public office.

You can also think of this as "shifting the center". The Overton Window is the range of actual, reasonable possibilities as perceived by the general public. Anything outside of this would be considered radical or unthinkable.

A post at the Daily Kos points out that if you look at healthcare options on the spectrum— from universal single-payer health care to completely unregulated market solutions—it might look something like this today:

- No government involvement in health care insurance
- Health care industry loosely regulated by government / no mandate
- Individual mandate / health care insurance exchanges (Obamacare)
- Business mandate / health care insurance exchanges
- Managed competition – The Clinton plan
- Public option
- Medicare for all
- Single payer/universal healthcare

The two options in bold above represents the current Overton Window. Notice that the more government-centric plans that the GOP says are considered "too radical—or in Republican terms, "Socialist". Anything not in bold is considered politically impossible or "radical" by today's Washington establishment.

The problem is, the only time conservatives have ever supported anything (other than a completely unregulated market) has only been when better government-based solutions were on the table—like Obamacare—only this time, they don't seem to have an alternative plan (because Obama is using their last one!)

A Brief History:

  • The 1970s: When Ted Kennedy chaired the Health subcommittee in the early 1970s, Nixon introduced an early version of the ACA called the Comprehensive Health Insurance Plan (CHIP) that included an employer mandate and subsidies for low-income families.
  • 1989: Stuart Butler at the Heritage Foundation introduces the individual mandate, the basis for Romneycare and Obamacare. Here, in Butler's own words, is why:

"Increasingly, pressure is building for some kind of national health insurance system in America. I believe that eventually the U.S. will have a “national health system,” in the sense of a system that assures each citizen of access to affordable health care. At issue is the kind of national system we should have."

  • 1992 and 1993: Butler’s ideas were used by Republicans in Congress as they sought an alternative to Bill Clinton’s health care reform. The Health Equity and Access Reform Today Act (or HEART) was introduced by John Chafee and co-sponsored by 19 Senate Republicans including Bob Dole, Chuck Grassley, Orrin Hatch, and Alan Simpson.

Are you sensing the pattern? Republicans only propose a version of their own healthcare plan when a better government program is also possible (and gaining momentum within the Overton Window). In other words, by popular demand, we should shift the Overton Window, instead of accepting it as it is now.

And what better healthcare plan could the GOP possibly come up with that's better than Medicare for All? Earlier this year Rep. Alan Grayson (D-Fl) introduced a bill called the "Medicare You Can Buy Into Act" --- and here is a petition asking Congress to pass it: "Pass Medicare for All"

* As an aside --- Another reason why the ObamcaCare website first failed: In 1995 lawmakers killed a tiny federal agency called the Office of Technology Assessment that was first established in 1972. It was Congress' own non-partisan in-house think tank, which studied new technologies and offered recommendations on how best Washington could adapt to them. But it was then- Speaker of the House Newt Gingrich (R-Ga.) who turned off its lights.

RELATED TO OBAMACARE BRANDING: Progressives Need to Use Language That Reflects Moral Values

Mark Karlin: Why are conservatives so successful in "framing" much of the national political discussion?

George Lakoff: They've been working at it for over three decades. They understand the importance of morally-based framing, the importance of language, the importance of repeating language, the importance of not using the opposition's language, and the importance of an extensive communication system that operates daily everywhere, election or no election.

Mark Karlin: Can you explain how this played itself out in the public perception of the Affordable Healthcare Act (which the Republican Party successfully branded as Obamacare). In particular, can you explain why most Americans support a large number of the specific provisions of healthcare reform, but resoundingly have opposed the bill as a concept in polls?

George Lakoff: The specific provisions of the act were chosen (via polling) to be provisions that most Americans (60-80 percent) liked --- and they still like those provisions (e.g., no preconditions). Conservatives never attacked those provisions. For example, they never said there should be preconditions. Instead, they shifted to a different part of the brain, changing the framing from a practical medical care framing to a moral framing. They used two moral frames: freedom and life, with the slogans "government takeover" and "death panels." They repeated these slogans over and over, until their moral framing came to dominate the public discourse. Less than half of Americans support the whole plan, while 60 to 80 percent support its provisions.

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