Bernie Sanders made an observation on Thursday:
Regardless of what one thinks about single-payer health care’s drawbacks, it’s hard to say Sanders is wrong about what its benefits would be in the current situation. If more Americans could have gotten testing and treatment for viral infections in the past month without having to pay out of pocket—and if the country’s health care capacity had already been extended to handle people who are currently un- or under-insured—there would be fewer cases of coronavirus in circulation, less concern about potentially imminent shortages of intensive care unit spots and ventilators, and less potential for economic collapse. It’s an example, for fiscally cautious voters, of why it can be in one’s self-interest to pay higher tax rates in exchange for systemwide protections. (South Korea, in particular, is showing that effective universal health coverage can exist in a country that is otherwise a rapacious beacon of craven neoliberal capitalism.)
Meanwhile, Sanders has signaled that he is remaining in the presidential primary against presumptive nominee Joe Biden in order to give his platform the fullest possible airing rather than to attempt a miracle comeback via aggressive attacks on Biden’s record and complaints about a “rigged” process. As Slate’s Jim Newell wrote this week, Sanders is all but explicitly giving Biden the opportunity to win over his supporters and cruise into this summer’s (possibly virtual?) convention without any of the factional bitterness that characterized 2016. (Whether that bitterness was more attributable to Hillary Clinton’s stubborn, enemies-everywhere personal style or Sanders supporters’ sexism is a debate that we’ll all probably have, sometime soon, on social media. It’ll be fun.)
Biden, for his part, would like to become more popular with voters under 45, who have broken against him even in states in which he otherwise delivered—what’s the technical term here—total whompings to his rivals. Sanders and his policies have also been popular with Latino voters whose support Biden will require to win in states like Nevada and Arizona. As I and others have written a tedious number of times, the former vice president’s campaign also lacks a signature proposal—something beyond “he’s a genial guy who’s not Donald Trump”—that might appeal to voters more concerned with “pocketbook” issues than with restoring decency and dignity and whatnot. And while Biden played the “moderate incrementalist” role against Sanders and Elizabeth Warren during the primary, he’s shown during his career that he will support sweeping changes—like the original Affordable Care Act, marriage equality, and, er, the 1994 crime bill—if they seem like common-sense groundswell causes rather than ideological quests.
These arrows are all pointing in the same direction. Sanders is asking Biden to give his supporters a little something. Biden needs Sanders’ supporters, and needs to strengthen his case for being president. The U.S. health care system needs …. a lot of things. It is an ideal moment for Biden to “evolve” on his health care position, which is currently to “protect and build upon” Obamacare with additions that, though they include a tax-funded public insurance option, wouldn’t cover everyone in the country even under the campaign’s own projections. Suddenly calling for single payer to replace private insurance would be too jarring a shift from this stance, but he could, for example, say he’s become convinced that the U.S. needs to guarantee universal coverage by creating an aggressive public option along the lines of those proposed by Pete Buttigieg and Elizabeth Warren. He could name it after Harry Truman, the first Democrat to propose national health insurance, to make it more reassuring to his “base” of people who remember Harry Truman because they were alive when he was president.
The most recent poll on the subject (by the Kaiser Family Foundation, a reliable nonpartisan group) found that 68 percent of Americans support a public option (and that’s with 80-plus percent also saying they expect that taxes “for most people” would have to go up to fund it, which is the key catch). While that number would fall in a partisan election, it’s a pretty good number to be starting from.
Update, March 13, 2020: This post has been updated to clarify that Biden’s current health care proposal includes a public option.