Healthcare May Be Hazardous To Political Health

Sherry Bebitch Jeffe & Doug Jeffe

Sherry Bebitch Jeffe, Professor of the Practice of Public Policy Communication, Sol Price School of Public Policy and Doug Jeffe, Communications and Public Affairs Strategist


Many Democrats at the state and national levels are playing with fire as they pursue a complete overhaul of the healthcare system. In California, Lt. Governor Gavin Newsom’s gubernatorial bid and State Senator Kevin DeLeon’s US. Senate campaign could founder if they push too hard for a government takeover of health insurance.

Healthcare has become the third rail of American politics and those who touch it are asking for an electoral shock.  Just as Congressional Republicans are smarting from self-inflicted wounds, suffered in their failed attempt to repeal and replace “Obamacare,” a Golden State battle is developing, as the California Nurses Association and their allies are pushing for a single-payer system, paralleling Bernie Sanders’ proposal for “Medicare for All,” now.

While still unhappy about health insurance rates and drug prices, most Americans now view the Affordable Care Act (ACA) as beneficial and Republican alternative proposals as poison.  The impact on the GOP is best illustrated in the recent Virginia elections; exit polling showed 40% of the voters cited healthcare as their most important issue. Those health care voters went overwhelmingly for Democratic candidates.  The health care debacle has also played a big part in defining President Donald Trump as untrustworthy and a failure in delivering on his promises–and that showed in Virginia election results.

In recent history, healthcare was not kind to the political standing of former Presidents Bill Clinton and Barack Obama. In 1994, Republicans swept into control of the House of Representatives largely because of backlash against the ill-fated “Hillarycare” proposal championed by then-First Lady Hillary Clinton.  Newly minted Democratic Congressional majorities were booted out in 2010 after passage of the ACA and the relentless Tea Party attacks on “Obamacare.”  In addition, President Obama’s ill-considered statement that people could keep their doctor and their insurance turned out to be wrong for a small slice of the populace, and that over-promising generalization backfired bigtime

The underlying reason proactive health care reform is so dicey is that the majority of Americans and of Californians are satisfied with their health care coverage through their employers or Medicare.  In medicine, change is often a hard pill to swallow—for providers and patients.  Anything that threatens or eliminates benefits or interferes with consumer choice is met with public resistance.  Doctors, hospitals, and other providers are allergic to anything that might reduce their revenue. The ACA only picked up public support after it had been operating a few years and showed improved health care access for many and not much of the scary stuff that critics had predicted.  Now, threats to the ACA are considered dangerous.  The bottom line is that you can’t take back benefits and entitlements without paying a big political price.

While public opinion now tends to favor Democrats on the issue of healthcare, there are those in the party who are intent on charging robotically into the abyss.   Instead of pushing for the protection and fine tuning of the ACA and for fixing some of the cracks in the healthcare system, the progressive left is pushing hard for single-payer proposals and making support for single-payer healthcare a litmus test for Democratic candidates—both nationally and in the Golden State.

In Washington, Senator Bernie Sanders has put forth a concept he is calling “Medicare for All” which really isn’t Medicare and has no funding or implementation framework attached to it.  It is noteworthy that a number of Democratic Senators who want to be President have endorsed the Sanders proposal—knowing that it is a non-starter with Trump in the White House and Republican majorities in Congress (or maybe because it is a non-starter, but needs to be addressed politically to assuage the Democrats’ hard-liberal base).   Since a single-payer system would inevitably mean shifts of money and resources from current insurance plans, including Medicare and Medicaid, Senator Sanders is stirring up a hornet’s nest that will undoubtedly trigger internecine warfare in the 2018 Democratic primaries and in the 2020 Presidential race.

The issue is coming to a head in California just in time for the 2018 gubernatorial contest.  The California Nurses Association and its allies continue to push in Sacramento for SB 562—a single-payer measure for California.  Under the leadership of Senate President pro tem DeLeon, SB 562 passed in the State Senate, despite its lack of funding, a framework for implementation, or any prospects for cooperation from the Trump Administration.  When the bill got to the Assembly, Speaker Anthony Rendon called a time out and held up the bill for further study and deliberation.

There will certainly be a push to move the measure forward in 2018.So far, Lieutenant Governor Gavin Newsom, a leading candidate for Governor and the favorite of the California Nurses Association, has endorsed SB 562.  While not voicing outright opposition to the plan, both former Los Angeles Mayor Antonio Villaraigosa and State Treasurer John Chiang have urged caution in moving forward.

Ironically, California has made a decided success of the ACA and has vastly increased MediCal eligibility.  California voters have shot down single payer ballot initiatives in the past

If Newsom ends up in a November runoff with either Villaraigosa or Chiang, both fellow Democrats, his advocacy for a controversial go-it-alone, California single-payer healthcare overhaul could prove politically costly in a contest where less enthusiastic Republicans and No-Party Preference voters could very well decide the election. The same is true for DeLeon in his effort to unseat incumbent Senator Dianne Feinstein.

The health care system, in America and in California, is far from perfect and a number of fixes and upgrades are clearly in order. Nationally and in the Golden State, there appears to be limited public appetite for a total government takeover of health insurance.

Democrats might want to look at the recent past before embarking on what could be a political suicide mission. The record would show that proposing to turn the health care system upside down is not a prescription for political success.

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