There is a secret that Bernie Sanders and to a lesser degree Elizabeth Warren don’t want you to know.
That secret is, M4A as currently articulated (getting rid of private insurance) is never going to make it to the Presidents desk. Bernie and Liz both know this. (AND THAT'S FINE!!!)
Why?
Because both Sanders and Warren know how Congress works. Bernie has spent decades in Congress, he knows about the legislative process, about committees, about markups, about negotiating on the side to add changes and amendments.
So why do they still push m4a? Because its how you make progress. The operating reality is, Whether it ends up being Joe Biden, asking for only the most MODEST improvements to the ACA or Sanders, asking to get rid of the health insurance industry outright, the answer by Mitch & co. and the rest of the GOP will ALWAYS be NO.
NO.
Given that the opposition will obstruct even the most modest, pro-corporate improvements to our healthcare system, it makes zero sense to start negotiating from the center, knowing the legislative process will water down and draaaaaaggg to the right, any legislation that leaves the House or Senate.
Its about the fear: fear of those on shaky medical ground, fear of the industry and the millions it employs. m4a will never pass, even if we had some lucky 65-35 majority in the Senate. What has a chance of passing, is a public option to start. How do we get there? We put existential fear into the healthcare industry, forcing them to start spending hundreds of millions to defeat m4a. We talk them down to a public option.
The health insurance industry is going to spend massive sums to defeat healthcare reform either way. I would prefer that they spend the money watering down m4a to public option, rather than public option to private with medicare/caid in the current form those that qualify.
Obviously, Bernie and Liz can’t go around saying, “yeah my embrace of m4a is only for tactical reasons, to move the Overton Window to the left.” But that’s the reality.
Decoupling insurance and work ought to be an important goal for Democrats. Many people are trapped in a certain job or career because its their only access to healthcare. A public option helps us give those people more economic mobility and peace of mind. As a Bernie voter, do I want to abolish the for-profit insurance industry? You bet! Both Bernie and I know that’s not going to happen, certainly not overnight or in one term. But we need to desperately change the framing to move that Window left. Its why I can’t support moderates who continue to START FROM a position of incremental improvement.