Perhaps Democrats have misheard what the voters are saying about health care for several cycles now.
In the aftermath of a disappointing year in the down-ticket races, some Democrats are grumbling that the party’s focus on health care in 2020 was a mistake, and cost them votes among voters who were more worried about the state of the economy.
Perhaps Democrats have misheard what the voters are saying about health care for several cycles now. I suspect it’s quite easy to find a survey result or focus-group discussion indicating that an overwhelming majority of Americans find health care “important.” Few Americans would ever want to say that they don’t care about their health, or the health of other people. But whether or not health care is the issue that sways a voter’s choice is a separate question.
I suspect it’s also easy to find a survey result indicating that an overwhelming majority of Americans find health care to be too expensive. Between insurance premiums, copays, deductibles, and health-care needs that aren’t covered, it’s understandable that a lot of people find the current system of getting and paying for health care frustrating at times. If asked to describe their ideal system, most people would say they want the best quality care, with no wait, and to pay either nothing or as little as possible.
Democrats probably head into every election cycle with a small mountain of survey research suggesting that many Americans feel the current U.S. health-care system is “a problem,” and somebody ought to do something about it . . . with few specifics about what that “something” ought to be. Americans probably also remember the elections of 2010, 2012, 2014, and 2016 that focused so heavily on the Affordable Care Act, a.k.a. “Obamacare,” and recall that Obamacare was supposed to fix the problems of high premiums, copays, and deductibles, and provide affordable health-insurance options for everyone.
Surveys also consistently find that a strong majority of Americans – around 70 percent – rate their health-insurance coverage as excellent or good, including 71 percent of Democrats. And consistently, roughly 80 percent of American adults rate the quality of the health care they receive as good or excellent. Americans felt this way before the passage of Obamacare and afterwards as well.
And enough Americans have heard enough horror stories about waits for care in state-run health care systems to make them wary about an expanded government role. Americans may not love the current system of private health insurance, usually purchased through their employer, but they don’t necessarily trust government, or Democratic candidates, to fix the current system for the better.
Democrats are torn between ambitious plans to overhaul the health-care system in a sweeping way that would eliminate private health insurance companies entirely, and the public’s doubts that another sweeping change, on par with the Affordable Care Act, will actually improve the situation. You will have a hard time finding a better example of Democrats’ conflicting instincts than Vice President-elect Kamala Harris.
Harris famously declared in January 2019 that health-insurance companies were so “unconscionable, cruel, and inhumane,” she wanted to get rid of them entirely. “You don’t have to go through the process of going through an insurance company, having them give you approval, going through the paperwork, all of the delay that may require. . . . Let’s eliminate all of that. Let’s move on.” The next day, one of Harris’s aides said she was open to preserving the private health-insurance industry.
Then in June 2019, Harris answered a New York Times survey indicating that she did support eliminating private insurance for all services provided under Medicare for All:
Do you support a “Medicare for all” system — similar to the bill sponsored by Senator Bernie Sanders — that would eliminate private health insurance, including employer-provided coverage, and be paid for by taxes?
Yes. . . . Private supplemental insurance for procedures not covered under the Medicare for All plan would still be allowed.
Then in a debate a few days later, NBC’s Lester Holt asked: “Many people watching at home have health insurance through their employer. Who here would abolish their private health insurance in favor of a government-run plan?” Harris raised her hand, joining Bernie Sanders. The next say she said she had misheard the question, and thought she was simply indicating she would use a government-run health-care plan, and that she does not support eliminating private insurance.
Does Harris want to eliminate private insurance? It depends upon which day you ask her.
And Harris is probably representative of a lot of Democratic candidates this cycle. They want to “do something” about health care, but either don’t know, or can’t easily articulate what that “something” ought to be. In the dramatic, high-stakes environment of autumn 2020, no one should be all that surprised that voters weren’t moved by that.