The age of Trump is supposedly an age of Republican radicalism, a phenomenon about which we hear daily — indeed, hourly, if we endure cable-news commentary and talk radio.
But that Republican radicalism is almost nowhere to be found in the Republican policy agenda. President Donald Trump is a wild man on Twitter; in the Oval Office, pen in hand, he’s Jeb Bush. His signature domestic-policy achievement is a mostly conventional Republican tax cut that actually conflicted with much of what he had promised during the campaign, when he talked about jacking up taxes on investors and multinational business concerns. One of the least appreciated aspects of Trump’s presidency (so far) is that the president has been quietly — but thoroughly — dominated by the Republican leadership in Congress, even as he has loudly — but fruitlessly — proclaimed himself the boss. When it comes to the items on Trump’s agenda that conflict either in substance or in priority with the congressional-GOP agenda — new immigration restrictions, border wall, $1 trillion infrastructure program, neo-mercantilist trade policy — Senator Mitch McConnell & Co. simply decline to take up the president’s to-do list. As he learns about the political contours of his recently adopted party and the conservative movement that has helped to organize it, President Trump becomes a more conventional Republican day by day — on policy.
The radicalism of Donald Trump’s Republican party is rhetorical — the party’s language is unsparing and confrontational, its stance unyielding, its understanding of itself in relation to the major American institutions increasingly countercultural. But even though it is wed to an utterly conventional GOP political playbook, that rhetorical radicalism has provided the Democrats with what they take to be a plenary indulgence of reciprocal radicalism — not only in rhetoric but in substance.
This current of Democratic radicalism predates Trump and Trumpism — it was evident in the antiwar movement of the Bush years and the Occupy Wall Street movement that emerged toward the end of that administration. (Senator Elizabeth Warren, who is among the contenders for the 2020 Democratic presidential nomination, boasts that she laid the intellectual foundations for Occupy.) Both the protests against the Iraq War and the slow-motion riot that began in Zuccotti Park and never quite subsided saw ordinary and purportedly responsible Democrats, including both intellectuals and officeholders, making common cause with far-left radicals of many different stripes: Louis Farrakhan–style anti-Semites, Soviet nostalgists marching around Lower Manhattan in East German military uniforms. Anarchists such as David Graeber came into fashion (and have not gone out) along with old-fashioned Marxists such as Slavoj Zizek, the Slovenian psychoanalytic philosopher and apologist for political violence. Outside the realm of academics, imitators such as intellectual manquée Elizabeth Bruenig, now of the Washington Post, openly took up the banner of socialism. “Tankies” began to gleefully make the case for Josef Stalin’s liberal use of artillery and genocidal famine as instruments of political persuasion. The usual campus Maoists and mau-mauists began making their way off the quad and into the centers of Democratic power, carried there in no small part by the 2016 Democratic primary campaign of Senator Bernie Sanders, the Brooklyn socialist who represents Vermont in the Senate.
Trump’s victory helped to supercharge that emboldened radicalism, partly because of who he is and how he comports himself but chiefly because he was supposed to lose and didn’t.
Hence the emerging 2020 Democratic agenda as articulated by those seeking the party’s presidential nomination, an agenda that owes a good deal more to Hugo Chávez than to Jack Kennedy — or even to Hillary Rodham Clinton, whose failure as a candidate liberated progressive activists from the burden of pretending not to detest her relatively business-friendly approach and the Wall Street Democrats behind it.
As of this writing, that 2020 agenda has two major pieces: One is adopting a Soviet model of health care — no, not a British model; the British haven’t abolished private insurance, as Senator Kamala Harris proposes to do — and the other is wealth confiscation. Republicans, unfortunately, already are falling into the error of presenting as the principal argument against this radicalism that the latter will prove insufficient to pay for the former.
The budget math is not the most important argument, but the numbers are worth considering: The “Medicare for all” national-monopoly model of health care proposed by Senators Sanders, Harris, Warren, Gillibrand, and others is projected to cost about $3.5 trillion a year — and that is a relatively friendly estimate. That figure exceeds all federal tax revenue — all of it — for 2018. That health-care entitlement alone would cost more than Social Security, Medicare, Medicaid, and defense combined, and would represent a near-doubling of federal expenditures. It would require more than doubling total federal taxes just to keep the deficit where it is, which is right around the $1 trillion mark, an unsustainable level that is in and of itself a major policy problem.
The defects of the monopoly model of health care already are evident in all of the places where such monopolies have been created, not only in distant backwaters but in economically advanced countries such as the United Kingdom and Canada, where delays, poor quality of care, and corruption are ongoing problems that are getting worse. In Canada, the average delay between referral to a specialist and treatment has gone from about six weeks in the 1990s to nearly three months today. Patients crippled by joint failures can wait nearly a year for a knee replacement. In November, a House of Lords committee warned the British government that the figures produced by the National Health Service do not accurately reflect the prevalence of bribery and fraud in that system. Scottish hospitals are in crisis over deadly infections caused by unsanitary conditions, including deaths of children from diseases transmitted in the hospital by pigeon droppings. It is worth keeping in mind when evaluating these horror stories that both Canadian and British public-sector institutions reliably outperform their American counterparts when it comes to effectiveness, transparency, and honesty. The NHS is not great. The NHS as run by something like Cory Booker’s former mayoral administration in Newark would be worse.
There are many ways to get to universality in health-care coverage, and it should be emphasized that very few countries actually have a single, unitary, national-monopoly system of the kind Democrats are envisioning. Neither liberal Western European countries such as Germany nor the Northern European welfare states so admired by American progressives typically rely on such systems. Far from being a Scandinavian answer to the NHS, Sweden has a broadly decentralized system in which administration and responsibility lie with the county governments or, in some cases, with municipalities. This helps to create accountability; for example, if a Swedish patient does not receive timely care from a local provider (“timely” of course being elastic; in the Swedish context, it generally means three months, part of what health-care scholar Arne Björnberg describes as the system’s “seemingly never-ending story of access/waiting time problems”), then the county government is obliged to send him elsewhere for care — and to pay for his care and his travel both. That kind of accountability is hard to provide in a national system with 325 million patients, as indeed the U.S. experience with both Medicare and Medicaid has made abundantly clear. The Swiss system, which the architects of the Affordable Care Act attempted partly to replicate, relies exclusively on private insurance, and it emphasizes cross-jurisdictional competition, consumer choice, and individual responsibility. There is no single-payer system in Germany or France. Germany, in fact, is rated by the Euro Health Index as having the most consumer-driven system in Europe.
If the goal is to increase Americans’ access to high-quality health care and to minimize the financial risk and uncertainty associated with the American system — both worthy goals — then instituting a political monopoly and abolishing private insurance is not the most obvious plan of action. If the goal is to prove that you are more radical than Joe Biden — and more anti-Trump than Starbucks founder Howard Schultz — then monopolies and authoritarianism are just the thing.
Much the same thing applies to Democratic radicalism on taxes: The politics of vendetta produce results at odds with the goal of raising revenue.
Representative Alexandria Ocasio-Cortez, who is — angels and ministers of grace defend us! — too young to run for president this time around, has hit upon the idea of raising tax rates to 70 percent on very high-income households: those earning $10 million and up.
But even assuming (unlikely as it is) no change in the economic behavior of high-earning Americans in response to such radically higher taxes, the Ocasio-Cortez proposal and others like it would raise, even according to friendly projections, only a trivial amount of money relative to the cost of their policy proposals. But as Vanessa Williamson (no relation) of the Brookings Institution makes clear, revenue is not the point. Revenge is. “The revenue question is the wrong question,” she writes:
Not because talking about revenue plays into a Republican strategy of deeply hypocritical deficit fear mongering — though it does. Not because extracting money from rich people is easy; there are serious technical questions about how to implement taxes on the very wealthy. The problem with using revenue to justify progressive taxation is that over time, an effective progressive tax system should actually raise less and less money.
Progressive taxation should work as a corrective tax, like tobacco taxes or a carbon tax. . . . Taxes on the wealthy discourage a different societal ill: exploitative capitalism. Progressive tax policy is a powerful corrective to economic inequality and wealth concentration.
Which is to say: The current progressive conception of justice holds that making the wealthy less wealthy is morally necessary and worthy even if doing so does nothing at all to make the poor more wealthy or to provide the government with additional revenue with which to offer services to those in need. Wealth itself is to be understood as a sinful vice, like smoking, to be punished and if possible reduced through vengeful taxation.
Understood from that point of view, Senator Sanders’s proposed 77 percent tax on the estates of wealthy Americans and Senator Warren’s proposal to impose a 2 percent net-worth tax on similar households make more sense: Senator Sanders’s proposal would raise less than 1 percent of what he wants to spend on a single new health-care entitlement, but it would inconvenience a few billionaires and rob them of the opportunity to take their families from shirtsleeves to shirtsleeves at some Monaco baccarat table.
It is notable that Senator Harris is also campaigning for a very large tax cut: nearly $3 trillion in savings for Americans earning incomes into the six figures but short of Mark Zuckerberg money. Her plan would add mightily to the deficit but, unlike most of what the Democrats are talking about, it has a good chance of making its way through a partly or wholly Republican-controlled Congress without too many bumps and scratches. Naked malice and venom may get you through the primary, but a middle-class tax cut is the way to a second term.
The Democrats are setting themselves up for disappointment in 2020. They believe that the answer to a glowering and polarizing figure such as Donald Trump is an equally divisive figure — and agenda — of their own. Howard Schultz already knows that he cannot run in his own party, even though Senator Sanders — who is not a member of the Democratic party — can. Former New York mayor Michael Bloomberg, the most experienced and reasonable of the likely Democratic contenders — and the one with by far the best actual record in office — already is being denounced as just another rich old white man who is a part of the problem more than of the solution. The proverb holds that revenge is a dish best served cold, but the Democrats are going into the primary season hot, hot, hot.