Medicare For All — The Democratic Party Audition for 2020

 Bernie Sanders' November 2016 aggregate approval rating. Net favorable: +18%  Hillary Clinton's November 2016 aggregate approval rating. Net favorable: –15%Donald Trump's November 2016 aggregate approval rating. Net favorable: –17%by Thomas NeuburgerThe next two years will present multiple tests of the soul of the Democratic Party, just as have the last 10 years. But two of those tests have "high profile" written all over them. The outcome of these tests could determine the Party's future, and consequently the nation's, in the 2020 presidential election. One test is the Green New Deal. The other is Medicare For All. Both are mere proposals for now, and neither is as well defined as it needs to be in order to become law. But that day is coming for both, and the first time either comes before the House as an bill, the soul of the Democratic Party will be tried and judged, in full public view, with the bright 2020 klieg lights fully upon them. How will the Democratic Party, in the aggregate, respond when those bills present Party leaders with a moment of decision — to support or not to support; to sabotage in secret or to show their approval in plain sight and by their actions?The Party "In the Aggregate" A note about the meaning of "in the aggregate": Yes, there are many forces and factions within and around the Democratic Party and its ecosystem, and many voices offering different directions to go. Similarly, there may have been many voices in the wheelhouse of the Titanic as well, with factions offering different decisions to consider.But in the end, one decision was taken, the ship "in the aggregate" stayed its course, and "in the aggregate" it sank to the ocean floor.It make no difference, in the end, if a small group of senators is opposed to flash-confirming Trump nominees, for example, while Chuck Schumer and his leadership faction act otherwise. The Party "in the aggregate" confirmed those nominees. That's what the public sees; that's what the public bases its opinions on.Three Questions With respect to the issues identified above — Green New Deal, Medicare For All — the outcome will be determined by answers to the following questions:A. Will progressives by then have taken control of the Party, or will current anti-progressive leaders still be in charge? B. Will current Party leaders keep control but "see the light," thus joining with progressives and the electorate in supporting the strongest possible versions of these bills? C. Or will money-corrupted leaders controlling the Party dig in their well-funded heels and fight instead to defend the donor class and its destructive privileges? If either of the first two answers is yes, the Party's 2020 presidential chances look bright. But if both of the first two answers is no and the last answer is yes, the odds are at least even that a faux-change Republican will win or keep the White House.2016: The Past as Prologue Consider: The 2016 presidential election should have been a blowout, and Democrats, in their wisdom, turned it into a squeaker by nominating an uninspiring status quo candidate in a change (actually, pre-revolutionary) year. Democrats have now taken the House. 2020 will certainly be another change election — and another pre-revolutionary year — unless things come completely apart first. The Party's aggregate behavior (meaning, its actions as directed by whoever is in charge) will serve as a two-year audition for the trust of the American people.In that sense, the 2020 campaign has already begun, and Democrats, especially but not exclusively in the House, are giving an early and important audition for the role of savior of the nation.  If the Party (in the aggregate) continues to show that its first loyalty is to the donor class — Bernie Sanders' now famous "billionaires" — its voting base will be reduced to Party loyalists, the 25% shown in the graphic below, and any status quo or suspicious-but-progressive-sounding candidate will attract only the "never Trump" or "never Republicans" portion of the larger independent-voter pile. Almost half of the American public identifies with neither party, and a great many dislike bothThis is what happened in 2016. The Party, with Clinton as its candidate, turned a sure thing into a squeaker. Bernie Sanders, a genuine change candidate, would have wiped the floor with Trump, a pretender at best.Note the 2016 election-day approval and disapproval ratings at the top:

  • Clinton, –15% approval
  • Trump, –17% approval
  • Sanders, +15% approval

The race between Clinton and Trump was close, and Donald Trump won. It's easy to see the past as prologue, unless Democrats (in the aggregate) act differently. The "Medicare For All" Test of the Democratic PartyLet's look at Medicare For All (we'll turn to the Green New Deal separately). Early indicators of the shape of the Medicare For All battle are not promising, despite nominal support from otherwise weakly progressive or pro-corporate Democrats. I'm especially troubled by the implications of these recent stories.First this, about congressional "call time," the practice of "dialing for dollars" by calling members of the donor class for cash. Every such call is an implicit contract: You support me with dollars; I'll support you with votes.

For most members, fundraising is becoming an ever-steeper hill to climb. Incumbents in the House and Senate raised $486 million in 2000. By 2016 that number had nearly doubled to $909 million — far outpacing inflation. Members don’t have to report how much time they spend on fundraising, but leaks to the press have indicated that the parties expect new members to budget four hours a day of call time, plus an hour a day for fundraisers, which can be anything from a breakfast to a cocktail hour to a pass-the-hat potluck to a $1,000-a-plate gala dinner.“Both parties have told newly elected members of the Congress that they should spend 30 hours a week in the Republican and Democratic call centers across the street from the Congress, dialing for dollars,” Rick Nolan, a Minnesota Democrat who retired from Congress this year, said recently, adding: “The simple fact is, our entire legislative schedule is set around fundraising.”

This is a vastly undercovered story, because its so obviously embarrassing, and there are too few public rebels, like Ocasio-Cortez, against "call time." How many others like her will there be? Enough to change the grip on Congress of the money that buys its members?When the day to be bold arrives, will the donors who finance elections call in their chips and sink Medicare For All? Based on the following story, I'm convinced they will:

Chamber of Commerce CEO vows to 'use all our resources' to fight single-payer proposalsThomas Donohue, the president and CEO of the Chamber of Commerce, on Thursday vowed to use all of the Chamber's resources to fight single-payer health care proposals. ... "We'll use all our resources to make sure that we're careful there," he said, though his previously released prepared remarks had said the Chamber would use all of its resources to "combat it."

The billionaire industries that benefit financially from our destructive status quo health system are not going to go without a fight. Medicare For All represents an existential threat, and they recognize that. Finally, will their corrupting influence extend to Democratic members of Congress? Based on the following, it already has:

Wow. This letter to Congress opposing Medicare price negotiation claims to be from "224 patient organizations," but the majority of signers don't represent patients at all.The US Chamber of Commerce?Biotechnology Innovation Organization?Third Way?What is going on here? pic.twitter.com/iK4tQjBawx— Public Citizen (@Public_Citizen) January 18, 2019

When Medicare For All becomes a bill, the fight will be a cage match with the bright lights on. What will the Democratic Party (in the aggregate) do in response? Will it support, whole-heartedly and by its actions, the health and welfare of the American people, or continue the abuse of the American people by supporting those who extract wealth from suffering? I'd love to be wrong, but I fear the Party (in the aggregate) is almost certain to blow it. If it does, the public is certain to notice. Which means the nation's last hope lies with Party rebels, perhaps Bernie Sanders, perhaps this guy, to make another insurgency run for the nomination, save the Party from itself, and save the nation from the predators who currently run it.Unfortunately, the last time that happened, the Party made sure the insurgent never had a chance.