Would Medicare for All Be Immune to Republican Sabotage?

While I just wrote that Democrats should defend Obamacare in 2018, Kevin Drum explored the question of whether or not they should run on Medicare for All. He repeats something I’ve heard often in these kinds of discussions, but have never understood.

…if there is anything that Dems could credibly promise, my best guess is some version of universal health care. The basic pitch would be that they’ve learned their lesson: incremental change doesn’t work because Republicans will sabotage it the first chance they get.

It probably goes without saying, but the “incremental change” he’s referring to is Obamacare—which Trump has been determined to sabotage since Republican efforts to repeal it failed.

My first thought when I hear that argument is probably best captured by a video put out by Democrat Jacky Rosen, who is running against Republican Sen. Dean Heller in Nevada.

There are lives that have literally been saved by Obamacare (not to mention those who received care for illnesses that weren’t life-threatening). These people might take exception to the idea that incremental change doesn’t work.

But my bigger question regarding that argument has to do with something not stated outright but obviously assumed. It takes for granted that Republicans wouldn’t attempt to sabotage Medicare for All. That makes no sense to me.

Even the most progressive Democrats in Congress have taken the position that a transition from the status quo to Medicare for All would have to be phased in over time. That would create a fair amount of upheaval—much more than Obamacare—which Republicans would be guaranteed to exploit.

Beyond that, Medicaid was established over 50 years ago and, to this day, Republicans continue their efforts to sabotage the program. The same can be said for their attempts to destroy Medicare as we know it via privatization. It is true that as those programs became more established, the Republican attempts to sabotage them have become less successful. But we’re about to face yet another major assault on both of them in 2018.

This is not an argument against Medicare for All. There are certainly proposals on getting to universal coverage via some expansion of public programs that would greatly improve on what has been accomplished via Obamacare. My point is simply that this particular argument that bigger changes would be less vulnerable to Republican sabotage strikes me as at odds with both logic and reality. Am I missing something?

Nancy LeTourneau

Nancy LeTourneau is a contributing writer for the Washington Monthly. Follow her on Twitter @Smartypants60 .