Elizabeth Warren has finally laid out a detailed plan for providing universal, government-funded health care to the entire country, a signature issue for her presidential campaign. That she has at last cleared up some of the questions of how she will pay for the program she’s been promising could help her quest for the Democratic nomination. Certainly the pledge to directly avoid tax hikes on the middle class while placing much of the $20.5 trillion cost on corporations and the ultra-wealthy will appeal to progressives.
But Warren’s plan may hurt her when it comes to competing with President Donald Trump if they face each other in 2020. Trump’s already running on a general election message on health care: Rather than gamble on a pricey universal fix, expand a part of the system that many people like — especially older voters in swing states, a group key to any 2020 victory. Warren’s massive disruption of the healthcare industry might delight her base, but what swing voters will hear is: If you like your current doctor or health plan, you most likely will not be able to keep it.
Beyond the political pitfalls, talking about universal health coverage plans won’t result in any immediate change, whereas Trump’s strategy can be adopted quickly.
And beyond the political pitfalls, talking about universal health coverage plans won’t result in any immediate change, whereas Trump’s strategy can be adopted quickly and easily (in fact, many elements are already available in the current open enrollment period). As a public health and military doctor, health care isn’t just a political talking point for me and my colleagues; inaction in Washington has real impacts on the patients we care for. (Full disclosure: I am a lifelong Democrat and voluntary, unpaid contributor to the health policy council of Warren’s chief rival, former Vice President Joe Biden; regardless, I will line up behind our eventual nominee).
Warren and her fellow progressive Democratic candidate, Bernie Sanders, argue for a “Medicare for All” health system that provides comprehensive services free of monthly premiums and copayments. At first blush, that sounds great to me — especially since so many of my patients are indigent and have to choose between medications and food to subsist.