The Actual Pauline Kael Quote—Not As Bad, and Worse

Amid an overly complex process designed to compel Republicans to make good on seven years of campaign promises, the Senate GOP conference cleverly forced their Democratic colleagues to share some of the pain. Republican Senator Steve Daines put to the floor an amendment to implement a Medicare-for-all system in the United States, using the same language as a bill sponsored in the House by Democratic Rep. John Conyers. The amendment drew precisely zero votes in its favor. Fifty-seven Senators voted against it, including Democrat-caucusing Senators Joe Manchin, Joe Donnelly, Jon Tester, Heidi Heitkamp, and Angus King.

Democratic Minority Leader Chuck Schumer called Daines’s maneuver “pure cynicism” and accused him of wanting only “to get Democrats on the record,” which he achieved. “I suspect that what Senator Daines is doing is nothing more than an old political trick,” said self-described socialist and nationalized health-care proponent Bernie Sanders, “trying to embarrass Democrats.” How would voting for Conyers’s language “embarrass Democrats,” you ask? For the answer, we look to Senate novice and 2020 presidential prospect, California Senator Kamala Harris.

“I intend to co-sponsor the Medicare-for-all bill because it’s just the right thing to do,” Harris told Democrats at a town hall this week. She insisted that her support for Senator Sanders’s radical bill was rooted in prudence and frugality. “Taxpayers,” she insisted, “are paying huge amounts of money” for emergency-room care. A Medicare-for-all system would generate “a return on investment for taxpayers.” This is, to be gentle, nonsense.

When Vermont’s favorite collectivist was hawking the dream of the 20th-century left, he estimated that his single-payer plan would cost the country $13.8 trillion dollars—with a “T”—over ten years. This was exceedingly charitable. The nonpartisan Urban Institute pegged the cost of a Medicare-for-all system in America at $32 trillion in the same period, requiring an average tax hike on all Americans of $24,000 annually (to say nothing of the billions in lost economic activity as Americans tighten their belts).

ObamaCare also had to lie its way into becoming law, but the lie was an order of magnitude more modest. When Democrats pitched the public on the ACA, the “cost” estimated to taxpayers was supposedly just $848 billion over ten years after implementation, but the Congressional Budget Office insisted that the actual figure was just over $2 trillion. That’s an incredible strain on the nation’s budget, but it pales in comparison to the galactic numbers Senator Harris and her ilk heave about recklessly. She is playing to the cheap seats, but it’s telling that her instinct is to pitch a single-payer plan by insisting it is an attack on, not an endorsement of, profligacy.

Even in Harris’s home state, the Democratic Party’s infatuation with the idea of socialized health care was crushed against the immovable object of fiscal realities. In June, the state legislature tried and failed to pass a state-level single-payer system. As Democratic Assembly Speaker Anthony Rendon wrote, a peek under the hood revealed that, under all the gauzy rhetoric about access to taxpayer-funded health-care coverage representing a human right, there is no feasible way to make that a reality. The bill could not address the hurdles associated with cost control, delivery of care, and how to finance the thing. The Assembly bill was estimated to cost the state approximately $400 billion every year, more than double California’s total annual budget.

While Harris may advance her own political prospects in the long-term, the immediate future now looks confused for Democrats. The opposition party has spent the last month cheering ObamaCare’s resurrection. Republicans have laid siege to the law for the better part of a decade and their every assault has been repulsed. They are in retreat. Moreover, the myriad gaps in the law are, we’re told, filled at last. Every county that lacked an ObamaCare insurer will have one in 2018 (even it if it’s only one).

So as Democrats are celebrating the success and even permanence of the Affordable Care Act, Harris is insisting that the system is broken. Whether the press demands it of Democrats or not, the party’s liberal grassroots activists will ensure that every Democrat seeking office in 2018 and 2020 will say whether they agree with this assertion or not. Is Barack Obama’s health-care reform law a triumph of progressive public policy? Or is it, as Republicans have long insisted, a poorly-conceived measure with more adverse than positive effects?

That’s where Senator Daines’s gimmick becomes a trap. Republicans don’t want to be ObamaCare’s defenders, and conservative reformers are right to resent the party’s ignoble retreat on health care. But Republicans may soon have to defend a suboptimal status quo from an unpopular liberal campaign to nationalize the health-care system. A defensive crouch is a comfortable and familiar position for the GOP.

Democrats have convinced themselves that the rising popularity of Medicare-for-all among Democrats amounts to a national wellspring of new faith in progressivism and, by extension, themselves. They’re welcome to test that proposition at the ballot box. But, first, Democrats may want to rethink their messenger.