Medicare for All should be more like Medicare

A floor for health care, not a ceiling

A medical worker assists a senior patient while walking in a hospital corridor. (Photo by Maskot via Getty Images)

Yesterday, I mentioned Abdul El-Sayed’s updated messaging on Medicare for All as a promising example of him trying to win over moderate voters. This is also the issue on which I think it makes the most sense for moderate Democrats to broadly embrace what the leftists are saying. But coming together around Medicare for All also means thinking more seriously about what Medicare for All means because you have to go from a slogan to an actual program.

Yesterday’s post was free for all to read, but today’s is for paid subscribers.

---

“Medicare for All” is an appealing slogan for two related reasons.

One is that “Medicare” is the name of a program that exists and is already widely used and popular. Taking a popular and widely used thing and giving it to everyone has a kind of obvious appeal that’s lacking in many proposals for sweeping change.

The other is that while most people disagree with most of the values and worldview of secular cosmopolitan liberals, on health care specifically the mass public’s high-level ideological view is basically aligned with progressives’.

Health policy involves a lot of fussy details, and there are plenty of more specific left-wing policy ideas that may be unworkable or at odds with public opinion. But voters fundamentally reject the idea that whether or not sick people get care (or healthy people get preventative treatment) should be left up to the market or depend on ability to pay.

This broad principle, though, greatly under-determines what the policy should actually look like. In the real world, we can’t actually provide unlimited quantities of free on-demand health-care services to everybody, and the fact that this is an appealing moral vision doesn’t change the fact that we can’t do it.

So the question becomes how to instantiate these values in a way that is workable.

Different countries have come up with different answers, and to the extent that the specific proposal that American leftists call “Medicare for All” looks like any of those models, it seems derived from the health-care system of Canada. But going back to the fact that part of the appeal of the slogan is that people are in favor of Medicare, the actually existing health program for senior citizens, it would be smarter for “Medicare for All” to look a lot more like American Medicare.