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Medicare Mania

This article is part of David Leonhardt’s newsletter. You can sign up here to receive it each weekday.

If you’ve watched the Democratic debates so far, you may have noticed a theme. The discussion, especially during the first hour, has focused on one issue: Medicare. That discussion has often felt repetitive, with Bernie Sanders and Elizabeth Warren arguing for one approach to expanding Medicare while the other candidates argue for a different approach.

Enough already.

It’s time for the 2020 campaign — both the media and the candidates — to broaden its focus. Health care policy (health insurance policy, to be more specific) is obviously an important issue, but it’s not more important than climate change, voting rights and tax policy. So far, though, health care has received more debate time than all of those other topics combined.

[Listen to “The Argument” podcast every Thursday morning, with Ross Douthat, Michelle Goldberg and David Leonhardt.]

My column this morning argues that Medicare should not be the No. 1 priority of the next president. Presidents must make choices, and they are far more likely to make progress on the issue that they decide to make their first or second legislative priority after taking office.

Both Bill Clinton and Barack Obama put health care policy at the front of the line, and the next Democratic president should not be the third consecutive one to make the same decision. Other issues — climate change, democratic reform and the unfair tax system, for example — all have a stronger moral and political case to go ahead of health care.

And it’s possible for the federal government to help people afford good health care without passing a sweeping bill that tries to transform the health care system. (Reducing prescription drug prices and helping more people buy into Medicare are two good examples.) If the next president still wants to go for a sweeping bill later, that’s fine, but she or he should at least accomplish some big, bold changes in another area first.

I hope you’ll read the column and leave comments if you have thoughts.

For more …

“Progressives should move beyond health care and focus on other holes in the U.S. safety net,” my colleague Paul Krugman wrote in 2017. “When you compare the U.S. social welfare system with those of other wealthy countries, what really stands out now is our neglect of children. Other countries provide new parents with extensive paid leave, provide high-quality, subsidized day care for children with working parents and make pre-K available to everyone or almost everyone; we do none of these things.”

Lily Batchelder and David Kamin of N.Y.U. Law School have reviewed the options for raising taxes on the rich.

“To win a national mandate for action” on climate change, Jay Inslee, the governor of Washington and former presidential candidate, has written in The Washington Post, “we must nominate a candidate who will deploy clean energy and cut carbon pollution on the ambitious scale required, even if it means deferring other worthy goals.”

“It is time to focus on renewing and modernizing our democracy to make it responsive to the people and not just to special interests,” John Kowal of the Brennan Center has written. “Progressives will always face obstacles in advancing their issues in a political system that elevates the voice of the few at the expense of the many — a system which perversely awards victories to the candidate who wins fewer votes and which makes the process of voting feel meaningless.”

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