Some of us are old enough to remember what Bill Clinton chose for his campaign theme song in 1992, and old enough to remember seeing Fleetwood Mac perform "Don't Stop" at the Inaugural Gala (playing together for the first time since 1982—no wonder many of us seeing it believed this new president could do remarkable things). The current Clinton campaign would do well to remember the role that optimism and hope played not just in electing Bill Clinton, but in electing Barack Obama when he ran against Hillary Clinton in 2008.
But we've had another week, another round of Very Serious People trashing the Bernie Sanders single-payer plan. It's worth remembering, however, that some of these very same wonks, pre-Obamacare, were quite excited by the concept of single-payer. For example, Ezra Klein, who really piled on to Sanders, wrote a survey of healthcare systems:
So let us, in these pages, shut out the political world for a moment . . . and ask, simply: What should be done? To help answer that question, we will examine the best health-care systems in the world: those of Canada, France, Great Britain, Germany, and the U.S. Veterans Health Administration (VHA).
That survey was so well-received, Paul Krugman put it on his class syllabus at Princeton. Another of Sanders detractors, Matt Yglesias, has been demanding more specifics, when in 2007, he reviewed various healthcare reform plans from both parties and concluded essentially that the principles behind the competing plans were more important than the details: "these proposals are vague in some key respects, and nothing that’s proposed on the campaign trail is going to be enacted as is by Congress. But these plans show something about the values and priorities of the different parties."
Yet now, what's essentially the outline of a plan—and yes, it is hugely ambitious and no, it's not realistically viable in the short term—is being treated as if it were a legislative proposal about to be dropped on Congress by a Sanders administration. It's still a campaign document. A statement of "values and priorities." It's not being analyzed as if we had "shut out the political world." But it deserves to be to the extent that some form of single-payer healthcare is going to be the answer for the United States, as it's proven to be in the rest of the developed world. As such, this attempt to shut down serious discussion of it in this election is doing a disservice not just to Sanders, but to future efforts to get us to a sustainable system.
I get it. All of us who've been so bruised and battered over the past seven years fighting first for the kludgey, incomplete, and often disappointing Affordable Care Act, and then fighting to just keep the damned thing alive are cynical. But healthcare reform is not done in this country. While incrementalism is going to have to be the short-term approach in making Obamacare more responsive to the still-existing problems—individual and systemic costs, and a still-unacceptable number of people uninsured—incrementalism is not going to solve them.
Okay, the barrier is Congress. What do you do about that? You get a new Congress. How do you do that? By electing them. This is what the Clinton campaign should be keeping in mind.
Admittedly, the political reality right now sucks. Totally. And with as many Republican governors and the House realistically set to stay not just Republican, but nihilistically extreme in its conservatism, the prospects for substantive, progressive health reform seem dim. We've learned a lot since 2008 about the Republican will to resist letting anything of benefit to the masses happen. But that realization is leading to a cynicism that's not just turning off a lot of base voters, but one that could damage real, substantive efforts for future reforms—reforms that Clinton herself sees as critical.
When the plans from Sanders and Clinton are viewed as statements of the "values and priorities" of the candidates, the one that's not cynical, that's not starting at a point of giving into Republican obstruction is a lot more inspirational. And inspiration is something you need to keep stoked in your base in an election.
You also need to keep inspiration stoked as you're governing. It would be pretty handy in upcoming elections to have a Democrat with the bully pulpit reminding voters—and all those people who should be voting—why they should be participating and why her side has better answers than the opposition. That job would be a lot easier with a strong statement of values like "universal healthcare means everyone, and affordable means affordable."
Looking at the political landscape of 2016, particularly the current implosion of the Republican party in the presidential race, it's not out of the question to see the possibility of substantial change. Imagine Donald Trump or Ted Cruz as the Republican standard-bearer. It could be as disastrous for Republicans as 1964 and Barry Goldwater. It could be bad enough that Democrats could pick up some House seats, some governorships and some state legislatures in 2018. It's just possible that the 2020 redistricting—which would coincide with the possible second term of a Clinton presidency—could result in a flipped House of Representatives.
Now, those are a lot of "ifs." But winning presidential campaigns need some "ifs" in the mix to provide the kind of enthusiasm it takes to make wave elections. It's not enough now to tell people that you understand their pain, that you'll get them health care and higher wages and better jobs eventually. You've got to at least act like you mean it, and that you're open to the things that will get us there.
Both Clinton and Sanders need us—the most committed, activist progressives and liberals it's got in the party. They both also need all those people who might be motivated to vote in a presidential year, but then drop out because they aren't seeing a serious commitment by elected officials to keep their promises, defend their positions, and blast the opposition party every time it obstructs. That's the political side—you've got to show people that there's a reason to vote for you, to volunteer for you, to fight for you.
This needs to happen because serious healthcare reform needs to happen. A beacon for what can be achieved needs to be maintained. I can't say it better than Social Security Works President Nancy Altman, who writes:
An incremental approach only works if one has a vision of where the incremental steps are leading. In a campaign, candidates present the ultimate goals, not a blueprint for incremental change. But to attack the ultimate goal as unrealistic, when incremental steps can get you there, is a disservice. It is a disservice to all of the millions of Americans who believe that high quality, affordable health care should be a right, not a privilege. It is a disservice to all those who want a more efficient health care system in order to have resources to spend on other pressing domestic needs. It is a disservice to those who see that a more efficient health care system will allow more compensation to be paid in the form of cash wages, as opposed to health insurance.
Claiming that such a noble, important and popular goal—Medicare for all—is unrealistic does not show pragmatism. Rather, it shows a lack of imagination.
We still need imagination, Secretary Clinton. We still need hope and we still need inspiration. Remember your 2008 theme song?
Don't stop thinking about tomorrow and don't stop believing. Too much is at stake.