Earlier this week, Andy Slavitt, a former administrator of the Centers for Medicare and Medicaid Services under President Barack Obama, launched the “nonpartisan, non-profit” United States of Care. According to its website, the organization seeks to “build and mobilize a movement to achieve long-lasting solutions that make health care better for everyone.” How are we going to get there? By putting “healthcare over politics.”
It's a little surprising, then, that the organization's board of directors includes so many prominent politicians. In addition to Slavitt, there are former governors Steve Bashear (D-KY) and Jim Douglas of Vermont (R-VT), along with erstwhile United States senators Dave Durenberger (R-MN) and Bill Frist (R-TN). During his four years as Senate majority leader, one of Frist's major initiatives was the privatization of Medicare.
It should go without saying that "healthcare over politics” is a platitude, one reminiscent of the now-irrelevant and soon-to-be-forgotten "No Labels” movement. These groups are not nonpartisan but bipartisan, and their goals and solutions are driven as much by ideology as those who push for single-player on the left. As the last 10 years have made abundantly clear, health care is politics, and pretending otherwise is its own form of political choice.
The United States of Care website doesn’t mention any of this. Instead it promises to provide “affordable care” rather than free care, “protection from financial devastation" and “political and economic viability.” By this, it means that health care must be “fiscally responsible and win the political support needed to ensure long-term stability.”
Because of the fact that the language is vague in pretty much every way except on these last two points—that healthcare solutions must be politically feasible, an oft-heard criticism of single-payer from the center, and that they can’t be fiscally “irresponsible,” the usual charge against Medicare for All from the right—the assumption of many on the left is that the group’s intent is to head off the growing popularity of universal healthcare in favor of less radical, more consensus-driven solutions.
In addition, the participation of healthcare executives, as well as prominent Democrats like former Obama speechwriter and Pod Save America co-host Jon Favreau, has spurred charges that the nonprofit is an astroturf organization. (Favreau insists this is not the case, tweeting that he “he wouldn’t have joined the group if they were trying to derail single-payer.")
Because the group hasn't explicitly stated its objectives, and Slavitt’s own explanation on CNN has offered little in the way of clarity, it’s difficult to say for sure whether its critics are correct in their assumptions (although we can probably guess from Bill Frist’s involvement that single-payer is not on the group's to-do list). Whatever its ultimate mission, the United States of Care can still do plenty of good; there are many pressing healthcare needs right now, and Medicare for All is three years off in the best-case scenario.
Still, an organization focused on more immediate concerns should have a long-term vision for American healthcare. Even if we extend them the benefit of the doubt on single-payer, the way the organization is marketing itself reveals a fundamental misunderstanding of what people want from their coverage—specifically that it's available, affordable and as hassle-free as possible.
Part of the reason a majority of the public now supports single-payer is that tens of millions have been excluded from benefits of the Affordable Care Act. This isn't entirely the fault of Barack Obama—it was the Supreme Court, after all, that gave states the right to screw over their poorest residents—and he deserves credit for awakening the public to the notion that healthcare is a basic human right. But Democrats have failed to follow his goals through to their logical conclusion.
The party also misreads what people want from their politicians, but this is not a new problem: a 2012 study shows that Democrats thought voters in their district were considerably more conservative than they actually were. and just two since a septuagenarian socialist from Vermont pulled over 40 percent of Democratic primary voters, it's clear establishment officials are as divorced from their base as ever.
Even a cursory glance at the approval ratings of Congress or the president will tell you how dissatisfied the American people are with their government. That doesn’t mean they’re frustrated with the idea of politics as a concept, but the way ours operate—specifically their failure to improve people's material lives. And as long as the dominant strain in the Democratic Party continues to push for bipartisanship, even as the Republican Party drifts ever farther to the right, the Democrats will struggle to convince apathetic voters that they're worth voting for.
During the final year of his presidency, as Republicans refused even to grant Merrick Garland a hearing, Obama pleaded with them to treat the Supreme Court as an institution “above politics.” As with virtually all of his entreaties, the call fell on deaf ears, and the GOP suffered no consequences for its intransigence.
One year into the Trump administration, the pathology of the Democrats remains the same. Whether they call themselves bipartisan, nonpartisan or consensus-driven, they're still seeking compromise from a party that has no intention of reciprocating, even as millions of Americans are deprived a basic human right. And make no mistake, this is an inherently political act.
Ultimately, it's not enough to hide behind anodyne labels or banalities like "healthcare over politics". To achieve real change, to forge a better world, Democrats must do the difficult work of politics.