Today is Giving Tuesday—and any gift you give will be doubled

Bernie Sanders Schools Ted Cruz on Why We Need “Medicare for All”

CNN’s Obamacare debate opened up fundamental questions that Republicans would rather avoid--like how to make healthcare access universal.

Theo Anderson

Bernie Sanders and Ted Cruz debate the repeal of the Affordable Care Act at a CNN debate on Tuesday, Feb. 7, 2017.

About halfway through CNN’s Tues­day evening debate between Sen­a­tors Bernie Sanders and Ted Cruz, Sanders tried to pin Cruz down on a fun­da­men­tal ques­tion: Is health­care a right?

Republicans have all the power, but no plan. The Sanders wing of the Democratic Party has a plan but no power.

Cruz cir­cled around the ques­tion, talk­ing about rights as pro­tec­tions from gov­ern­ment over­reach. The right to guns came up, nat­u­ral­ly, and he got near­ly misty eyed talk­ing about the right to pur­sue life, lib­er­ty, and hap­pi­ness. What he believed in, Cruz said, was the right to access to health­care. Sanders pounced. If you can’t afford health­care, he said, Access doesn’t mean a damn thing.” It was the most clar­i­fy­ing exchange of the dif­fer­ences between two men at the far poles of U.S. politics.

CNN billed the top­ic of the debate at the future of the Afford­able Care Act, but it wasn’t real­ly that. Sanders was cast in the role of defend­ing the ACA, which he did duti­ful­ly but half-heart­ed­ly, when he wasn’t pulling the dis­cus­sion to what he real­ly want­ed to talk about: the need for a a sim­ple,” Medicare-for-all sys­tem, which was a major part of his plat­form as a can­di­date, and which he asked the audi­ence to please join me and fight for.”

What we are look­ing at is a dys­func­tion­al sys­tem,” he said at one point, while acknowl­edg­ing that Oba­macare had increased access to health­care for about 20 mil­lion peo­ple. But there was no escap­ing the fun­da­men­tal ques­tion of those — 28 mil­lion or so — who remain unin­sured. Every sin­gle year,” he said, tens of thou­sands of our fel­low Amer­i­cans die because they [lack insur­ance and] don’t go to the doc­tor when they should.”

For the GOP, the debate rep­re­sent­ed a last hur­rah of sorts: the chance to offer a cri­tique of all the ways that Oba­macare has come up short, with­out any respon­si­bil­i­ty for cre­at­ing viable alter­na­tives. It summed up, in oth­er words, eight years of mag­i­cal think­ing about how Oba­macare had ruined the best health­care sys­tem” in the world.

The mag­i­cal think­ing is about to crash about against some cold, hard realities.

One is that there is actu­al­ly very lit­tle appetite for an imme­di­ate repeal of the law with­out a replace­ment. A Kaiser Fam­i­ly Foun­da­tion sur­vey in Jan­u­ary found that only 20 per­cent favored that option, while 75 per­cent want­ed no repeal, or want­ed the GOP to have a plan in place first. Anoth­er is that there is no plan. Recent­ly leaked audio of a Repub­li­can retreat found that, for all their blus­ter, Repub­li­can lead­ers are divid­ed and con­fused on how to pro­ceed with Oba­macare repeal. In Tuesday’s debate, Cruz rehashed some GOP favorites, like allow­ing insur­ance com­pa­nies to sell across state lines and pro­mot­ing health sav­ings accounts. And he seemed to think that sim­ply repeat­ing the word empow­er” would make it mean some­thing. Even Repub­li­cans, appar­ent­ly, aren’t per­suad­ed that any of it amounts to much of a plan.

If they lack a path for­ward, though, Repub­li­cans did get some word­smithing from the GOP strate­gist Frank Luntz, who sug­gest­ed that they call what­ev­er they come up with repair.” That smoke and mir­rors will like­ly be lit­tle com­fort to their vot­ers, who stand to lose the most from Oba­macare repeal. Kaiser found that, of the 11.5 mil­lion peo­ple who bought insur­ance through the Afford­able Care Act, well over half — 6.3 mil­lion — live in GOP-con­trolled House dis­tricts. Repeal and repair” is also most like­ly to hurt rur­al, elder­ly peo­ple — in oth­er words, Don­ald Trump’s base. 

In his ear­ly remarks, Cruz not­ed that there’s an urgency to hon­or the promis­es we’ve made.” That’s not exact­ly true, since the only promise the GOP has made is to repeal Oba­macare, and only 20 per­cent of the pop­u­la­tion seems to feel there’s any urgency about it.

Nonethe­less, this debate promis­es to be — as it has so often been in U.S. pol­i­tics — a defin­ing theme of the com­ing months, con­sum­ing much of the first year, or more, of the Trump admin­is­tra­tion, as it did for Bill Clin­ton and Barack Oba­ma. Repub­li­cans have all the pow­er, but no plan. The Sanders wing of the Demo­c­ra­t­ic Par­ty has a plan but no pow­er. And yet: There is hope in the fact that this debate tends to force fun­da­men­tal ques­tions, like whether health­care is a basic right.

If Repub­li­cans found their path back to pow­er in part by stand­ing fierce­ly in oppo­si­tion to Oba­macare, Democ­rats might find a path back by, as Sanders did on Tues­day, defend­ing what it has accom­plished and simul­ta­ne­ous­ly mak­ing the case for mov­ing beyond it. Trump has insist­ed that the GOP’s replace­ment plan will have insur­ance for every­body.” As with every­thing Trump says, there’s no way to know what that means to him, if it means any­thing at all. Even so, it’s on the record, and it’s at least an implic­it acknowl­edge­ment that health­care is a human right. Democ­rats must insist on that stan­dard and must hold him to it. 

Theo Ander­son is an In These Times con­tribut­ing writer. He has a Ph.D. in mod­ern U.S. his­to­ry from Yale and writes on the intel­lec­tu­al and reli­gious his­to­ry of con­ser­vatism and pro­gres­sivism in the Unit­ed States. Fol­low him on Twit­ter @Theoanderson7.
Subscribe and Save 66%

Less than $1.67 an issue