PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

Karl Rove asked this question in a recent piece for the Wall Street Journal.

I answer yes based, at least in part, on some of the statistics Rove provides.

Now, I know some will question Rove’s perspective because, in the past, he was a political consultant who helped get George Bush get elected, then served in the White House. Frankly, that experience doesn’t bother me; I consider it to be a credential, though there is little question that he still operates right of center.

What does bother me is the rationale from the left – perhaps even the far left from those who favor socialism over capitalism – as they make a case for a fully government-run health care system.

I don’t favor such a government-run system based on my 25 years as a private sector lobbyist in Oregon, which included representing several private health care enterprises.

To come up with improved health care policy, I also favor a bi-cameral, bi-partisan process at the Capitol in Salem – a process that takes all sorts of good idea from the left and the right and molds those ideas into a consensus product from the middle.

In Washington, D.C. that has not happened to the discredit of both parties. The Affordable Health Care Act, one of President Obama’s major achievements, passed without one Republican vote. Then, to retaliate, Republicans spent several years trying to tear down the act. No one tried to improve overall health care policy from the middle.

In Oregon, I believe a solution from the middle is still possible, though this blog will focus on federal issues.

Here is a summary of the points Rove makes to raise questions about Medicare for All:

• Democratic presidential candidate Senator Kamala Harris made her party’s left-wing base happy this week. But in doing so, she might have made Democrats less attractive to general-election voters.  In a CNN town hall Monday, Harris endorsed “Medicare for All.” Pressed about whether the proposal would abolish private health insurance, the California senator breezily declared, “Let’s eliminate all of that. Let’s move on.” After Republicans jumped on her for this policy’s radicalism, a Harris adviser said the attacks were “good trouble” for her.

• A January 14 Kaiser Family Foundation poll seems at first glance to support that view. It found 56 per cent of Americans favor “a national health plan, sometimes called Medicare for All, where all Americans would get their insurance from a single government plan,” compared with 42 per cent who opposed the idea. Thirty-two percent strongly oppose it, roughly matching the 34 per cent who strongly favor it.
• Yet, these results come before this deeply flawed policy gets scrutinized and picked apart. Medicare for All becomes less popular when people hear more about its possible effects. Support dropped to 37 per cent, with about 60 per cent opposed, when respondents were told it would “eliminate private health-insurance companies” or “require most Americans to pay more in taxes.” Support fell to 32 per cent when respondents were alerted it would “threaten current Medicare.” And it crashed to 26 per cent if those polled heard it would lead to “delays in people getting some medical tests and treatments.”
• Names matter, too. A November 2017 Kaiser poll found that, without mentioning negative effects, “Medicare for All” drew a 62 per cent favorable rating. But labeling the same idea “single-payer health insurance” dropped support to 48 per cent. Calling it “socialized medicine” produced a nearly even split, 44 per cent favorable to 43 per cent negative.
• Medicare for everyone may sound good to voters at first. But after sustained reflection—and Republican attacks—it will likely be soundly rejected. Most Americans do not want to surrender control of their health-care decisions to an impersonal bureaucracy in Washington.
• Just wait until Republicans raise questions about how much single-payer health care will cost. In an analysis last summer, Charles Blahous of George Mason University’s Mercatus Center pegged its price tag at $32.6 trillion over the first decade. The total federal budget for this fiscal year is only $4.4 trillion.
• Congressional supporters of the plan fear that nearly doubling the federal budget could sink their proposal. That’s why Senator Bernie Sanders, the father of Medicare for All, refuses to say how much it will cost. One of the plan’s principal cheerleaders, Representative Alexandria Ocasio-Cortez, calls fiscal concerns “puzzling.” She told Jorge Ramos on Univision last November, “You just pay for it. We’re paying more now!” The following month, she tweeted that two-thirds of Medicare for All could be paid for by cutting wasteful Pentagon spending. The total Pentagon budget is about $700 billion.

In a column this morning, Wall Street Journal writer Holman Jenkins put his finger on one of the main notions from the left on Medicare for All – that, if it works for Scandinavia, it can work for us.

The problem, Jenkins contends, is that Scandinavian countries may have excellent medicine because they import innovations that wouldn’t be developed and proven if the U.S. weren’t developing them.  So there is free-riding in the Nordic system after all.  On us.

So, what is the future of Medicare for All?

The rush by Democrat presidential candidates to embrace free government-run health care — and measures like “free” college, guaranteed jobs and universal basic income—may make the 2020 election a contest between promise-them-anything Democrat socialism and free enterprise. The stakes don’t get much higher than that.

And, as for me, I vote for free enterprise.