Climate, voting rights are now more important than Medicare
When Bill Clinton became president, his top legislative priority was health care. When Barack Obama became president, he first had to prevent a depression, but then he too turned to health care.
The next Democratic president should choose a different priority.
Too many Americans still suffer from inadequate or expensive insurance coverage, and the next president should certainly look to make progress on health care. But realistically, presidents have to pick one or two sweeping bills to try to push through Congress in their first year.
And the both moral and political case for some other issues is now stronger than it is for health care.
The next president can save more lives and better improve human health by slowing climate change than by improving health insurance.
The wounded state of American democracy is also more pressing. If it doesn’t get fixed, any expansion of health insurance could be reversed in a few years anyway. If the political system can be shored up — by guaranteeing voting rights, regulating campaign donations, among other things — every other national problem will become easier to address.
Unfortunately, at every one of the six debates so far, Medicare has dominated most of the first halfhour, when the viewing audience is typically largest. In total, the candidates have spent more time talking about Medicare onstage than on climate change, voting rights and tax policy, combined.
The good news: Some candidates are also frustrated by the Medicare preoccupation. At a campaign stop in Iowa last week, Elizabeth Warren asked reporters if any of them wanted to ask her about education. (She could have added: Research suggests that expanding pre-K and college may do more to improve people’s health than expanding health insurance.)
Obama’s presidency shows why the choice of priorities matters so much. He rightly insisted on not only dealing with the financial crisis, but also health care and the climate. As a first priority, Obama picked health care.
Health care became Obama’s signature accomplishment, extending coverage to some 20 million Americans. Climate was arguably his biggest disappointment. The country can’t afford to overlook climate policy again.
The next president can reasonably expect to have time for two big early priorities (barring another financial crisis). Even without health care — and even if the Democrats retake the Senate, a precondition for almost any ambitious bill — the decision would not be easy.
Michael Linden, who runs the Groundwork Collaborative, a Washington group that advocates for a fairer economy, suggests what seems right to me: One priority should be democratic reform, like voting rights. The other should be a major economic bill that increases taxes on the wealthy and spends the money helping the middle-class and poor and promoting economic growth.
This second bill would include funding for clean energy, as well as limits on pollution. Depending on the politics, it might make sense to call the bill a Green New Deal.
What should the next president do on health care? Start by looking for concrete ways to expand insurance access and reduce costs, through narrower legislation or executive action. Many of these ideas — on prescription drugs, for example — are enormously popular, polls show. A radical transformation, however, is not.
Popularity isn’t everything, of course, and I understand why the next president may still want to go for radical transformation. It just doesn’t deserve to go at the front of the line. Health care should not be the only area where Democratic presidents are willing to spend political capital.