What if you like your private insurance?

Susan Estrich — Syndicated Columnist
Monday, August 5, 2019

About 138 million Americans voted in the last presidential election.

Almost 220 million have private insurance.

“Medicare for All”? I can’t begin to imagine the bureaucracy.

Employer-based insurance is still the most popular; more than half of the population is covered by employer-based private plans. Jobs with benefits, my mother taught me as a kid — those were considered the good jobs. Even when you retired, good jobs with private insurance would provide for the huge gaps in Medicare.

Why in the world would we want to give up those benefits?

But my focus here, after watching Sen. Elizabeth Warren take on Mayor Pete Buttigieg on television, is not public policy. Warren, more than any other candidate, can hold her own in a public policy debate.

My focus is on winning the election.

Six in 10 Medicare recipients supplement Medicare with private insurance, either through retirement coverage provided by employers or by Medigap plans offered by private insurers. Among Medicare recipients, a group with the highest turnout records, those who have private supplemental insurance tend to be better educated and have higher income than other Medicare beneficiaries.

Likelihood of voting increases with age, education and income.

If the people on Medicare don’t want to give up their private insurance and they are among the demographic most likely to vote, is this policy plan the Democrats’ best path to the White House?

“Elizabeth Warren’s America.” I can just see the ads.

The endless lines at the ER, punctuated by someone dying while they wait.

The utter chaos at the border when illegal border crossings are decriminalized, as Warren has proposed.

Medicare for All. Open Borders. Free College.

How are you going to explain it in a general election?

None of these positions make it impossible to win Democratic primaries. The problem is that primary voters don’t decide general elections.

General elections are decided by people who probably don’t care enough about parties or politics to vote in a Democratic primary. They may not consider themselves Democrats. They may not be. They don’t love Trump, and they don’t hate Trump, and they’ve probably had enough with the shouting.

“Ordinary Americans,” the politicians call them. “The American People,” as if they speak for everyone. People who work hard and play by the rules. And vote.

People who worked hard to send their kids to college, or to go themselves.

People who earned the benefits they are now receiving.

People who want to know who is going to pay for Medicare for All and Free College, who is going to provide the social safety net for the desperate people flooding over the border.

The divisions in the Democratic Party run deep. It’s not so much ideological — although that is how it looks — as it is strategic and generational. When you’re 29, why wouldn’t you want to fight for the heart and soul of the Democratic Party? Especially if the so-called moderates are right about how likely it is Trump will win. If I were 25, I’d be going door to door for Warren. But I’m not. I lived through the ‘80s, when we Democrats lost three in a row, after which a moderate Southern governor seemed a perfect choice. I know that what Trump can do in the next four years won’t easily be undone in the next eight.

How about we start by helping the people who don’t have private insurance?

How about giving people who want Medicare a change to opt into?

How about putting winning first?