Matt Bruenig vs. Ezra Klein on Medicare for All
M4A and the left/liberal divide
If I were granted the ability to change one thing after living through this pandemic it would be the destruction of employer-sponsored healthcare. Unique to America, the system of obtaining your healthcare through your employer is illogical and evil. If you think about it for longer than a second, you intuit several contradictions.
Consider: maybe (god forbid) you get seriously sick with cancer, the chemo treatment for which prevents you from working regularly, and unfortunately your colleagues have run of out sick days to donate to you so you can keep your job (a perverse, not inspiring, story by the way). So you lose your job. Which means you also lose your health insurance…because you were too sick to work…but working is the only way to access health insurance….How does this make any sense? It’s a cruel, cruel system.
Consider another contradiction of private healthcare: health insurance companies, by their nature as private, profit-seeking corporations, are inherently motivated to deny you coverage. The only way they make money, their entire business model, the entire purpose of their existence is to PREVENT you from obtaining treatment, to not pay out for your medicines and surgeries and rehab. It is a sick irony. A company sells you health insurance while actively working to prevent you from using it.
Covid-19 is a horrible tragedy, obviously, but in the back of my head, at the beginning of the pandemic at least, I wondered about a silver lining: this kind of unprecedented global public health crisis might just be the one kind of spacetime-altering event required for us to rethink our broken system. Think about it: to defeat the virus businesses would have to close and people would inevitably lose their jobs. And since those jobs are the sole portal to healthcare, and healthcare is obviously the number one priority during a public health crisis, maybe the sins of the system would finally be reckoned with, I thought.
In my heart of hearts I genuinely thought that this might be a lesson we learn: tying healthcare to employment makes no sense when a global pandemic forces businesses to close and a forced recession causes millions to lose their jobs and employer-sponsored healthcare.
Hope! The argument for decoupling employment and healthcare was making itself, and in addition Bernie Sanders was running for president on exactly the same idea: Medicare For All, not just Americans over 65. But we all know what happened. Despite all this, we have learned no such lesson, and Bernie was defeated. Joe Biden is on record, in the middle of a global pandemic, saying he would veto M4A if it got to his desk. I’m less hopeful than ever. If M4A couldn’t gain purchase during a global pandemic, then when?
Single payer, government healthcare, socialized medicine, Medicare For All, whatever you want to call it — the idea of removing healthcare from the private market mechanism, of changing the goal of healthcare from seeking profits to improving health outcomes, that’s long been the litmus test for me on politicians. If you don’t support M4A then I don’t support you, simple as that. There’s a ton of deliberate obfuscation, bad faith arguments, and straight lies about this issue, particularly in the center/center-left wonk world of politics, which tries so hard to convince us that M4A is impossible. Don’t believe it. They’re lying.
I believe this litmus test, the question of public vs. private healthcare, is a simple, useful method for teasing apart the growing left/liberal split. There is a podcast episode from the Ezra Klein Show that aired in August of 2019 in which he interviews and debates leftist Matt Bruenig on the question of Medicare For All. Although at times a bit wonky, this podcast episode is a true Rosetta Stone for explaining the liberal/left divide. Klein, a standard center-left technocrat who endorsed Elizabeth Warren for president, offers the typical arguments we’re used to hearing about M4A: it’s expensive, it eliminates “choice,” it’s impractical, it won’t even pass congress. Bruenig, meanwhile, provides the simplest, most convincing case for M4A as the superior policy I’ve heard. I hope you’ll listen:
