Debate Preview: Medicare For All

The health care policy that excites their activist base--Medicare For All--happens to be unpopular. 

That's a second chance opportunity for Joe Biden.

Affable, sure. But can he fight?

In tonight's Democratic debate candidates will attempt to stand out and be noticed.

Pre-debate commentary uses phrases like "the knives will be out." TV commentators are doing what they do, hyping and promoting the event, but it isn't false advertising. Every Democratic candidate saw Kamala Harris a month ago. To get noticed it isn't enough to break into Spanish. You have to "draw blood."

Candidates are auditioning for the role of prize fighter and warrior. Who can stand up to Trump?

That means that tonight's debate over health care policy is going to be acrimonious. You don't get noticed by being civil and reasonable. You get noticed by showing indignant moral certainty.

"How dare you fail the American people!?" 

Facebook and other social media chatter already reveal the division within the Democratic electorate. The progressive left, dominated by Bernie Sanders supporters, but now including apostates who support Warren or Harris as potentially more electable alternatives to the pure classic Sanders, say Medicare For All is the only acceptable route to universal, affordable health care.

Click Kaiser Family Foundation poll

Within the activist left, the ACA was a cop out. It preserved a status quo. It was a payoff to drug and insurance companies.

The issue has become a litmus test of moral virtue and progressive bone fides. It is a perfect issue for a debate knife fight. 

The media wants a knife fight. The public will watch a knife fight. 
The candidates want a knife fight.
I predict we will get a knife fight.

 It is Biden's chance to prove he is the Democratic candidate who can beat Trump. He does it by beating the Medicare For All candidates.

His advantage comes from the fact that a great many people both understand there is a national health care problem but are, themselves, actually in pretty good position. These are the millions of people secure in Medicare; veterans happy with the VA; people with secure jobs with benefits; union members. 

These people personally happy-enough with their situation skew toward being older, more stable, more educated. They are high turnout voters. They are the people who liked hearing Barrack Obama say that if you liked the health care you have you can keep it. They are comfortable with building on the ACA rather than replacing it with Medicare For All. A majority of Democrats--55%--favor that.

With the question asked another way, and Democrats identified as liberal vs. centrist a Pew poll showed that 57% of liberal Democrats do favor a single national health care system. Among moderate Democrats only 33% favor a single-payer program.  CLICK: Pew  Biden has a clear shot at those moderate voters, the only major candidate in his lane.

Note that a Public Option is very different from Medicare For All, and that will be a likely dividing line in tonight's debate. Public Option means choice, and 87% of Democrats favor it, even as polls simultaneously show greater numbers for single payer.

This is an opportunity for Biden to define the issue in terms that favor him. He wants choice and choice is popular. 

Tonight's debate will rough up both sides. Democrats have experience advocating for "choice" via the abortion debate: our bodies, our decision. Republican attack ads are already airing describing Democrats as "Socialists" who confiscate your money and take away choice. 

Choice polls better than socialism.

Biden came across as tepid when he was attacked by Harris in the first debate.He gets a rematch, and he comes into it with a policy advantage. He has an opportunity tonight to defend--and attack--from the higher ground of the more broadly popular position. If he can do it, he will reposition himself as the solid frontrunner. 

Democrats should not expect a great number of Republican votes, but even in this partisan environment, there are moderate voters, and they want choices. 

The make or break question for Biden is whether or not he is any good at fighting for choice.