“The fact is, we have the Affordable Care Act,” Clinton said. “There are things we can do to improve it, but to tear it up and start over again, pushing our country back into that kind of a contentious debate, I think is the wrong direction.”
The nation has not recovered from the last big health-care reform debate. But Sanders dismissed Clinton’s call for practicality. Medicare for all, he insisted, is “the rational way to go forward.” Since that is the case, the only thing keeping the country from embracing his plan, he argued, is “a campaign finance system that is corrupt,” “super PACs” and health-care industry lobbying. Sanders did not appear to consider the possibility that, even with campaign finance reform that reduces the influence of big money, a great many lawmakers might still oppose him, whether because they don’t believe in the European model, they don’t believe that Sanders’s version of the European model would deliver on his unbelievable promises or they don’t want to further strain the nation’s politics. He also did not explain what he would do on health care absent a major campaign finance overhaul that would enable him to reshape the country.
Clinton stuck with her case for realism: “Even during the Affordable Care Act debate,” she said, “there was an opportunity to vote for what was called the public option. In other words, people could buy into Medicare, and even when the Democrats were in charge of the Congress, we couldn’t get the votes for that.”
“We have the Affordable Care Act,” she concluded. “Let’s make it work.”
Sanders’s all-purpose argument is to call for a “political revolution” that will vanquish the dark interests standing between the nation and his vision. His campaign is not about governing in the real world of trade-offs and constraints. Which is to say, it is not about governing at all. It is increasingly worrying that large numbers of Democrats appear to believe otherwise.