So if the Democratic nominee is an advocate of M4A — as are Warren, Bernie Sanders and Kamala Harris (sort of) — will that doom his or her campaign, or even damage it significantly?
The answer is that it probably won’t. But there’s an important reason so many liberals — even many who would personally prefer a single-payer system — believe that it will. Liberals care deeply about policy. As a consequence, they often drastically overestimate the degree to which voters care about policy, or even grasp policy distinctions.
As a group (of course there are exceptions), conservatives are far less burdened by any concern for the nuts and bolts of governing. They just want to cut taxes, slash the safety net and increase military spending, and you don’t have to think too deeply about any of it to do all that. As a result, they have a much better understanding of what doesn’t matter in presidential campaigns.
Democratic issue positions tend to be more popular than Republican ones, often hugely more popular. Majorities of Americans prefer raising taxes on the wealthy, increasing the minimum wage, guaranteeing all Americans health coverage, taking action on climate change, keeping abortion legal and passing stricter gun laws, to name a few.
But ironically, this fact has in the past proved problematic for Democrats. As Michael Tomasky explained in 2004, while Democratic pollsters tell their candidate that they are winning on issues, the GOP candidate, knowing he can’t win on a simple issue comparison alone, makes the campaign about character, or about broad themes that transcend any particular issue. And it frequently works.
Try to recall a time when a single policy issue not only made a significant difference in the outcome of a presidential election, but it was because one candidate had a more popular position on it than the other. It certainly isn’t what got Donald Trump elected. Or Barack Obama, or George W. Bush, or Bill Clinton, or George H.W. Bush, or Ronald Reagan.
Sure, there were arguments about policy in those elections. But voters don’t keep a scorecard on which they tick off points of agreement and disagreement with both candidates, then total up the results to decide their vote.
To be clear, I’m not offering a brief for single payer in general, or Warren’s plan in particular. There are plenty of legitimate critiques you can make of M4A on substantive and political grounds. It’s also unquestionably true that a public option plan is, at the moment, anyway, more popular than an M4A plan. And it’s perfectly fine for the candidates to argue about the details of their plans during the primaries. Right now that’s what the candidates should be doing.
But that’s very different from saying, “This particular policy position taken by the candidate will be potentially fatal in a general election.” The truth is that presidential campaigns are fought on character and broad themes.
So what will happen if an M4A advocate such as Warren is the nominee? Her campaign will be about the corruption of the system, that wealthy and powerful individuals and corporations keep it in their grip to enhance their own wealth and power. Her proposal for health care will almost certainly be subsumed under that theme.
Trump, on the other hand, will claim that Warren wants to institute an oppressive big-government scheme that will destroy everything good about American health care. Which is exactly what he’ll say if Joe Biden or anyone else is the nominee. She will counter that Trump has been trying to take away people’s health care since the moment he took office. It will be an argument not between M4A and a public option, but between M4A and Trump’s position, which is that millions of people should be thrown off their coverage and protections for those with preexisting conditions should be revoked.
Who will win that argument? We don’t know yet. But the election will be determined by the contest of broad themes and character arguments, not by disagreements over policy details. As Mark Schmitt famously put it, “It’s not what you say about the issues, it’s what the issues say about you.”
If Warren is the nominee, voters will either decide she’s right about the corruption of the system and that she’s the one to do something about it, or they’ll decide that having Trump in office for four more years would be preferable.
So Democrats should consider acting a little more like Republicans. Instead of worrying that their preferred policy solutions will be unpopular, they should decide what they want to do, then run a campaign in which those positions — even if in isolation a couple of them may not be the most popular of positions — add up to a larger argument about the candidates, the country and the future. It’s the only thing that ever works.