Election campaigns vet candidates, but they also vet ideas. In the case of Medicare-for-all, it is hard to think of an idea that one or more major candidates have advanced in a primary that has fared worse. And the more facts that come in, the worse it fares.

Politico reported recently:

Initial research from University of Massachusetts economists who have consulted with multiple 2020 campaigns has estimated that 1.8 million health care jobs nationwide would no longer be needed if Medicare-for-all became law, upending health insurance companies and thousands of middle class workers whose jobs largely deal with them, including insurance brokers, medical billing workers and other administrative employees. One widely cited study published in the New England Journal of Medicine estimated that administration accounted for nearly a third of the U.S.’ health care expenses.

Uh-oh. It seems that “health care workers are interwoven throughout the economy, employed by large institutions like hospitals, health insurance companies and nursing homes but also in places like small accounting firms that help clinicians get reimbursed for care, and as independent brokers who help sell insurance products to customers.”

This does not even account for job losses among medical providers (e.g., doctors, nurses, technicians) who will be squeezed by reimbursement rates lower than what private health insurance has provided.

Seizing on this news, Joe Biden’s deputy campaign manager Kate Bedingfield put out a written statement wthat read, in part: “The Medicare-for-all plans that Senators Warren and Sanders are proposing will not only cost 160 million Americans their private health coverage and force tax increases on the middle class, but it would also kill almost 2 million jobs — and that’s according to one of Sen. Warren’s own policy advisers.” Moving to the heart of the electability issue, Bedingfield argues, “Simply put, we’re not going to beat Donald Trump next year with double talk on health care. And we’re certainly not going to beat him by trying to kill millions of jobs in communities around our country.”

Warren’s cavalier response to the issue, namely that health-insurance workers would find invisible jobs in other insurance industries, is nonsensical. It is ironic that Warren and others would enact all sorts of trade protections to insulate American workers from disruption but think nothing of enacting their own plans that would be equally if not more painful for American workers. This is what comes of thinking of problems as Bad Guys (e.g., Big Insurance Companies, Big Pharma) vs. Good Guys. In fact “Bad Guys” employ millions of ordinary Americans and help maintain, for example, some rural hospitals that could not survive on government reimbursement rates. Those hospitals in turn provide the backbone of the economy in small towns and rural communities throughout the country.

Health care (both insurance and its delivery system) is complicated and expensive. Dramatic changes will have dramatic unintended consequences. That is not an excuse for doing nothing. It is, however, a powerful argument for building on what works, not frightening millions of Americans, and proceeding with caution and humility. Moderates would be wise to apply this lesson beyond health care to a range of issues. Sometimes less really is more.

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