If you’re an advocate of Medicare-for-all, it hasn’t been an easy couple of months.

A year and a half ago, it seemed as though everyone in the Democratic Party was suddenly embracing the idea, but lately things have changed. As pollsters began asking detailed questions about what people hoped for and feared when it came to health care, it became apparent that opening up public programs on a voluntary basis is substantially more popular than a wholesale reform that puts everyone in a national insurance program.

Sen. Elizabeth Warren’s (D-Mass.) recent slip in the polls has been widely attributed to the rollout of her single-payer plan. (I’ve yet to see any actual evidence that her health-care plan is what produced that fall; it’s just what everyone seems to assume.) And suddenly it seems that there’s a multitude of voices, Democrat and Republican, assailing Medicare-for-all.

I’m sure many of those critics are perfectly sincere. But as The Post’s Jeff Stein reports, there’s more going on behind the scenes:

Lobbyists either helped draft or made extensive revisions to opinion columns published by three state lawmakers in a way that warned against the dangers of Medicare-for-all and other government involvement in health care, according to emails obtained by The Washington Post.
Montana state Rep. Kathy Kelker (D) and Sen. Jen Gross (D) acknowledged in interviews that editorials they published separately about the single-payer health proposal included language provided by John MacDonald, a lobbyist and consultant in the state who disclosed in private emails that he worked for an unnamed client.
Gross said MacDonald contacted her on behalf of the Partnership for America’s Health Care Future, a multimillion-dollar industry group founded in 2018 and funded by hospitals, private insurers, drug companies and other private health-care firms.

This is hardly the first time a lobbyist or representative of an interest group wrote an op-ed for a legislator, but it’s an important reminder of what’s happening with the health-care debate. On one side, you’ve got some pro-Medicare-for-all groups such as Physicians for a National Health Program, with modest budgets and small staffs. (PNHP has a staff of four.) In the middle, you have Democratic presidential candidates arguing about how far to go on health-care reform. And on the other side, you have insurers, hospitals, drug companies, device companies and other health-care interests who together wouldn’t think twice about dropping hundreds of millions of dollars to destroy Medicare-for-all and anything that resembles it.

After all, there are tens of billions of dollars in profits at stake. Which is why those groups formed the Partnership for America’s Health Care Future, which will be the vanguard of the war on health-care reform should a Democrat be elected president and try to get an ambitious bill passed.

Here’s one of the most important things to understand about these interests: They despise “moderate” reform as much as they do Medicare-for-all. There are reasons the kind of expansive public-option plan being offered by Joe Biden or Pete Buttigieg is more politically practical than single-payer, but opposition from industry is not one of them. Just look, for instance, at this ad from the Partnership for America’s Health Care Future, in which actors doing their best worried faces say, “Politicians may call it Medicare-for-all, Medicare buy-in or the public option, but they mean the same thing: higher taxes or higher premiums, lower quality care, politicians and bureaucrats in control of our care.”

Although a single-payer system obviously presents the greatest threat to their profits, their belief is that any reform that allows large numbers of people to move on to government programs makes genuine cost control more likely, and that’s what they want to avoid.

In what may be the most revealing moment in the article showing consultants associated with the Partnership crafting op-eds for state legislators, the consultant “removed three paragraphs from a draft of Kelker’s op-ed that pointed out that the United States 'clearly spends significantly more on health care per capita than other developed nations.’” This is one of the most important facts about our health-care problem, but it’s the last thing the Partnership and its backers want anyone thinking about. Why? Because if you start cutting costs, they make less money.

The current proposals for a public option envision huge numbers of Americans — tens or even hundreds of millions — moving over to public plans, depriving insurers of customers and facilitating future cost-cutting. So the health-care industry’s strategy is to fill Americans with terror, convincing them that any major reform will cost them more, give them poorer care and make them more insecure. Even if the opposite is almost certainly true on all counts.

This raises an important point all the Democratic presidential candidates should be forced to address. Any of them, if elected, would face a furious industry campaign to destroy their proposed health-care reform. All the candidates should explain how they plan to overcome it. As of yet, none of them have had much to say on the subject.

Read more: