But it’s one thing to be a member of Congress and it’s another to be president, and should Sanders win the White House, questions of how far to push and what to accept will define his term in office.
Which is why it was interesting to see his most high-profile supporter, Alexandria Ocasio-Cortez, inject this note of pragmatism into the debate:
Ocasio-Cortez ― one of the most outspoken advocates for Medicare for All ― said she thought voters understood there was an “inherent check” on the president’s ability to actually change things like our health care system. And she argued that the realities of governing were actually an argument for someone like Sanders, as he’d be able to push Democrats and resulting changes further left.But Ocasio-Cortez is also realistic about how far even a President Sanders could actually move Congress.“The worst-case scenario? We compromise deeply and we end up getting a public option. Is that a nightmare? I don’t think so,” she said.Ocasio-Cortez stressed that just getting a public option for health care wasn’t the left’s ultimate goal. But she also said she wasn’t here to railroad other members with differing viewpoints on health care ― she just thinks it helps to have a president who has a more ambitious platform than Congress so that Democrats could stretch what’s possible.
I’m sure this left some of Sanders’s more intense supporters — the ones who have been policing the Democratic Party to locate people who take policy positions less categorical than Sanders’s and are therefore to be vilified as neoliberal corporate shills — positively slack-jawed.
The thing is, I’m almost sure that Sanders would privately agree with AOC — even if he can’t say it publicly. Which he can’t, for both electoral and negotiation reasons.
Much of Sanders’s career has been devoted to moving the debate to the left, giving voice to ideas and policy proposals that aren’t given much consideration in “mainstream” circles. And just as you wouldn’t walk into a negotiation saying “I’d like to pay $250,000 for this house, but if you ask for $300,000 I’ll probably say yes,” you don’t want to compromise with yourself before negotiations begin. Likewise, as a candidate Sanders can’t say that he knows he’ll fail to pass his signature policy proposal.
But he knows the unfortunate truth: There is precisely zero chance that a single-payer system of the kind Sanders proposes will pass Congress anytime soon. It wouldn’t even be close. Not only couldn’t you get 50 votes for it in the Senate, you probably couldn’t get 30.
But it’s important that single-payer remain on the table as an option, not only because talking about it helps highlight everything that’s wrong with the current system, but also because it serves as a kind of cognitive and rhetorical anchor for everyone involved. It’s like the suggested retail price you never actually pay; a pair of pants that has been reduced from $75 to $35 looks like more of a deal than a pair of pants that’s just $35.
If Democrats win the presidency and the Senate, there has to be a way for members from more conservative districts and states to justify embracing large-scale reform, both to themselves and to their constituents. They need to be able to say, “I sure as heck wasn’t going to sign on with some gigantic government takeover of health care like President Sanders originally proposed. But let’s give people a choice to sign up with Medicare if that’s what they want — that seems like a good compromise to me.”
To be clear, that isn’t going to be easy — the health-care industry is ready to fight a public option with everything it’s got, and every Republican will oppose it. But the question of whether reform can pass comes down to moderate Democrats.
If Sanders is president, those moderates are going to have to spend pretty much every moment trying to show their constituents that they’re supportive of him, but not too supportive. They’ll need to find high-profile ways to demonstrate some distance, to show they’re independent and not farther left than their constituents want them to be.
To a certain extent, Ocasio-Cortez is giving away the game here, but she’s just being honest, both by implicitly acknowledging that single-payer isn’t going to happen and by granting that a public option would do a huge amount of good. Which it would — it could be a much more dramatic reform than the ACA. And if it’s designed and implemented well, it could also be a waystation on the road to single-payer, or perhaps a hybrid system similar to what they have in France or Australia, in which a basic government plan covers everyone, and you can choose to buy private supplemental insurance on top of it.
Again, I’m certain Sanders understands all this, even as his candidacy is promoted by superfans who have convinced themselves that even the barest hint of compromise from Sanders’s maximalist positions is tantamount to treason. I doubt they’re going to cast Ocasio-Cortez out for speaking the truth, but it might make them consider whether they’ve been a little too doctrinaire.