The biggest mistake the Democratic candidates running for president have made has been to allow the Republicans to suck them into a debate over “Medicare for All.” The Democrats can’t win this debate, because such a specific proposal is premature.

When it comes to health care, the Republicans have proved they have much more dexterity discussing the issues; at least during election campaigns. Remember the Republican health care drumbeat in the 2016 election? The attack on Obamacare was simple, “repeal and replace.” This all-encompassing slogan made their point, but it meant that the Republicans could not be pinned down on either process or substance of their promise. Of course, after the Republicans won control of Congress, they neither repealed nor replaced Obamacare.

By committing to the specific concept of “Medicare for All,” Democrats opened themselves up to all sorts of both valid and misleading Republican attacks. Republicans can and have claimed that “Medicare for All” is socialism; that it is impossibly expensive, it will force people away from their own doctor and insurance coverage they like.

Republicans paint Medicare as a gigantic government takeover of health care that will eliminate freedom of choice for individuals, while forcing all private health insurance companies out of business. (Note: Medicare is not a government health care provider, but rather a program that pays the bulk of the cost of medical care delivered by private providers.)

The Republican attacks have already gained traction. This is evidenced by Sen. Elizabeth Warren being pushed into a corner (ironically by some of her Democratic competitors) and forced to put a scary price tag ($20 trillion spread over 20 years) on her “Medicare for All” plan. (According to the Centers for Disease Control and Prevention, as of 2015 the estimated total annual cost of health care in the US was $3.2 trillion.)

So what should the Democrats do? They could start by shifting the focus of the health care debate. Instead of being mired in a dispute over “Medicare for All,” Democrats should force the Republicans to take a stance on the issue of “medical care for all.”

Since its inception, the American health care system has been based on the premise that health care is a privilege, not a right for all citizens. A person can receive all the health care they may desire or need, just so long as they have the resources to pay for it. On the other hand, if a person did not have the money to buy insurance or pay for health care, they were basically out of luck. The American model for health care is at odds with most health care plans of other industrial nations, where medical care is considered a right.

The Democrats will be better served if they press the Republicans to indicate whether they believe health care is a privilege for the wealthy, rather than a right for all. We embrace the right of any child to the guarantee of a basic education, no matter their family economic status, so why not debate the same type of right to basic health care for all citizens?

Once we as a nation decide if health care should be a privilege or a right, we can move forward. If the discussion comes down on the side of health care being a privilege, we can maintain the current system, without further debate.

That could mean actually repealing Obamacare or maybe even Medicare itself. On the other hand, should we decide that basic health care should be a right of any American, then a debate as to how best to fulfill that promise can begin.

It could be some form of Medicare, but there are numerous other viable options that could be considered to achieve the objective of medical care for all.

The simple message to Democrats is that being diverted into a debate over “Medicare for All” before resolving the “medical care for all” question is a losing proposition.


Robert MacDonald is the former chairman and CEO of Allianz Life. Reach him at bobmac5201@gmail.