- - Sunday, April 7, 2019


Politics is a lot like fishing. Getting the best catch requires the right bait. Democratic candidates for the 2020 election have been trolling for popular support with easy promises of some version of socialized medicine. Observing their enthusiasm success, President Trump baited his hook with the health care promises he couldn’t deliver in 2017.

Bernie Sanders made it safe in 2016 for Democrats to pledge public allegiance to government-run health care. With a slim majority of Americans now thinking well of the idea, 2020 candidates are casting their lines. Mr. Sanders is joined by Kamala Harris, Julian Castro, Tulsi Gabbard and John Hickenlooper to push “Medicare for all,” opening to everyone the plan now reserved for seniors. Others in the crowded field advocating various types of Medicare or Medicaid expansion include Cory Booker, Amy Klobuchar, Beto O’Rourke and Kirsten Gillibrand. Elizabeth Warren and John Delaney have telegraphed their usual mixed health care messages.

Mr. Trump, apparently sensing enlarging ripples in the pond, last week joined the frenzy. Obamacare continues its tailspin in the wake of a federal court striking down the individual mandate that requires everyone to buy health insurance, with President Trump vowing a renewed effort to craft a replacement. He says the Republican Party would become “the party of great health care.”

Though his earlier attempt to replace Obamacare fizzled when the late Sen. John McCain unexpectedly joined Senate Democrats to block his replacement legislation, Mr. Trump is itching to try again. Republican leaders caught unaware of his plans, such as Senate Majority Leader Mitch McConnell, groaned. The prospect of a second Obamacare struggle does not please.

Chastened, the president recalibrated his aim this week and made health care affordability a sweetener for his re-election: “Vote will be taken right after the Election when Republicans hold the Senate & win back the House,” he tweeted. “It will be truly great HealthCare that will work for America.” He appointed a team of Republican congressmen to devise a replacement for Obamacare. Among them are Sens. Rick Scott of Florida, a former health-insurance executive, and John Barrasso of Wyoming and Bill Cassidy of Louisiana, both physicians.

If Democrats think the president’s change of heart will make the campaign safe for socialized medicine, they should think again. Word is getting around that the British are witnessing the not-so-slow collapse of their single-payer medicine, as Sally Pipes, an authority on health policy, points out in Forbes magazine. The British National Health Service hasn’t met its goal of treating 95 percent of emergency patients within four hours since 2015. With the current accomplishment at 84 percent and falling, the National Health Service is considering a fix of just eliminating the goal.

Worse, a growing number of Britons are dying needlessly of readily treatable diseases. Just 81 percent of British breast cancer and 83 percent of prostate cancer patients live five years after diagnosis, compared to 89 percent and 97 percent in the United States. Importing the British model to the United States, writes Sally Pipes, “would be a massive blunder.”

The details matter. A Kaiser Family Foundation earlier this year found 56 percent of respondents favoring “Medicare for all,” with its promises to eliminate premiums and deductibles. When poll respondents are told it would mean eliminating their existing insurance, support drops to 37 percent. That does not include accounting for the cost of an enormous new government entitlement, which the free-market-oriented Mercatus Center reckons would reach nearly $33 trillion over 10 years. (That’s trillion, with a “t.”)

Health care consistently ranks in the top half-dozen concerns of voters and Obamacare is still more popular than Obamacare repeal in favorability polls, and Mr. Trump’s impulse to re-engage the fight is predictable. But without a better plan for lowering costs that can pass constitutional muster, he could only join Democrats in offering implausible promises and hope voters bite. Or he might say nothing, which is hard for any politician to do. Mr. McConnell clearly speaks for a bipartisan majority in the Senate — “we’ve been there and done that.”

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