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In January, the Intercept reported that Nancy Pelosi’s top healthcare aide, Wendell Primus— who really is called that— told executives from Blue Cross Blue Shield that Democratic leadership would help them defeat Medicare for All.




Today, Politico reported on another meeting, this one with health policy researchers, in which Primus “dismissed Medicare for All during the private session as an unhelpful distraction” and asked for “more research focused on the risks and tradeoffs of Medicare for All.”

According to the site , Primus raised concerns that Medicare for All would “distract” from the party’s “core health agenda.” This messaging is common across single-payer opponents, from Pelosi herself to the Partnership for America’s Health Care Future, a healthcare industry-backed lobbying group that was formed to defeat single-payer and which frequently says Democrats should focus on “building upon the progress we’ve made” and protecting the ACA. Primus believes Democrats should focus on protecting pre-existing conditions and lowering drug prices, per the site.


The most troubling part is Primus’ reported “invitation to discredit the idea, or at least amplify its risks” with research. Pelosi spokesman Henry Connelly told Politico that “no one has anything to fear from good faith research on Medicare for All.” He also said: “Wendell absolutely did not ask for any kind of one-sided analysis of Medicare for All, and anyone who says otherwise wasn’t actually listening,” and that, “As Democrats, across the entire spectrum, we believe in legislating based on facts, data and honest analysis.”

It is unsurprising to hear that a Democratic aide would treat health policy researchers like a vending machine for research to back up their talking points. The Washington think tank scene positions itself as nonpartisan, high-minded academics who are merely interested in investigating the policy landscape of the day, but it is far more complicated than that. Foreign governments donate to influence the policy landscape; think tanks promise “mutually beneficial” relationships with donors and sometimes force out critics of those donors.

Of course, those think tanks are desperate to dispel the notion that their research might be skewed in any way. From Politico:

Linda Blumberg, an institute fellow at Urban’s Health Policy Center, told POLITICO in response to questions about the meeting that the think tank is “very, very protective” of its nonpartisan mission and reputation. “Our objective has always been and continues to be to provide the best possible research and analysis to support responsible policy conversations and debates,” she said, emphasizing that Urban doesn’t take policy positions.


We do not take policy positions, but we will take $1 million from J.P. Morgan Chase and between $100,000 and $249,000 from Wells Fargo, Google and the U.S. Mortgage Insurers. For science.

The business of pushing policy in Washington is built on a foundation of bullet-pointed quotes from Non-Partisan, Independent sources; if you have an agenda, but you quote someone who sounds like they don’t have an agenda because they come from the Institute of Research, Policy, and Very Serious Thinking, people will take your agenda more seriously. And never mind if those Non-Partisan, Independent sources take money from gigantic corporations, who are surely just giving out of the kindness of their hearts; they would surely give the same donations if all of these think tanks came out and called for a 80 percent tax on the rich and the requisitioning of their vacant properties to turn into homeless shelters.


If Primus wants to put his quarter in the research machine and pop out an anti-single-payer study, he could try the Koch-funded Mercatus Institute, which issued a study last year claiming Medicare for All would cost $32 trillion. It also accidentally revealed that this would be $2 trillion lower than if we changed nothing, meaning Medicare for All would be cheaper than the status quo. (This makes total sense: The inefficiencies in the current system, like having to bill multiple providers and people not getting care until they’re almost dead because they can’t afford it, are extremely expensive.) But, you know, a good effort otherwise.

Wendell Primus may well have wanted a neat and tidy study, headlined The Problems With Medicare for All, from a nice, liberal-friendly institution that he could point to because, as Connelly said, the Democrats pride themselves on being the Facts Party. If your opponents are making a moral case like it is immoral to limit access to healthcare on the basis of wealth in any way, it’s much easier to say that doing it any other way simply doesn’t work, I’m afraid, than it is to say no, I disagree with you, and I want people to continue to have to pay to live. Or, to be more generous, it’s easier to say that it wouldn’t work than it is to say it is simply too scary to take on pharma, hospitals, and insurers all at once, because those fellas do donate an awful lot to our party, and they have a lot of money to spend on making us look bad if they want to. Even if you end up making those people’s cases for them; even if you destroy the party’s chances of ever getting to Medicare for All by spending years saying how desperately awful those scary risks would be, it is better than simply saying, sorry, I just don’t want you to have free healthcare and I won’t fight for it.


The Democratic leadership does not want single-payer on the table. They will happily parrot industry talking points about how bad it would be, so long as those talking points are laundered through a Respectable source. They will tell lies (or be incredibly ill-informed and get the fundamental facts wrong). They will fight against single-payer as long as it remains tenable to do so. The goal for the left is to make it untenable.