Bernie Sanders, Hillary Clinton

Bernie Sanders and Hillary Clinton

(The Associated Press)

Health care has been a core issue for former Secretary of State Hillary Clinton for more than two decades. But she hasn't wanted to really get into it during the 2016 Democratic presidential primaries.

That's because she knows Vermont Sen. Bernie Sanders has the upper hand among progressives with his call for "Medicare for all." "The only long-term solution to America's health-care crisis is a single-payer national health-care program," Sanders says.

Democratic critics of Sanders' single-payer proposal have tried to push back against it, insisting it isn't politically doable and so we should focus instead on improving the Affordable Care Act, the signature domestic-policy accomplishment of President Barack Obama's tenure.

"I got a great deal of admiration and affection for Sen. Sanders," former Virginia Sen. Jim Webb said during a Democratic presidential debate last October. "But, Bernie, I don't think the revolution's going to come. And I don't think Congress is going to pay for a lot of this stuff."

Webb was soon out of the race, his poll numbers barely making it into the single digits. Progressives had made it clear that they didn't want to hear about what couldn't be done. They preferred the late Robert F. Kennedy's famous sentiment, borrowed from playwright George Bernard Shaw: "There are those that look at things the way they are, and ask why. I dream of things that never were, and ask why not?"

Clinton has tried to walk a thin line on the health-insurance issue, heralding the breakthrough that the passage of Obamacare represents and insisting it can be made even better. Sanders supporters, however, have been unimpressed.

"Secretary Clinton has said that 'Medicare for all' will never happen," prominent Sanders backer Dr. Paul Song said last month. "Well, I agree with Secretary Clinton that Medicare for all will never happen if we have a president who never aspires for something greater than the status quo. Medicare for all will never happen if we continue to elect corporate Democratic whores who are beholden to big pharma and the private insurance industry instead of us."

Song resigned as chairman of the progressive advocacy group The Courage Campaign after being criticized for the remarks, but his attitude nevertheless continues to have resonance among Sanders voters.

Now, finding herself in May and still in a brutal battle with Sanders for the Democratic nomination, Clinton is finally ready to say, Why not? Sort of. This week, responding to a question from a voter who said health-insurance rates were still too high under Obamacare, Clinton offered a possibility she first floated years ago but hasn't been talking about during this election cycle: Medicare buy-in for people under 65. (65 is the eligibility age for the government health-insurance program.)

"If you were able to move people 55 or 50 and up, who are the biggest users of health care, into the Medicare program -- they would have to buy in but they would be buying into such a big program that the costs would be more distributed," she said. "There's a lot of things I'm looking at to try to figure out how to deal with exactly the problem you're talking about."

The Wall Street Journal noted that Clinton's idea is "significant because it is seen by many advocates as a step to a single-payer system that Mr. Sanders favors. The idea is to grow the Medicare program so that it covers more and more people until there is, one day, support for it covering everybody." The right-leaning business newspaper insists that Sanders' "Medicare-for-all plan would increase federal spending by $32 trillion over 10 years, more than twice as much as the $13.8 trillion his campaign estimates. Other independent estimates have also found that the Sanders plan would be much more expensive than he says." (Sanders explains how he would pay for it on his campaign website.)

Sanders put out a statement saying Clinton's Medicare buy-in idea "is a step in the right direction, but just like her support for a $12 minimum wage, it is not good enough."

-- Douglas Perry