The Congressional Budget Office predicts that 22 million people will be left uninsured by the Republican Senate healthcare plan, voting on which will now happen after the Fourth of July recess. “It’s not that people are getting pushed off a plan,” Paul Ryan told Fox & Friends after those numbers were released on Monday. “It’s that people will choose not to buy something that they don’t like or want.”



Ryan claims to have been dreaming of slashing social programs since his days doing keg stands, and when he and other Republicans managed to push the similarly disastrous American Health Care Act through the House, they wheeled out cases of beer to celebrate. Under that House bill, 23 million were expected to go without healthcare. These proposals and the Republicans backing them aren’t just “mean”, as Senate Democrats are calling Trumpcare. They’re sadistic.

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In light of that, fighting for single-payer healthcare – or universal healthcare, or Medicare for All, in more populist phrasings – might offer the best opportunity yet for progressives to contrast themselves publicly with the Republican party’s politics of death, showing a quality the left is uniquely qualified to offer in this moment: empathy.

The Republican’s healthcare dreams might be the clearest articulation yet of the American right’s decidedly un-empathetic agenda, fusing naked greed with a near-total indifference to human life. Essentially, Trumpcare boils down to a massive transfer of wealth from the sick and poor to the 1%.



Among those who stand to be worst hit are the elderly seeking nursing home and end of life care, disabled children and the working class Americans nearing retirement – all to feed a gargantuan tax cut for the wealthiest Americans. A news (not op-ed!) headline from the New York Times might have put it best: “Trump Tax Plan Would Shift Trillions From US Coffers to the Richest.” Charles Dickens himself would be hard-pressed to write a better or more blatant story about class war.

And though the crucial push to save the Affordable Care Act (ACA), known as Obamacare, will save millions of lives, defending that program shouldn’t cloud the fact that our healthcare system was deeply flawed and unequal under it.



Tens of millions of people would still be left uninsured under the ACA in the coming years. Almost 29 million already were in 2016. This fails miserably by what should be the only metric for success of any healthcare system – guaranteeing as many people as possible with quality health insurance.

Despite what might seem a clear moral mandate, liberal pundits and elected officials have seemed dead-set on occupying a neoliberal middle ground on healthcare that simply can’t be justified as a winning strategy.



The failed US House candidate Jon Ossoff, of Georgia, refused to back single-payer on the campaign trail, and California’s governor, Jerry Brown, recently moaned that single-payer would constitute a “bigger problem” than the ACA, complaining – as the Washington Post’s editorial board did recently – that it would be too expensive.

Beyond it being the right thing to do, fighting to extend healthcare to all Americans may also be the politically prudent one. Democrats who cast doubt on that goal seem to not get that message, and will continue losing because of it.

Support for single-payer has grown steadily. About 33% of respondents to a Pew Research Center poll released last week supported such a program outright, while 60% said it was the responsibility of the federal government to provide healthcare coverage to all Americans.



Medicare – the program a universal healthcare system would look to expand to all Americans – is popular with Americans across the aisle, wooing not just progressives but also Tea Party activists.

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This isn’t some anomaly about healthcare, either: the austerity politics embodied in Trumpcare simply aren’t popular, and expansive social programs are. A recent study from Lee Drutman at the New America Foundation finds that very few Americans at all – Republican or Democratic – support the kind of rightwing economic policies that undergird Trumpcare.



When it comes to support for draconian cuts, the Republican party and its ultra-wealthy donors stand alone.

As Labour’s upset in the UK confirmed recently, boldly redistributive programs are popular, and may well hold the key in the US for both winning back power and the kind of quality care millions of uninsured Americans deserve.



Jeremy Corbyn didn’t win the general election, of course, although his party came damn close by running on agenda that resolutely promised things thought incompatible with a winning politics, from renationalizing key public services to banning fracking “for the many, not the few”.



Universal healthcare – a policy premised on that very principal – has long been similarly verboten stateside, with means-tested and market-based alternatives prevailing, to disastrous effect. But in 2017, to borrow another phrase from across the pond, there simply is no alternative.