You would hope that Democrats had learned the dire consequences of a lost election. Guess again. They’re already hard at work at losing in 2020.

Look at their “Medicare for all” single-payer health care proposal. Most Americans agreed that health care reform is long overdue; however, “Medicare for all” alienates many voters whose support is critical to electing Democrats in 2020.

Remember that this approach does away with private insurance. Let’s do the math. Forty percent of Americans voters (52 million) are Trump Republicans whose votes will not change, regardless of any health care proposal. Of the voters left in play (78 million), the majority (75%) have private health insurance and most of these (about 70%) are happy with their coverage.

That means 41 million voters risk losing coverage they like in favor of an uncertain government plan. If even a third of this group votes for the status quo, Trump wins again. In addition to the above, I doubt the powerful health care insurance industry and its 499,300 employees (even more lost votes) will go quietly into the night. This may be a simplification but it gets us in the ballpark.

There is more to this than the numbers. T.R. Reid, a Washington Post correspondent, wrote an excellent book (“The Healing of America”) comparing health care systems in various countries. A central finding was that each developed country found a unique way to achieve high-quality, universal health care coverage. England has the prototypical single-payer system. Critics of the British system cite the long wait for joint replacement. Yet the average Brit prefers a system in which everyone waits to a system in which some get no replacement at all. The same may not be true for the average American. A single-payer system may not be a good fit for the U.S.

The proposal that would increase the chance for a Democratic victory in 2020 is “Medicare as an option for all.” This would garner support from the uninsured and those unhappy with their private insurance without alienating those happy with their current plans.

Remember that Medicare expansion is not health care reform. Reform has to address cost — the central problem with our health care system. Nearly half of your health care dollar is wasted or goes towards huge profits for nearly every segment of the health care industry. The pharmaceutical industry is getting a lot attention these days, but it is no worse than other segments. Its prices are just more visible.

Look for an uphill battle as the healthcare industry spends roughly $500 million a year on lobbying our Congress — more than any other industry. We’ll get there only if more Americans understand the issues and become advocates for change.

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By the way, please e-mail candidates Bernie Sanders, Kirsten Gillibrand, Kamala Harris, Julian Castro, and Tulsi Gabbard and tell them to ditch the “Medicare for all” proposal now. It could very well cost Democrats the election in 2020.



