Bernie Sanders introduced the latest version of his single-payer health care plan Wednesday, with few details and only vague ideas about financing it. Jonathan Chait, in an excellent column, argues that this means single-payer is “zero percent closer” to passing, given that many Democrats have liked the idea for years but they’ve never been able to solve the policy and political problems involved in transitioning to it.
Chait has a lot of smart things to say about Sanders’s weaknesses as a policy-maker. But “zero percent” isn’t quite correct, and in fact this episode is an interesting window into how U.S. political parties work and why they are so important right now.
(Related: Sanders Calls for a 65% Top Estate Tax Rate)
American political parties — the Democrats, in this case — are whatever their politicians, governing and campaign professionals, formal party officials and staff, activists and donors, and party-aligned interest groups and the partisan press want them to be. The most important way these party actors determine what the party will be is through nominations, with the most important of those being the presidential nomination. But conflict and cooperation over the party continues between elections, too, informed by how the last nomination contest played out.
The lifeblood of the party flows through extended networks; formal organizations such as the Democratic National Committee and its local counterparts are part of it, but there’s no overall top-down structure. People enter and leave the party all the time, and people and groups build up influence within the party in a variety of ways. Winning nominations is the best method of building influence, but bringing important resources such as money, constituencies, or expertise can win influence as well.
During the middle of the 20th century, parties were weaker and it was easier for individual politicians to make things happen without working inside the party system; powerful House chairs could advance ideas into law or block things from becoming law without needing permission from the party at large. The same was true of individual senators, who didn’t even need a committee perch to make something happen.
But parties grew much stronger within the political process over time, and Congress is now basically run by the parties; indeed, most things that happen in American politics, from elections through governing, flow through the parties. Major legislation, for example, is now in large part about getting into a party queue and building up support and formulating policy in preparation for when the party wins unified control. This period is likely to be relatively brief, so the first agenda items have the best shot of becoming law.
By any logic at all, another major overhaul of the health care system shouldn’t be on the Democratic agenda. It’s had its turn, rising to the very top priority the last two times Democrats had unified control of the federal government, which resulted in one failure in 1993 and the successful passage of the Affordable Care Act in 2010. Obamacare still (from the liberal point of view) needs additional legislative tinkering, but it’s been implemented, and it is extremely popular among Democrats and relatively popular overall. Meanwhile, other policy areas that were lower on the list in 2009 still need to be addressed — and more have emerged since. Advocates within the party demanding action on climate, income inequality, voting rights, immigration, infrastructure, campaign finance, and several other issues should have a strong case for pushing off anything major on health care.