Democrats’ aren’t just dreaming about health care reform

We no longer have a two-party system in American Democracy.

We have an asymmetrical system where one party continues to comport itself largely along traditional lines with deference to the law, the Constitution and Democratic norms, and the other has declared total and complete war on any institution or check that would constrain its power.

And because of that difference, Democrats’ policy proposals are treated differently than those from Republicans.

When Republicans undertake outrageous proposals or anti-democracy actions — banning Muslim immigrants, building a border wall without congressional funding, upending protections for LGBTQ people, scrapping the emoluments clauses of the Constitution, blocking efforts to improve election security, budget busting tax cuts for the mega-wealthy and huge corporations, holding a vote while Democrats are at a 9/11 remembrance, stealing a seat on the US Supreme Court — scholars, the media, pundits and Democrats take great pains to explain why Republicans can’t do it.

Then Republicans do it anyway — consequences and your pesky rules be damned. They have power, and they’re going to use it to get what we want.

From left, Democratic presidential candidates Sen. Amy Klobuchar, D-Minn., Sen. Cory Booker, D-N.J., South Bend Mayor Pete Buttigieg, Sen. Bernie Sanders, I-Vt., former Vice President Joe Biden, Sen. Elizabeth Warren, D-Mass., Sen. Kamala Harris, D-Calif., entrepreneur Andrew Yang, former Texas Rep. Beto O’Rourke and former Housing Secretary Julian Castro debate on Sept. 12 during a Democratic presidential primary debate hosted by ABC at Texas Southern University in Houston. (AP Photo/David J. Phillip)

Meanwhile, every Democrat running for president has had to answer questions about how they will enact their “pie in the sky” ideas — read progressive policy initiatives, like better and cheaper health care — given the willingness of congressional Republicans, and particularly Senate Majority Leader Mitch McConnell, to take unprecedented actions to halt progress.

Not to pick on Roll Call, where I once worked, but here’s a headline that makes the point: “2020 Democrats may dream big now, but reality will bite them later.”

“The problem right now is that most of the leading Democrats (even Joe Biden) are running on ambitious legislative agendas that would offer high drama on Capitol Hill in 2021 but little chance of short-term legislative victory,” Walter Shapiro wrote on Sept. 17.

Republicans — and their voters — ignore such niceties.

Big majorities of voters support maintaining legal access to abortion. To outlaw abortions would be a draconian overreach. But Republicans have been promising to ban abortion for years.

Were they just being aspirational?

Does anyone doubt, even for a moment, that they are serious? That they are potential closer than ever before? That Roe is seriously at risk?

I don’t.

During the most recent Democratic debate, the candidates spent about 40 minutes talking about health care and their individual plans to increase access to coverage and reduce out-of-pocket expenses for the American people.

The debate was heated at times and the contrast was drawn between those candidates who prefer some sort of public option that would allow citizens to purchase health care similar to either Medicare or Medicaid and those who advocate for some version of Medicare for All, which would likely eliminate private health insurance coverage.

While the differences between the candidates are real, there’s not a single candidate running for the Democratic nomination for president who is not committed to improving the way people receive health care. Argue about the details, sure, but that underlying fact cannot legitimately be disputed.

On the other hand, President Donald Trump and Republican members of Congress — including US Sen. Susan Collins — have and continue to take steps to undermine and destroy the Affordable Care Act. In fact, Trump and McConnell have made it clear that they also want to upend Medicare and Medicaid. Are they just dreaming?

The Democratic candidates are committed to improving access to health care and making it more affordable for millions of people and then talking — in great detail — about how to go about it.

To a person, the candidates are all offering up big ideas about health care, even if folks in good faith argue about which is best.

The policies aren’t just dreams or aspirations. They are a clear indication of where the candidates would push and pull the system.

When the president says he intends to cut Social Security, Medicare and Medicaid, we are smart to believe him. It’s not just a daydream.

When the Democrats running for president talk about fixing America’s broken health care system, we should believe them too. Voters are demanding more than a policy debate; they want action.

David Farmer

About David Farmer

David Farmer is a political and media consultant in Portland, where he lives with his wife and two children. He was senior adviser to Democrat Mike Michaud’s campaign for governor and a longtime journalist. You can reach him at