I am watching a Twitter fight evolve between pragmatic liberals like me and dreamy-eyed unicorn progressives over… wait for it… “incrementalism.” The center of the fight is based on Bernie Sanders’ “Medicare-for-All” bill, which will never pass this Congress in any form. And the objection is over “incrementalism,” based on the unicorn left’s dream that we get to their “single-payer” dream in one shot because, otherwise, what’s the point.
On the one side, you have realistic people like me, who understand that you have to work hard over a long period of time to get to the ultimate goal. On the other side, you have white “progressives” who are so used to having things handed to them, they think that’s how the world works.
Life and politics doesn’t work that way.
In fact, Medicare serves as a perfect example. The Medicare law passed in 1965, and it has taken roughly 52 years to get to where it is right now, which still isn’t as great as it could be. For example, Medicare only covers 80% of most medical procedures, which is why seniors have to have a private insurance policy (or Medicaid) to get them over the hump. Sure, that policy is only about $109 now, but that isn’t even enough for many people. My father had a hearing problem for many years, and my son and I used to have to leave my parents’ house early when we visited because he had the TV up so loud. He wanted a hearing aid, but it WAS NOT COVERED by Medicare and he couldn’t afford it otherwise. If a poor senior couple has vision problems, Medicare doesn’t cover glasses, either. And perhaps you remember a few years ago, when the GOP had to be bullied into adding a prescription drug benefit to Medicare. They did it sloppily, and Democrats had to fix it with the ACA, but it is there now. Incrementally, the system changed.
However, the point is, it wasn’t included until Medicare was about 40 years old. For many years while being covered by Medicare, seniors often had to choose between paying for medications they needed to live and paying to heat their home. Now, they’re covered, at least until the current Republican Party tries to take it away. Incrementalism is how we got a Medicare system that is (mostly) worth expanding.
The same is true of Social Security. If you think Social Security started out as the “third rail of American politics” it is these days, well, you should perhaps try to Google it sometime. Social Security was a mess when if first began. It was also racist. It was paid for with a ONE PERCENT payroll tax and there has always been a cap in place. Also, because of the wording of the law, black people didn’t even qualify at first. I know, that’s a shocker, isn’t it? I mean that a racist country would discriminate like that? Shocking.
The Social Security Act would never have passed without Dixiecrat votes, so the bill was required to contain some racist elements. At first, all Black people (and 27 percent of whites) were excluded from benefits because the system excluded farmers and maids, among other professions that Black people were engaged in in huge numbers. It took two major expansions of Social Security in 1950 and 1954 before even that “oversight” was fixed. At the same time, Social Security taxes had to be raised and coverage expanded. In short, what you know as Social Security now didn’t appear with the passage of the Act in 1937; it was constantly tweaked and improved to get where it is. (If you want to know more, read the book, “Fear Itself,” by Ira Katznelson, which is available on Amazon.)
In other words, incrementalism is built into the DNA of the United States. This concept of “revolution” in one bill or one vote is ridiculous and has zero basis in reality. If you want “Medicare for All,” the ACA is a great way to get there. But first, you’ll have to stop ragging on Democrats and get as many Republicans as possible the hell out of there. But make no mistake, the advance to “Medicare-for-All” will be incremental. That’s how politics in a democracy works. The people who “want it now” only balance out those who “like things the way they are.” You don’t supplant them. Unicorn Progressives always talk about “starting a discussion,” but they really don’t discuss anything, so much as dictate and demand and then retreat when they don’t get their way. They are the problem, not the people who are happy with making incremental progress.
“Better than Before” is the best anyone can hope for on the short-term.
Also published on Medium.