Endgame: Plurality of Republicans now favor single-payer health care

More than a third of the public overall “strongly favors” Medicare for all. Toss in the “somewhat favor” group and you’ve got 60 percent of Americans ready to live the socialist dream.

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The conservative movement is ovah.

That’s 46/38 among Republicans, perilously close to a majority. Surprisingly to me, Trump voters were a bit less likely than the average Republican to back single-payer:

Conversely, Hillary voters were slightly more likely than the average Democrat to back Medicare for all. I assume that’s a function of electoral politics: Ideologues are more likely to turn out to vote than average party members are, so it’s no surprise that Clinton and Trump voters would be a bit more left and right, respectively, than their parties at large.

Anyway: Is this a fluke poll? Maybe not. Jesse Walker flags a Gallup survey last year that asked voters if they’d support “repealing the ACA with a federally funded healthcare program providing insurance for all Americans” and got a 58/37 split, including 41 percent of Republicans in favor. Clarity on which Republicans are in favor would be useful, but these polls tend not to drill down that far. Walker and Dylan Matthews of Vox each note a not-that-surprising degree of support for single-payer among the populist-nationalist right, though, ranging from more mainstream types like Chris Ruddy and F.H. Buckley to alt-righters like Richard Spencer. Partly that’s due to disgust with the current health-care system, with the idea being that if we’re going to have a corporatist ObamaCare Frankenstein in which the feds meddle more and more, we might as well scrap it and go for a “clean” socialized-medicine program. But this bit, from Walker, is true too:

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Many nationalists are already on the road toward embracing a herrenvolk welfare state that bestows its services on the designated in-group while excluding outsiders. The alt-rightists may be inclined to frame this in purely racial terms, but that’s not actually necessary—many on the right embrace a sort of rainbow nationalism that isn’t limited to white people. At any rate, there will be a broad agreement on the fact of the boundary even if there’s some disagreement about where it should be drawn.

It’s no coincidence that Trump stands firmly against entitlement reform, made noises more than once as a candidate about admiring single-payer, and famously said, supposedly in contrast with other Republicans, that he wouldn’t let Americans die in the street for lack of health coverage. In January, he commented that his goal in replacing ObamaCare would be “insurance for everybody,” something the subsequent GOP bill, er, did not prioritize. His foreign policy — as a candidate, not as president! — was also premised, tacitly and not always so tacitly, on redistributing resources from improving the lives of people overseas to improving the lives of Americans. “America First” doesn’t necessarily mean coverage for all, but the whole thrust of Trump’s winning strongman message was that he was going to get government working for “you” again. If that doesn’t include government making sure, at a minimum, that you can pay for a doctor when you need one, what does it mean?

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None of this means, though, that single-payer is coming soon, at least not with Republicans still in control of Congress. Nationalism is still years away from replacing enough conservatives and leaners in Congress with their own kind to make single-payer viable in the House and Senate. And needless to say, once this issue is on Congress’s agenda, the old familiar partisan lines will be drawn to tamp down GOP support. (Here’s a nifty graphic from Reuters showing how the “Trump effect” works in poll questions to polarize the two parties.) But there’s a germ of consensus here. If Democrats sweep back into power in 2020 or 2024, beware.

Update: It may take awhile for them to gain the upper hand electorally, but young adults seem open to this idea: “Two-thirds of young people agree with a smaller majority of Americans overall that the government should make sure people have health care coverage. And they understand that will cost more: Sixty-three percent want the government to increase spending to help people afford insurance.”

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