A Brief History of Pete Buttigieg Faking It on Medicare for All

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Pete Buttigieg sucks, for all the reasons I laid out in detail here—from his technocratic worldview to his penchant to describe his milquetoast policy plans as a sort of pragmatic progressivism. But a new reason to add to the list? His newly discovered contempt for Medicare for All, which he deployed—some might argue cynically and opportunistically!—as his main line of attack against Elizabeth Warren and Bernie Sanders during the Democratic primary debate earlier this week. Was his hard pivot against the proposal a sincere reflection of his policy position? Maybe! Was it a desperate attempt to claw at relevance with the older, wealthy white voters who seem to like him? Perhaps! Either way, what a weenie!

In September, Buttigieg released a detailed version of his health care plan—which is notably not Medicare for All—but what he calls Medicare for All Who Want It. Get it? By including “Medicare for All” in the name of his plan, despite it not being Medicare for All and maintaining a significant role for private insurance companies to keep raking in profits, he gets to claim that he supports the idea while working diligently to keep it from succeeding. (Congresswoman Pramila Jayapal, the sponsor of a strong Medicare for All proposal in the House, recently called out this kind of mislabeling: “I appreciate the robust healthcare debate my Democratic colleagues have brought to the table,” she tweeted this summer. “But as lead sponsor of Medicare for All, I find it misleading when my fellow Democrats use the M4A name to describe proposals that are not Medicare for All.”)

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It’s a neat trick, really. But as the Washington Post wrote in an analysis of Buttigieg’s plan, “[W]hen it comes to expanding coverage to the uninsured and making it more affordable for people, the Buttigieg ‘plan’ is comparable to the public option plan from the race’s top moderate, former vice president Joe Biden.”

And as Tim Faust, the author of Health Justice Now: Single Payer and What Comes Next, laid out in Splinter (RIP), people really invested in universal access to medical care should be wary of plans like Biden’s and Buttigieg’s. “If you hear 2020 candidates talk about the rot of American healthcare, look out if they float a ‘pragmatic policy solution’ or talk about plans named something like ‘Medicare Extra As A Service... For You!’” Faust cautioned, adding, “If they’re polite, perhaps they will at least say they support ‘Medicare for All’ before announcing they’d be open to keeping the feet of private insurance companies on our throats.” The danger of proposals that maintain a role for private insurers, he explained, are many—not least of which is that they would fail to create a “universal risk pool,” which would lower costs for everyone. (Consider, here, the failures of the Affordable Care Act, which I know well, having paid for health insurance through the marketplace as a freelancer and watching my premiums go up every year while my coverage got worse.) 

And unfortunately for Buttigieg (and infuriatingly for me), he used to claim to be a supporter of Medicare for All. How convenient, then, that he discovered a new sense of outrage over the proposal at a debate in which his flailing campaign fought to establish the South Bend mayor as America’s Next Top Moderate. It’s actually because of this hard turn that his recent comments in support of the policy have been recirculating among political journalists and supporters of Medicare for All.

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Like this exchange from February 2018, when a Twitter user wrote that Buttigieg did not support Medicare for All, and Buttigieg wrote back: “Buh? When/where have you ever heard me oppose Medicare for All?” Buh, Pete? Buh! Buuuuuuuuh?

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When he was then asked in a follow-up to reiterate his support for Medicare for All, Buttigieg laid on the Midwestern-but-with-a-dash-of-Harvard snark thick: “Gosh! Okay... I, Pete Buttigieg, politician, do henceforth and forthwith declare, most affirmatively and indubitably, unto the ages, that I do favor Medicare for All, as I do favor any measure that would help get all Americans covered. Now if you’ll excuse me, potholes await.”

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And then there’s this, from a mere eight months ago:

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He is no longer, as he said, “on it,” though he is definitely on one these days!

Buttigieg is not the only Democratic presidential candidate who has switched positions on supporting Medicare for All, or is just generally using the public and political confusion around the issue to undermine real efforts to move to a universal system. Kamala Harris, who co-sponsored Bernie Sanders’ Senate bill, has consistently waffled, and has settled on a plan that continues to let private insurers play a role. But Buttigieg is the only candidate who is now making opposition to the Sanders- and Warren-backed Medicare for All a central focus of his campaign. (It was, notably, the sole subject of a recent campaign ad.)

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And he’s now trying to make the argument that his support for Medicare for All hasn’t changed (the fact that his plan most notably is not Medicare For All notwithstanding). “The difference between Pete, Warren and Sanders isn’t on the goal of achieving universal health care coverage through Medicare. It’s on how to get there,” a Buttigieg spokesperson told Axios earlier this week.

Here’s what Buttigieg told a reporter in Iowa on Wednesday night, according to his campaign:

“I’ve laid out a plan that now explains how we’re going to get there, that makes Medicare available to all and at the same time doesn’t do away with private plans. I think I’ve been consistent through the year that we don’t have to abolish private plans in order to have Medicare available to everybody. And what we’ve done is we’ve laid out a detailed plan on how to get there.

“Now, if that public plan that we’re creating is superior to every alternative, well then it’s going to turn into a glide path that’ll bring us to Medicare for All. It’s just that for me, the most important principle isn’t how many people are being covered by the government, it’s making sure that every single American has health care.”

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The idea that we’ll just smoothly “glide” our way to Medicare for All, and that billion-dollar health insurance companies are going to just quietly loosen their profit-extracting grip on the public, is extremely naïve if not straightforwardly dishonest. And here, I’m just going to quote from what I’ve written in the past on this subject:

He says he believes that “competition will create the glide path toward Medicare for All”—a wonder-inducing statement that seems to propose that private insurance companies will just happily, incrementally, wither away once individual “consumers” make the right choice. (Buttigieg is very clearly not paying attention to ways the private insurance industry and certain powerful Democrats are currently working to undermine support for Medicare for All—or he’s just chosen to ignore these things in service of the story he’d prefer to tell about how political change happens.)

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So what’s going on here? Perhaps it has something to do with the fact that Buttigieg has raked in the most donations from the healthcare industry compared to his Democratic rivals as of August 2019, according to an analysis by the Center for Responsive Politics. Or if you want to view political donations as less nakedly transactional than that (but why would you!), then perhaps it has something to do with the fact that Buttigieg, whom I’ve previously described as a “Boomer wrapped up in a millennial’s clothing,” is realizing he needs to grow his support among moderate, older, wealthy voters to have any chance at all of staying in the race. The left lanes that he initially seemed eager to run with are occupied by actual progressives at the moment, so he had to change tactics, I guess. 

During Tuesday night’s debate, Buttigieg asked, in his exchange with Warren, “Why unnecessarily divide this country over health care when there’s a better way to deliver coverage for all?” Exactly, Pete—why?

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About the author

Esther Wang

Senior staff writer, Jezebel