Do you want better healthcare? Vote Democrat!

Health care is not as central to the 2024 campaign as it was in 2020, when the issue largely dominated the Democratic primaries before COVID took the political world by storm, or in 2016, when the long-running Republican conspiracy to derail the Affordable Care Act. in the center next to a world-historic number of Hillary Clinton’s personal letters. But one thing is certain. the democrats still have full rights to health care, and the idea that it will be a strength for former president donald trump and the republicans next year is so impossible that even the most delusional person on the planet is not. one could believe it before breakfast.

Republicans care about health care like MLB Commissioner Rob Manfred cares about keeping baseball in the city of Oakland. They may talk a good game, but ultimately they are going to follow the money trail directly to the headquarters of the insurance companies that have created this country’s health care system, which is mind numbing. You don’t have to go very far in history to see that this is so; Under Trump in 2017, the GOP got the keys to the health care debate and decided to drive the car nowhere but into a deep hole they dug. for themselves.

During the 2016 campaign, Trump made big, vague promises about health care that predictably went nowhere. “Everybody will be taken care of much better than they are now,” he said, promising to “repeal and replace the Affordable Care Act.” Still, neither Trump nor his congressional allies, despite years of planning, had any earthly idea of ​​what they would replace the ACA with other than a drumbeat of half-baked ideas and some dismal vibration. and it became clear that the Society was not interested in returning to the pre-Obama regulatory environment. After several legendary and humiliating attempts to repeal Obamacare, Republicans simply gave up and moved on to other things, like convincing several hundred thousand of their most devoted followers to die needlessly from COVID rather than get a free vaccine.

“We will make it legal to discriminate against sick people again. USA, USA.” it wasn’t quite the rousing battle cry they thought it would be. And it’s a steep hill to climb, but health policy is perhaps the most frivolous intellectual conflict in conservatism, an area MAGA watchdogs won’t touch because it requires hard-earned expertise and seriousness, not media stunts. and nomenclature. It’s also an area of ​​politics where traditional Republican cynicism about the magic of the free market is particularly harsh.

What’s more, we can be sure that health care is not a priority, because that’s what Trump and his rivals are telling us in word and deed. Trump’s campaign website has five lines about health care, including this masterpiece that sums up his promises: the cost of prescription drugs and health insurance premiums.”

As always with Trump, it’s a combination of things Democrats already want to do (like ending windfall bills) and ill-defined goals in search of a policy plan. How does one “reclaim medical freedom”? Is there something they can bomb that will accomplish this noble goal, or a book about it that Ron DeSantis can ban in Florida? There is not even a basic outline of what Republicans would do if they won the presidency and both houses of Congress next year. They literally leave it up to the voters’ imaginations and hope they fill that blank slate with vibes. Even Trump’s leading challenger, DeSantis, has nothing on health care on his website and never talks about it except in the context of banning gender-based care.

This continues a long historical trend of Democrats being the only one of our two major parties to ever care or do anything about health care. Democrats created Medicare and Medicaid. Under Bill Clinton, Democrats created the Children’s Health Insurance Program (CHIP). Under Barack Obama, Democrats passed a sweeping health care reform law that banned discrimination against people with pre-existing conditions, expanded Medicaid coverage, imposed limits on out-of-pocket costs, offered new coverage options for young adults and created lower-cost marketplaces. health insurance. The list of Republican legislative accomplishments related to health care could fit in the top fifth of the paper, and even that would be long, because only one word is required: “nothing.”

Were these democratic ideas perfect? No, they weren’t. Do today’s Democrats agree on exactly what needs to be done to contain health care costs? Also no. President Biden has campaigned and continues to support a public health insurance option and lowering the Medicare eligibility age that best fits a public opinion landscape that wants the federal government to guarantee health insurance for individuals without necessarily assuming full control of the system. Other leading Democrats want to pursue more fundamental reforms under the banner of “Medicare for all.”

In any case, the Democrats are the only ones serious about health care, and that won’t change next year, especially when the GOP elites are completely consumed with their culture war hysteria and Republicans are more interested in not using vaccines. their children rather than keeping people alive. Good news for Republicans, though. if they like the inconsistency of their health policy, they can keep it, and most likely they will.

David Farris is an associate professor of political science at Roosevelt University and an author It’s time to fight dirt. How Democrats Can Build a Stable Majority in American Politics. His writing appeared Saturday, The Washington Post, New Republic, Washington Monthly and more. You can find him on Twitter @davidmfaris.

The views expressed in this article are those of the author.