44 United States The EconomistSeptember 28th 2019
searchers to check in on the same individ-
uals over time—a method that allows
pollsters to conduct what they call “panel”
surveys—to measure actual changes in
opinions and to focus on smaller sections
of the population. Both these practices are
close to unaffordable for all but the best-
funded telephone pollsters.
The future of polling has yet to be deter-
mined. “It pays to be nimble,” Mr Griffin
says. Online surveys rely on complex sta-
tistical adjustments called “weighting” to
ensure the demographics of their respon-
dents match the overall portrait of Ameri-
cans. At present this strategy is working,
but only because Americans’ political be-
haviour is closely related to their demo-
graphic group. African-Americans and
whites differ on who they want as presi-
dent as do voters with and without collegedegrees. Changes in those correspon-
dences can catch pollsters off-guard. Re-
searchers at the University of New Hamp-
shire neglected to take education into
account when weighting their polls for the
2016 presidential election, over-counting
degree-holders. They predicted Hillary
Clinton would beat Donald Trump in the
state by 11 percentage points. In the end, she
won by 0.4 points.
“The truth is that surveying people is
hard,” Mr Griffin says, “and any single sol-
ution is probably going to be inadequate.”
The only way to future-proof the public-
polling industry is to experiment constant-
ly with new technologies. Many organisa-
tions are doing just that. Because of the
speed of technological change, the ones
that are not will soon be forced to follow
suit—or shut their doors. 7S
peaking to acrowd of 20,000 from be-
neath the arch of Washington Square
Park in New York on September 16th, Eliza-
beth Warren received the loudest cheers
when she declared: “I know what’s broken,
and I’ve got a plan to fix it.” In a Democratic
presidential primary contest in which
there has been little movement in the can-
didates’ positions in the polls, Ms Warren,
a senator from Massachusetts, has engi-
neered anexceptional rise, thanks in part
to her plans, both wonkish and attention-
grabbing, for universal child care, a wealth
tax, a $3trn climate-change plan and the
break-up of America’s biggest technology
firms. But on health care—which may be
the biggest issue of the election—Ms War-
ren does not have a plan of her own. Nor, it
seems, does she intend to release one.
Throughout the primary, Ms Warren
has signalled unwavering fealty to the
Medicare for All proposal advanced by Sen-
ator Bernie Sanders, a fellow progressive.
But she was once more open to other posi-
tions. Though all the Democratic Party’s
primary candidates agree on the need for
universal coverage (27.5m Americans, or
8.5% of the population, still lack health in-
surance), they disagree on the best way to
achieve it. Medicare for All, which has be-
come the default progressive plan, envis-
ages a single-payer system free at the point
of service—abolishing private health-in-
surance schemes altogether. The moder-
ates who dislike Mr Sanders’s ideas—like
Joe Biden, Pete Buttigieg and Amy Klobu-char—propose improvements to private
health-insurance exchanges created by
Obamacare and the creation of a public op-
tion for those who want it.
Ms Warren previously seemed persuad-
ed by such a policy. Her Consumer Health
Insurance Protection Act, reintroduced in
April of this year, sensibly focuses on shor-
ing up exchanges, ending surprise billing
and closing some loopholes for sub-stan-
dard health insurance. At a town-hall meet-
ing broadcast on cnn in March, she
sounded open to “different pathways” to
Medicare for All.
She has remained vague on the subject.Though she is famous for her attention to
detail, she often talks about health care in
no more than generalities. On September
19th Mr Buttigieg took a swipe at her for be-
ing “extremely evasive” when she was
asked whether Medicare for All would in-
crease middle-class taxes. Ms Warren
seems reluctant to talk about details like
costs and implementation timelines, per-
haps because remaking the enormous
American health-care sector in the image
of Britain’s National Health Service could
realistically take a decade.
This uncertain positioning is not un-
ique to Ms Warren. Kamala Harris has per-
formed a tortured dance of support for the
Medicare for All plan, flip-flopping several
times on whether or not she would ban
private insurance, as the plan dictates. Yet
even Ms Harris, who has been much wool-
lier on policy than Ms Warren, has released
her own version of Medicare for All. Other
candidates who are further down in the
polls, like Cory Booker, a New Jersey sena-
tor, and Andrew Yang, a businessman, have
embraced Mr Sanders’s plan without offer-
ing their own.
The drawback of Ms Warren’s vague ap-
proach is that Mr Sanders’s specific vision
for achieving universal coverage goes un-
challenged. Both Germany and Australia
have done what he proposes through a mix
of public and private options—a model that
may be more easily accomplished in Amer-
ica than a single-payer option. At the same
time Medicare, in its current form, also has
some disagreeable attributes: it is far from
free at the point of service, it pays for many
expensive drugs without conducting cost-
benefit analyses and it involves some oner-
ous billing paperwork.
Preliminary costings of a Sanders-style
plan suggest new government expendi-
tures of $30trn or more over the course of a
decade. That is 11 times the (optimistically
estimated) revenue brought in by Ms War-
ren’s wealth-tax idea—suggesting that
most of the balance would have to be raised
from less wealthy Americans. Her general
retort to this sort of point—that aggregate
health costs would still drop for middle-
class families—is both fair and deserving
of more detail.
Yet vagueness could be politically ad-
vantageous for Ms Warren. Her steadfast
support for Medicare for All allows her to
attract progressive voters within the
Democratic electorate—especially the col-
lege-educated whites who have fuelled her
rise in the polls. Criticism of the plan from
moderates has been directed at Mr Sanders.
That dynamic was on vivid display in the
last presidential debate, held in Houston
on September 12th. Yet if the primaries de-
liver Ms Warren the presidential nomina-
tion, she will need to be prepared for voters
to give her health-care plans a more thor-
ough examination. 7NEW YORK
The senator from Massachusetts, usually big on detail, has stayed vague on
health careHealth careWhat Warren wants
Very general medicine2