28 United States The EconomistSeptember 28th 2019
searcherstocheckinonthesameindivid-
uals over time—a method that allows
pollsterstoconductwhattheycall“panel”
surveys—to measure actual changes in
opinionsandtofocusonsmallersections
ofthepopulation.Boththesepracticesare
closetounaffordableforallbutthebest-
fundedtelephonepollsters.
Thefutureofpollinghasyettobedeter-
mined.“Itpaystobenimble,”MrGriffin
says.Onlinesurveysrelyoncomplexsta-
tisticaladjustmentscalled“weighting”to
ensurethedemographicsoftheirrespon-
dentsmatchtheoverallportraitofAmeri-
cans.Atpresentthisstrategyisworking,
butonlybecauseAmericans’politicalbe-
haviouriscloselyrelatedtotheirdemo-
graphic group. African-Americans and
whitesdifferonwhotheywantaspresi-
dentasdovoterswithandwithoutcollegedegrees. Changes in those correspon-
dencescancatchpollstersoff-guard.Re-
searchersattheUniversityofNewHamp-
shire neglected to take education into
accountwhenweightingtheirpollsforthe
2016 presidentialelection,over-counting
degree-holders. They predicted Hillary
ClintonwouldbeatDonaldTrumpinthe
stateby11 percentagepoints.Intheend,she
wonby0.4points.
“Thetruthisthatsurveyingpeopleis
hard,”MrGriffinsays,“andanysinglesol-
utionisprobablygoingtobeinadequate.”
Theonlywaytofuture-proofthepublic-
pollingindustryistoexperimentconstant-
lywithnewtechnologies.Manyorganisa-
tionsaredoingjustthat.Becauseofthe
speedoftechnological change,theones
thatarenotwillsoonbeforcedtofollow
suit—orshuttheirdoors. 7S
peakingtoacrowdof20,000frombe-
neaththearchof WashingtonSquare
ParkinNewYorkonSeptember16th,Eliza-
bethWarrenreceivedtheloudest cheers
whenshedeclared:“Iknowwhat’sbroken,
andI’vegota plantofixit.”Ina Democratic
presidential primary contest in which
therehasbeenlittlemovementinthecan-
didates’positionsinthepolls,MsWarren,
asenatorfromMassachusetts,hasengi-
neeredanexceptionalrise,thanksinpart
toherplans,bothwonkishandattention-
grabbing,foruniversalchildcare,a wealth
tax,a$3trnclimate-changeplanandthe
break-upofAmerica’sbiggesttechnology
firms.Butonhealthcare—whichmaybe
thebiggestissueoftheelection—MsWar-
rendoesnothavea planofherown.Nor,it
seems,doessheintendtoreleaseone.
Throughout the primary, Ms Warren
has signalled unwavering fealty to the
MedicareforAllproposaladvancedbySen-
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. 7NEWYORK
ThesenatorfromMassachusetts,usuallybigondetail,hasstayedvague on
healthcareHealthcareWhatWarrenwants
Very general medicine2