Author: Paul Deaton

Since signing a caucus commitment card for Elizabeth Warren on Sept. 15, all campaign activity increased in the state’s most Democratic county.

Traveling to Des Moines for the Nov. 1 Iowa Democratic Party Liberty and Justice Celebration was beyond the ken of my life in Big Grove. The event did kick off a final phase of the race to the Feb. 3, 2020 Iowa caucuses — campaigns are getting more serious because it’s now or never.

I favor doing well in the general election over a caucus victory for Warren. After all, there are 49 other states plus territories to weigh in by next summer’s Democratic National convention. Super Tuesday looms just ahead of the caucus when a quarter of the delegates will be selected. As the likely temporary chair of my caucus, it is important to be equitable in approach to candidates, keeping an eye on the bigger picture. The long haul to the general election is what matters most on Feb. 3.

Big Grove precinct went for Obama in the 2008 general election, and then for him again (just barely) in 2012. In 2016 Trump was a favorite here, winning by 54 votes. With effort, Big Grove precinct can swing back to support the Democratic presidential nominee and hopefully down-ticket candidates like U.S. Senator and U.S. Representative as well. There are primaries in both federal races which will garner more attention after Feb. 3.

The initial canvass of my precinct began. The first people contacted either don’t know for whom they will caucus or support Minnesota Senator Amy Klobuchar. Klobuchar would be my second choice. There was also a lone, vociferous Biden supporter.

I attended the county central committee meeting on Thursday and was surprised to see an organizer for Senator Michael Bennet still pitching his campaign. While there is surge capacity among campaigns, if a candidate doesn’t already poll at five percent or more, it is difficult to see their path to winning the Iowa caucus, let alone winning the nomination. Pete Buttigieg is arguably the only candidate who thus far surged to rank in the top tier of Democratic candidates. I’m just saying if candidates are not registering among voters there is no path to the nomination.

I’m also thinking of John Edwards who placed second in the 2008 Iowa caucuses but hadn’t built adequate campaign structure in South Carolina and Nevada. He couldn’t compete in Super Tuesday states. This cycle’s March 3 Super Tuesday may not decide the nominee, but it’s hard to see how candidates who go all-in in Iowa to get a ticket out, like Castro and Harris, can ramp up quickly enough to gain momentum by Super Tuesday. Anything is possible, but is it realistic?

I’ve been under the weather for several days, focused on getting better. My walk list rests on the steps waiting for healing. I worked outside during my shift at the home, farm and auto supply store and burned brush yesterday. Outdoors work has been needed time for reflection and healing.

Kale continues to grow despite overnight temperatures in the 20s. I brought it inside, cleaned it, and added some to a pot of soup. For lunch I plan kale and black bean tacos with chili sauce from New Mexico peppers. I’ll soon return to a hundred percent, ready to continue the canvass, and return to work toward the general election. Politics isn’t everything in my life. It is something.

A colleague at the warehouse club had it right. When he was ill enough to require treatment he went home to Mexico and walked into a clinic. Afterward he returned to work.

The distance between Iowa and rural Mexico notwithstanding, that’s what local health care should be. A person should be able to walk into a nearby clinic seeking treatment without cost or worry.

Instead we have an impossible discussion of how health care needs of Americans should be met.

Is it the responsibility of government to make sure every person within our borders gets health care they require? According to Gallup, after the Patient Protection and Affordable Care Act (ACA) was signed into law, the percentage of people who told pollsters government should not be involved in health care increased to a majority. After the inauguration of the 45th president, the trend changed with 57 percent of poll respondents saying government should make sure all Americans have health care coverage. Voters are divided.

The Kaiser Family Foundation found an answer among Democrats as to how government efforts to ensure people have health care coverage should change. 39 percent of poll respondents said the ACA should be replaced with a Medicare-for-all plan, 55 percent said the government should build on the ACA. The simple truth is many Democrats don’t favor a candidate who supports Medicare-for-all and have concerns such support will result in losing the general election.

In the Democratic primary contest four candidates are emerging as leaders: Joe Biden, Pete Buttigieg, Bernie Sanders and Elizabeth Warren. If any one of these candidates were the Democratic nominee for president I would support them in the general election. There could be surprises in the time leading up to the March 3, 2020 Super Tuesday primary election. However, it is a safe bet saying the nominee will be one of these four people.

Each has addressed health care delivery and the approaches vary. Biden and Buttigieg favor a method of health care delivery that allows continuance of private health insurance. Sanders and Warren favor Medicare-for-all. Here’s a brief statement about each position:

Joe Biden: “As president, Biden will protect the Affordable Care Act from these continued attacks. He opposes every effort to get rid of this historic law – including efforts by Republicans, and efforts by Democrats. Instead of starting from scratch and getting rid of private insurance, he has a plan to build on the Affordable Care Act by giving Americans more choice, reducing health care costs, and making our health care system less complex to navigate.”

Pete Buttigieg: “We must ensure that everyone has an affordable option for health coverage that guarantees access to care when they need it.” To differentiate himself from Sanders and Warren, Buttigieg calls it “Medicare for all who want it.”

Bernie Sanders: Medicare for All. “We say to the private health insurance companies: whether you like it or not, the United States will join every other major country on earth and guarantee healthcare to all people as a right. All Americans are entitled to go to the doctor when they’re sick and not go bankrupt after staying in the hospital.”

Elizabeth Warren: “Elizabeth supports Medicare for All, which would provide all Americans with a public health care program. Medicare for All is the best way to give every single person in this country a guarantee of high-quality health care. Everybody is covered. Nobody goes broke because of a medical bill. No more fighting with insurance companies.” On Friday, Warren released her plan to pay for Medicare for All.

Democrats appear to enjoy candidate debate over health care coverage, but here’s the rub: nothing, and I mean nothing, will happen on any of these plans without consent of the Congress.

Dial back for a moment to the inauguration of Barack Obama. If there were a way to create a public option for health care, the 44th president would have done it. There wasn’t, even with a filibuster-proof, Democratically controlled Senate. In a best case scenario this cycle, Democrats can hope for a Senate majority numbering in the low fifties. The master of delay, avoidance and obfuscation Mitch McConnell will kill any efforts on the part of a Democratic president to dream big and work hard to implement any of the proposed changes to government health care. For this reason it is critical to focus as much on the U.S. Senate races that are up this cycle as the presidency.

Like most Democrats I will support our eventual presidential nominee regardless of plan for health care programs. It is good the four leaders have a plan. What matters more is how hard they will work to implement some part of it. Equally ranked in importance is the primary election for Iowa’s U.S. Senate race and regaining a Senate majority. This is no time for distractions as much as we Democrats may like the debate over health care.