Since 2016, as Bernie Sanders has risen in national prominence and his Medicare for All proposal has gained increasing momentum, corporate America has been gearing up for a war over the policy. And now, as the health and pharmaceutical industries align themselves with Joe Bidens presidential campaign, we have a clearer idea of what their battle plan will look like.

As Bloomberg first reported Monday, the neoliberal think-tank Third Way has been polling Americans to figure out which attacks will be most effective in a coming public relations campaign against the policy. The survey builds on documents leaked to the Intercept in 2018, detailing the contours of a planned campaign by the private health care sector to change the conversation around Medicare for All and prevent it from becoming part of a national political partys platform in 2020.

While billing itself as a national think tank that champions modern center-left ideas, Third Way is a conduit for a panoply of corporate interests that campaigns against left-wing policies in 2013, two of its highest-ranking officials wrote a Wall Street Journal op-ed warning that economic populism is a dead end for democrats. One of those officials, Executive Vice President Jim Kessler, the former longtime aide of Wall Streets favorite Democrat Chuck Schumer, has admitted the majority of Third Ways financial support comes from Wall Street, which views the health insurance industry as a great investment. At least as far back as 2013, it was staffed with Republicans and fundraising from a variety of corporations, donations that the companies themselves sometimes listed as part of their lobbying budgets.

Today, one of its leadership team once worked for the National Association of Manufacturers, a Republican-aligned business group that, among other things, fights climate action and in its earlier years was one of the earliest forces to organize against Franklin Roosevelts New Deal. Meanwhile, Third Ways board of trustees currently features a former private equity titan, a former Goldman Sachs executive, the head of a major corporate lobbying firm that has counted pharmaceuticals as its clients, and several other private equity and bank executives.

Third Way has openly said it views Sanders alone among the Democratic field as an unacceptable choice for the nomination, so threatened by his campaign that theyve now come around to even longtime nemesis and Sanders rival Elizabeth Warren. In 2018, the organization convened a meeting of 200 elected Democrats, political operatives, and donors to launch a serious, compelling economic alternative to Sanderism, as Kessler put it.

Although health insurers and the pharmaceutical industry are funding a variety of Democratic candidates all of whom are now either attacking or backed away from their earlier support for Sanderss Medicare for All bill the primary conduit for their campaign against the policy appears to be Biden. Health insurers were thrilled when Biden entered the race, seeing his campaign as a bulwark against Sanderss plan for Medicare for All, and an In These Times investigation from July found that Biden received the most money in the Democratic field from insurance and pharmaceutical employees, while Sanders received the least. He kicked off his campaign with a fundraiser hosted by a health insurance executive, and one of Bidens campaign aides is a former health care lobbyist.

Not only that, but Bidens advisor and chief pollster John Anzalone is the president of the firm that authored Third Ways survey, Anzalone Liszt Grove Research (Anzalones partner, Lisa Grove, conducted the polling). Anzalone joined Trade Works for America earlier this year, an organization co-founded by Vice President Mike Pences current chief of staff thats partly funded by the pharmaceutical industry and is pushing for Trumps sequel to NAFTA.

The results of the survey, which found majority support for Medicare for All among those polled, including 75 percent of Democratic primary voters, potentially give us a sneak preview of the negative campaign the health care industry and the candidates it funds will embark on.

Polling showed that solid majorities thought statements arguing that Medicare for All would end Medicare as we know it (54 percent), produce lower-quality care and longer wait times for seniors and the disabled (60 percent), and that it would cost an extravagant amount and require doubling payroll taxes (59 percent), were all convincing arguments against the policy. Most potent were statements pointing to issues with the chronically underfunded Veterans Affairs health care system (64 percent), and fearmongering about the wait times of the United Kingdoms far superior (and deliberately underfunded) government-run health care system (61 percent). Deemed least convincing were arguments that Medicare for All would empower bigoted politicians to control Americans health care (39 percent) and that it would be a giveaway to employers (49 percent).

Weve already seen the Biden campaign and other candidates deploy some of these arguments. Biden has made the ten-year $30 trillion cost of Medicare for All a core part of his attack on the bill, saying that the tax hikes needed to fund it are too expensive, that it would mean Medicare goes away as you know it and that all the Medicare you have is gone, and, as he told a forum hosted by seniors advocacy organization AARP, that it would create hiatuses in care. He even briefly deployed the argument that the policy would let employers off the hook. There is a remarkable convergence between Bidens talking points and those tested by the organizations survey.

In spite of the motivation behind the poll, some of its results should actually hearten Medicare for All proponents.

Even after hearing only the arguments against Medicare for All, 48 percent of Democratic primary voters still supported the policy, versus 40 percent who opposed it. After hearing both the positive and negative statements about it, 58 percent of this group still supported Medicare for All. (Seventy-two percent did after hearing only positives.) All of this suggests that Medicare for All, brought into the political mainstream by Sanders after the 2016 campaign, has robust support among Democratic voters.

Perhaps more significantly, even as respondents gave high approval to doctors (83 percent) and, especially, nurses (95 percent), they were uniformly unfavorable toward health insurance (57 percent), pharmaceutical (69 percent) and prescription drug companies (67 percent). In fact, independent voters were markedly less favorable to those industries than Democratic primary voters were. While the road to persuading the public about Medicare for All is far from over, there is clearly little sympathy for the private sector companies that currently control the US health care sector and bankroll Third Way.

Meanwhile, 28 percent of respondents said premiums were their largest financial worry, while 23 percent named deductibles, and 16 percent singled out co-payments. Forty-three percent said somebody in their immediate family had gotten a surprisingly high health care bill in the last five years and when asked how much they thought was fair to pay for health insurance each month, a majority (68 percent) chose between $0 and $200.

Given that Medicare for All not only eliminates those costs, but is actually tipped to save households money overall a family of three on $60,000 a year would pay just $930 annually, or $77.50 a month, according to a 2018 analysis by the University of Massachusetts Amhersts Political Economy Research Institute this could present an avenue of persuasion for the bills proponents. Fifty-eight percent of respondents in the Third Way poll thought the bills elimination of these costs was a convincing argument in support of it. Of course, Third Way didnt mention Medicare for Alls cost savings to its respondents; a plurality thought the description will lower health care costs applied more to Third Ways health care plan, which simply caps out-of-pocket costs to a percentage of household income.

The 2020 election is less a contest between different candidates and more a battle between big business and the working class, with the issue of health care the number one concern among voters at its center. On one side is Joe Bidens campaign, which, whether hes conscious of it or not, is in reality one part of a multifront operation by the private health care sector to derail Medicare for All. On the other side is Bernie Sanderss campaign, which has sworn off big money donors, is aligned with a variety of grassroots groups pushing for Medicare for All, and has emerged as a nationwide tribune of working-class anger.

Somewhere between these two fronts is Elizabeth Warren, who is now genuinely surging in the polls after months of artificial elevation by a sympathetic media. Though Warren holds similar policy positions to Sanders, she has been inconsistent in her support for single-payer health care, calling it the most obvious solution in a 2008 book, before refusing to endorse it in her 2012 Senate run, and repeatedly waffling on her support for Sanderss bill to the point that even mainstream news outlets have taken notice. She also continues to rely on big money donors, anchoring her current run in a $10 million transfer from her Senate coffers that was raised from wealthy fundraisers and tapping a major big-dollar fundraiser to be her treasurer, and she refuses to rule out funding her general election campaign with big-money donors. Should Warren win the nomination, now a distinct possibility, this could offer another point of leverage for the health care sector to defeat Medicare for All.

Defeating Joe Bidens campaign, an unabashed electoral channel for all manner of corporate interests hoping to defeat Medicare for All and other left-wing policies, should be the number one priority of the broad left. But even after Bidens gone, well have to exert all the pressure we can to keep Medicare for All on the table in any future Democratic administration.

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In Joe Biden, the Health Care Industry Has Found Its Guy - Jacobin magazine