The choice: A healer or a heel

In 2017, Nancy Pelosi warned Republicans that their health care policies will be “tattooed on your forehead. You will glow in the dark with this one, you will glow in the dark.”

Using health insurance as their signature issue, Democrats routed Republicans in the mid-term elections of 2018, and Pelosi became Speaker of the House.

In the midst of a pandemic, in which the United States has suffered more fatalities per capita than all but a handful of other nations, Nov. 3, 2020, is almost certain to be a referendum on public health. Former Vice President Joe Biden has already defined the presidential election as, in essence, a contest between an empathetic and experienced healer and a callous and clueless heel.

The strategy appears to be working. A poll completed in mid-July found that 54 percent of Americans trust Biden to address the Coronavirus crisis, while only 34 percent expressed confidence in President Trump. In another survey, Americans gave Biden a substantial edge over Trump on a range of personality traits: honesty, cares about the needs of ordinary people, a good role model, even-tempered.

The health crisis provides an opportunity as well for Democrats to energize voters who support their party — and make inroads among those who cast ballots for Trump in 2016. Already aroused by the movement for racial justice that emerged in the aftermath of the death of George Floyd and President Trump’s defense of Confederate monuments, African Americans and Latinos, it is now clear, are about three times more likely to be infected with the Coronavirus as their white neighbors and nearly twice as likely to die from the disease. Many of them have front-line jobs, rely on public transportation, share living spaces with other people, including elderly relatives, have underlying medical conditions and less access to quality healthcare. They are collateral damage of Trump’s politicization of COVID-19.

Other casualties include Americans over the age of 65, who are more likely than younger people to support mask wearing and social distancing and who are apprehensive about a premature reopening of the economy. Many in this age cohort, which was responsible in no small measure for Trump’s victory in 2016, now find the president “self-absorbed” and “not serious” — and prefer Biden.

In 2020, Democrats should also return to the public health agenda that resonated with so many voters in the mid-term elections. Despite Trump’s promises, they can point out, his administration did not even draft — let alone get a Congress controlled by Republicans to pass — a replacement for the Affordable Care Act. Instead, they will no doubt remind voters, Trump’s Justice Department has asked the Supreme Court to overturn Obamacare (which, according to a Fox News poll, is supported by 56 percent of Americans), a move that would eliminate coverage for as many as 23 million Americans (in the midst of a once-in-a-century pandemic that has significantly increased the number of people without health insurance).

Democrats should expose as lies Trump’s claims — “I was the person who saved pre-existing conditions in your healthcare” and “I have now brought [healthcare] to the best place in many years.” With surveys indicating that 52 percent of Republicans, 67 percent of independents, and 80 percent of Democrats favor government regulations to insure coverage for pre-existing conditions, the Democrats can emphasize that many of the 130 million Americans who have pre-existing conditions will lose the ACA’s lifesaving protections.

Equally important, the Democratic campaign can tout Biden’s healthcare plan, which features lowering the age to opt into Medicare to 60; offering a “public option” to anyone not satisfied with employer-sponsored coverage; reducing costs to people who buy insurance on the ACA exchanges; and repealing laws exempting corporations from negotiating with Medicare over drug prices. Unlike “Medicare for All,” which remains controversial, these significant but incremental reforms are likely to garner support from a substantial percentage of voters.

Recently, Biden has contrasted his approach with that of the president, who, he says, “has quit on the country” because he is unwilling or unable to understand that “he can’t deal with our economic crisis without serving, saving, and solving the public health crisis.”

In the next 14 weeks, President Trump may well “glow in the dark on this one.”

Glenn C. Altschuler is the Thomas and Dorothy Litwin Professor of American Studies at Cornell University. He is the co-author (with Stuart Blumin) of “Rude Republic: Americans and Their Politics in the Nineteenth Century.”