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If Trump, Bernie are nominees 

Here's a puzzler: What happens if the major parties nominate Donald Trump and Bernie Sanders for president?

Here's a puzzler: What happens if the major parties nominate Donald Trump and Bernie Sanders for president?

Trump, after all, is the runaway leader in Republican polling, and the media are gleefully celebrating Sanders' steady rise as a sign that Hillary Clinton will collapse and give the Democratic left its first standard-bearer since George McGovern in 1972. What a hoot of an election that would be. While you might find it painful to contemplate for the future of the country, for sheer theater you couldn't beat it.

Bernie Sanders won't make it or even come very close, but simply to entertain the idea is to feast upon the central narrative of this political era: the fierce pressure to shove each party to its polar extremity. Trump and Sanders would just about achieve that, although on ideology alone the Republican field has more extreme candidates, notably Ted Cruz. But on the authoritarian-democratic yardstick, Trump and Sanders are at the poles.

Despite huge dissimilarities in both style and substance, Trump and Sanders weirdly share some of the same instincts on the burning issues of the day, like universal health insurance, their disdain for meddling in the fratricidal politics of the Middle East as the Bush presidents did, and their (somewhat distant) past agreement on social issues like abortion and guns.

As these contests ultimately do, a Trump-Sanders race surely would focus the candidates on the big issues of the day. When you're running against your teammates, who disagree only at the margins on nearly everything, promising to be meaner, louder and tougher is all that you can do. But when you are running against the other party's candidate, even Donald Trump will be forced to engage specifically on the big issues. Which are?

The biggest would be Obamacare. Since the summer of 2009, nothing has so absorbed the public mind in volume and intensity, like Obamacare. The House and the Senate have voted collectively more than 60 times to repeal the Affordable Care Act. Knowing a presidential veto would render each vote meaningless, none of the repeal resolutions ever proposed a system to replace it. Newt Gingrich, the former speaker whose pace-setting presidential run ended in Iowa in 2012, said if they ever had to get serious the Republicans — their presidential nominee and their Congress — would have to posit something to replace Obamacare.

By Election Day, no more than 19 states representing less than a fifth of the uninsured population of the country will be refusing the Medicaid expansion authorized by Obamacare. Close to 20 million Americans who never had health insurance or had lost it will be insured, and hospitals and other medical institutions in those states will be even more desperate for the program. For states like Arkansas that are now run by Republicans, the prospect of losing Obamacare and seeing their budgets wrecked and their tax cuts rendered catastrophic, just condemning Obamacare or fence-straddling would no longer be an option.

So what would a health-care debate look like if it were between Donald Trump and Bernie Sanders, who both favor scrapping Obamacare and implementing a single-payer, government-guaranteed insurance program for everyone?

Every Republican candidate has pledged to repeal Obamacare but none has laid out what he or she would do to replace it, though several have hinted they would keep parts of it that are popular. In fact, if you ask people about the distinct parts, almost every part of it polls favorably. It's just the notion of Obamacare they don't like. But vague though he is, Trump is more specific than any of his foes. He would cover every single person, whether they work or not, and the government would pay for everything. But he might, he says, use private insurance carriers like Obamacare does. While Obamacare subsidizes the premiums for people with low incomes, Trump would pay it all for them.

How would the government pay for it? Higher taxes obviously, but Trump won't say, now.

Over on the Democratic side they are having that debate. The example doesn't recommend itself to Republicans and it suggests the pickle that Trump will find himself in, whether he faces Sanders or Hillary Clinton.

Clinton defends Obamacare and will continue it, with some tweaks — as she should, since Obama borrowed it from her 2008 campaign for president. She, of course, borrowed it from congressional Republicans who proposed it to counter her ill-fated health plan in 1993. She attacks Sanders for wanting to raise taxes on the middle class to help pay for expanding Medicare to cover everyone.

Clinton has been as disingenuous in attacking Sanders as the Republicans have been in attacking Obamacare. While it is true that Sanders' plan, based on the bill he introduced in 2013, would mean about $850 billion a year in new taxes, much of it on the middle class, Clinton doesn't balance the new taxes with the household savings. No one would pay any medical expense. There would be no co-pays, no deductibles and no exemptions like dental or vision care. Politifact's analysis is that the Sanders plan would save average households, after the taxes, a net of $505 to $1,823 a year. Sanders says people would save between $3,855 and $5,173 a year.

But imagine a presidential candidate talking openly in any context about raising nearly everyone's taxes, not just the wealthy's. If Sanders and Trump meet this fall that debate will have to happen. Trump's plan, by the way, would be more expensive, demanding even greater taxes, if he writes the insurance industry into the universal plan. Taxpayers would have to pay for the industry's overhead and a modicum of profit.

And if it is Donald and Hillary, not Bernie, that debate will be particularly one-sided, with Hillary hammering the Republican for imposing gargantuan taxes on the American people.

Bring it on.

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