The Washington Post reports,

Facing a severe budget shortfall, Rhode Island officials are seeking unprecedented authority to rein in Medicaid spending in a move that has alarmed Democrats in Congress and advocates for the poor.

Read the whole story. I think it offers a preview of what is in store for Medicaid and Medicare in the future. Faced with unsustainable spending, political leaders will attempt to cut benefits. This will lead to intense political conflict. In fact, my prediction is that political health care strategy going forward will be focused on trying to be the party that avoids blame for cutbacks in medical services under government programs.

Universal health insurance is a pretend battle. Cutbacks are the real battle. The pretend battle helps to divert attention from the real battle. That is why progressives cannot afford to win the pretend battle.