Actually the Public Option-not Single Payer-is the Next Step
Nothing like an idea whose time has come. That idea is the public option-not single payer. So I disagree with Paul Waldman here-though I suspect much of the disagreement is merely semantical:
Whatever happens, the GOP is bringing us a whole lot closer to single payer
That all depends on what you mean by ‘single payer.’
In a much looser and broader sense-as I suspect Waldman may mean it here-then maybe so. I mean is ‘single payer’ is just a kind of marker signifier of mood affiliation then maybe so. If you intend a more precise definition, then I’m not so sure.
“Let me point to one politician as an illustration. For years, Sen. Elizabeth Warren’s position on single payer has essentially been “Maybe someday” — not opposed to it, but focused in the short term on the more urgent priority of defending and enhancing the ACA. But in an article in today’s Wall Street Journal, we learn that she is now ready to take that plunge:
“President Obama tried to move us forward with health-care coverage by using a conservative model that came from one of the conservative think tanks that had been advanced by a Republican governor in Massachusetts,” she said during an interview in her Senate office last week. “Now it’s time for the next step. And the next step is single payer.”
“Warren is not going to be the last Democrat to take this step. In fact, any Democrat who runs for president in 2020 — and there will be a lot of them — will have a hard time explaining to the primary electorate why they don’t want single payer, and most or all of them will probably say they do.”
I’m not sure I love this idea-or believe it’s true. I despise the whole ‘single payer or bust’ or-‘Bernie or bust’ blackmail where you have to say exactly what we want you to say now, or you’re no better than Hitler or something.
I’m skeptical about the notion that everything should be packaged in simplistic ‘right or wrong’ terms-as if there is no grey area on anything. But Waldman seems to think that though Bernie only got 42% of the primary vote, he effectively won the argument.
“All the ups and downs of the past eight years, from the beginning of the debate on the ACA to the end of the debate on Republican repeal plans, hold many lessons for Democrats who are still eager to address the problems in the American health-care system. Among other things, we know that voters are risk-averse, that they’re extremely sensitive to out-of-pocket costs, that they want security and that arguments about the glories of the free market aren’t going to be persuasive to them. After seeing how desperately unpopular this Republican plan is, Democrats are going to be much less afraid to defend government health care and advocate its expansion.”
“And they know that whatever they propose next has to be simple and understandable. We can debate whether the ACA had to be as complex as it was, but next time around, no Democrat is going to believe that you can take on President Trump with a technocratic approach to health care. Saying “Here are the 10 tweaks I’d make to the ACA” isn’t going to cut it.”
“That isn’t to say that whatever plans they propose won’t be fully fleshed out under the hood, but they’ll have to be presented in a way that is easy for voters to understand.”
This seems to be accepting a moral frame where everything is ‘good or evil.’ There are no grey areas. I’m not sure I like this dismissal of ‘technocratic solutions.’ Not every thing is a simple case of right or wrong where if you take position A your righteous. Position B? Then you’re an evil corporate shill.
Here’s the thing-you should be as simple as possible-but not simplistic. The urge to put things in overly simplistic terms if the mark of a demagogue.
I do agree that voters are risk adverse. He takes from that they need something very simple to understand and that simple thing can only be ‘single payer.’
If I understand Waldman his use of ‘single payer’ is a lot broader than was, say Bernie Sanders in the primary. The idea though is that people have to find it a simple intuitive idea-complexity makes them mad.
But I think this points to a certain tension. I agree on the risk adverse idea. But this seems to me to argue against single payer-that imposes a huge level of new taxes and a very abrupt transition.
The lesson Hillary took from the failure of Hillarycare in 1994, is that you never want to take things that people already have-that’s the problem with single payer-as opposed to the public option.
Obamacare was structured to mess as little as possible with what people already had as possible-but even some people losing some crummy plans that weren’t really adequate was enough to spark GOP demagoguery.
If voters are risk adverse-as I agree they are-single payer is not for them:
“But the most ambitious single-payer plans are probably dead in the water. The California bill, like Sanders’ campaign plan, calls for extraordinarily generous benefits that outstrip those offered by most real-world countries with universal health care. California’s bill would have the state pay for all long-term care, nursing homes, dental, and vision, none of which the single-payer system in, say, Canada typically pays for (it doesn’t even pay for prescription drugs or therapy sessions with psychologists).”
Think about that-79 to 21. Yet Paul Waldman seems to think Bernie won the debate over single payer-after all he won 42% of the Dem primary.
Clearly these risk adverse voters aren’t won over at the simple words ‘single payer.’
And public option is just as simple as single payer to understand.
Sometimes Bernie or Bust types say ‘I don’t want the public option-we demand Medicare for All.’
This misses the point that the public option is also Medicare for All-or more precisely, Medicare for All Who Want it.
This Vox piece by Dylan Matthews underscores the problems with the Berniecare style single payer monstrosity:
“Thankfully, there is another way to achieve universal coverage, and move decisively toward single-payer, either federally or at the state level, one which doesn’t require sudden massive tax increases.”
“In 2006, Rep. Pete Stark (D-CA) introduced the AmeriCare Health Care Act. And it provides a much more promising path the US could take to universal coverage. It wouldn’t force employers or employees to abandon their plans overnight, and would cost a sizable but manageable amount every year. In many ways it’s truer to Yale political scientist Jacob Hacker’s Health Care for America Plan, which inspired the Affordable Care Act, than the law itself is.”
Now that plan-the AmeriCare Health Act plan sounds promising. Dylan Matthews correctly identified the problem with Berniecare-huge tax increases and changes everyone’s healthcare overnight-including those happy with their current plan.
This was my point about the public option. The big difference is this. Both single payer and the public option would create a new government healthcare payer-call this new government payer Medicare or Medicaid if you like.
But for the public option, this new Medicare payer for everyone-not just seniors-would not be imposed on those who didn’t want it. Those who want to stick with what they have now-employer HC, Obamacare exchange, the current Medicaid expansion, some very expensive private insurer they can afford-can just go on as before.
Again, we can get into semantics. Would the AmeriCare Health Act be considered single payer? Strictly speaking if it allows us to continue at least for the time being with a multiple payer system it wouldn’t be. But perhaps some like Paul Waldman just believe that single payer is a very positive marker-despite it’s ignominious defeat in a number of places including Bernie’s Vermont.
There is more to the AmeriCare Health Act. Dylan Matthews likes it because it could take us to single payer in the long term. But it’s not like Berniecare where you do everything overnight and have absurdly generous benefits-that are unsustainable.
This post, it seems to me, is long enough. But maybe in a post coming soon to you here on the Internet, we’ll look more into the weeds as it is very intriguing.
P.S. The media release from my very surprising poll vs. Peter King NY 2 is out. It’s very surprising as I-Mike Sax-am actually leading 51-41. I know, but the numbers don’t lie.
If you believe that 25 years is enough for an imperious monarch like Peter King NY-2 who is a Republican first and an American second and is too arrogant to even speak to his own constituents please help me any way you can. If you live in the area you can volunteer-or at least tell everyone you know. And no matter where you are in the country, donations help.
Mike Sax is the One to Dethrone the King
As for the good question as who the heck is Mike Sax, read this.