Liberal activists and Obamacare supporters have been telling us for years that Ocare is not really meant to be a platform for single payer, and anyone who says that is engaged in a conspiracy theory. They aren’t really looking for that, you guys, all they want is to make sure citizens have affordable health insurance, and Ocare is doing so darned great that there’s no reason for a public option. Hence the reason no one is calling for a public option. Not Bernie Sanders. Not Hillary Clinton. Not the NY Times, Washington Post, elected Democrats. No one. Certainly not Obama. Right?
There’s an odd sort of complacency, and even smugness, in some progressive circles over the problems being created by the flight of private insurers like UnitedHealth and Aetna from participating in the Affordable Care Act’s purchasing exchanges. It is being widely noted that this is precisely the sort of contingency that a “public option,†originally supported by the president and most congressional Democrats but abandoned in the final legislation to get it through the Senate, was designed to address. In the most prominent “told you so,†Bernie Sanders has predictably commented that the leverage of private insurers over Obamacare shows why we instead need a single-payer system that abandons private insurance entirely.
The collapsing support from insurers in the exchanges is not a bug, it is a feature, much like most provisions of Ocare. It’s all designed to a) put people more under the thumb of government and b) move towards full single payer.
Of course, NY Mag’s Ed Kilgore is very upset that Republicans will block any fixes to Ocare, because it apparently needs a lot of repairs. Seriously, why didn’t anyone point out all the potential problems before this travesty was passed over the objections of the citizens?
That is all well and good, but the very same political problems that prevented the adoption of a public option (much less “Medicare for allâ€) in 2009 and 2010 when Democrats controlled Congress by comfortable margins have gotten worse, not better. Yes, if Hillary Clinton is elected in November she has already announced support for adding a public option to Obamacare, and there’s a decent chance she will bring a narrowly Democratic Senate along with her. A Democratic House, however, remains a very long shot, and even if it happens, getting something as controversial as an Obamacare “fix†through a closely divided Congress is at best an even longer shot. Yes, in theory, something like an increase in insurance subsidies to lure the private companies back in could be enacted via a budget reconciliation bill that is immune to a GOP Senate filibuster. But progressive Democrats who want to abandon private insurance entirely aren’t likely to go along with that, and it’s doubtful a major structural reform could be accomplished without the kind of legislation that could be filibustered (barring elimination of the filibuster altogether).
Those political problems would be the public not wanting government run health care, not wanting Ocare in the first place, and elected Democrats mostly not wanting to expose their ultimate agenda, which the progressive base was pushing, namely, government run health care.
So even if they hate Obamacare’s structure and the very existence of private health insurance, progressives should hope against hope that private insurers hang around and that the ACA continues to function. Much of the coverage gains achieved by Obamacare were via state Medicaid expansions that are unlikely to be revoked, at least in the bare majority of states that enacted them. So the picture is not all bleak. But it’s politically unseemly and morally questionable for progressives to enjoy the problems bedeviling the ACA, even if they told us so.
In other words, Progressives should be circumspect over their ultimate plan of single payer, and celebrating the collapse of Ocare in order to push single payer overtly should be put on the back burner.
Oh, but don’t forget, Democrats had been telling us that Ocare was doing super awesome
Crossed at Right Wing News.
Read: NY Mag: It’s A Real Shame Republicans Won’t Allow Single Payer »
