So, I’ve just read a delightful little piece from Vox’s Ezra Klein regarding the potential future of a single payer system. Basically it amounts to this: if the Republicans push through the AHCA they may very well pave the way for a medicare for all program.
Why would that happen? Well firstly because the AHCA, based off what we know from the house, will cause millions of people to lose healthcare, healthcare costs to skyrocket, and inevitably massive electoral changes because of that. Secondly, Obamacare, for all it’s successes was also fairly flawed (fixable but flawed), and due to the way it passed and what it attempted to achieve many members of the democratic congress may will prefer to go for the simpler system that people are now openly advocating for.
Let me explain: when Obama and his congress were trying to pass the Affordable Care Act they did two things, and had to deal with a third (you may have noticed, I like lists):
- Worked with insurers to create a system they could support in a public private marketplace. The insurers then undercut the Obama administration by screwing up the pricing and participation, and then failing to stand up to republicans as we speak (primarily so they can regain control over costs and types of insurance they provide, and therefore make more money)
- The Dems worked with the Republicans to try and create a bipartisan bill, mostly to be polite. They didn’t have too, but instead they brought them in, allowed a number of amendments to be added and removed and did their level best to involve and respect the Republican view of healthcare. In turn the Republicans turned their backs on the arrangement and opposed the bill as best they could then.
- Past that, the Republican party then opposed and demonized the ACA for the next seven years, and used it to sweep themselves into office, rather than work to make it an effective bill for their constituents. Because Obama, or something.
So, basically despite their best attempts, the Dems were opposed an obstructed from making an incrementalist healthcare program work because the Republicans were basically being a bunch of dicks. So this time they might not even bother, nor might they need to, consult them in anyway and just pass single payer health care. If they can sweep the house, get the senate, which might well be possible, on a healthcare platform there is every chance they could pass such a bill. And since it would fundamentally be ‘better medicare’ people would be more open and accepting and most importantly understanding of the bill, Insurers wouldn’t be able to get in the way and Republicans would have a much harder time attacking the program.
Best of all the Democrats are openly and actively talking about this, not just the hopefuls but the moderates. They’ve seen incrementalism fail despite their best efforts, and now they have momentum. This could actually work.
So hey, silver lining for American healthcare. Maybe.