sds:
Would a Public Option Will Lead to Single Payer? Many high-profile Democrats sure hope so.
There are many Democrats who want single payer and aren’t ashamed of it. In this video, I think Ezra Klein is the only individual (and he’s “merely” a high profile blogger) who seem to be saying that the public option is a trojan horse for single payer. I think what the rest of them are saying is, more or less, this:
given that single payer is not a realistic goal right now, that the single most effective thing that could its proponents could achieve would be to create a public health insurance option which, if successful, will short-circuit the rhetoric that government involvement in this sector is always a bad thing. It’s not stealth single payer. It would be a demonstration of the ameliorative effects of the government’s involvement, largely thanks to the size of the government’s bargaining power.
So here are the three most-predicted outcomes for a public option, off the top of my addled and kind of
1a. Lots of people pay less for health insurance and are happy.
1b. The public plan becomes a repository for high risk individuals. Without an offsetting population of healthier customers, the government must subsidize the program at levels that private alternatives can’t compete fairly with.
And here’s where ther rubber meets the road. Skeptics will say that either outcome will lead to:
2. The public plan crowds out private insurers and eventually becomes single payer.
So the plan will either be a success or it will fail itself into perpetual life support because people don’t give up entitlements once they get them.
And perhaps this is the case. Perhaps this is what Russ Feingold really wants, an institutionalized, permanent black hole on the federal balance sheet. I just don’t think so.
There is, of course, the chance that people who support the public option (and single payer!) genuinely want the net amount of money we spend on health care to go down, and while we think this would actually help, we would be willing to junk components of reform that didn’t meet that goal.
Perhaps I’m wrong and these folks are looking for a trojan horse (option 1b). I just don’t think so. The incentive to create a new entitlement just to give people free stuff so they love you is thwarted by the deadly allergy we now have to the tax increases that would be required for such a scheme to work. We’d be hoping for 1a, obviously, but I think there’s a downside scenario 1c in which a drowning-in-red-ink public plan is phased out rather than floated indefinitely. You’ll call me naive, but there you go.
In the current debate, the public option (which lacks robustness in the senate bills, btw) has been quite a distraction for the most part. But this conversation gets to the underlying cynicism so many have about the effort at health care reform: liberals can only be wanting to reform health care so that the end result is bigger government, because that’s what we want most, as opposed to affordable health care for the citizens of the country. Just bigger government and “free” shit. The public option can’t be something that we want in and of itself, it has to be a building block to total socialist utopianism, etc. There’s not even acknowledgement that the public option is a compromise position! Rather it’s a ploy.
