I’ve heard a lot of talk lately from the supporters of the Obama bill about how, if Congress can just pass some form of health care reform, we can work incrementally to build a single payer system out of that edifice. Somehow if we pass this bill, single-payer might grow out of slow but steady progress in the next decade or so.
Leaving aside the awful effects of the bill for a second, let’s see why.
Social Security, Medicare, and Medicaid were created as government programs, administered by the state via public agencies. These were and are redistributive programs removed from the market, and as much as they have been toyed with by legislators over the years the reason they are able to be counted as great victories is because they are under at least de facto public control. As citizens, if we are disgusted by how these programs function or are administered we can express our concern to elected officials. In addition they were created to deal with both festering social problems but also because large, powerful social movements were feared enough by officials that the programs were created to head off larger social explosions.
The Obama bill does not create a public plan at all but a system of elaborate corporate subsidies to the health insurance oligopoly. Subsidies, once entrenched, are extraordinarily difficult to remove. Think capitalists and corporations have too much power now? Imagine what trying to institute a single-payer system (obliterating the industry entirely) will be like in 2020 after even six years of these subsidies. America, welcome to the newest parasite attached to your lower intestines.
Finally, Obama and the Dems were clearly not afraid of a social movement – the single-payer wing of the health care debate has been routinely marginalized and ignored. Obama was far more afraid of the health care wing of the ruling class than he ever was of losing votes from the left. Truly bloodsuckers, indeed!