Rob Horowitz: The Politics Rule Out Single-Payer Health Care System

Tuesday, April 03, 2012

Rob Horowitz, GoLocalProv MINDSETTER™

 

Last week’s oral arguments over the constitutionality of “Obamacare” and the prospect of the Supreme Court ruling that the law’s individual mandate requiring citizens to purchase health insurance is unconstitutional has reignited dormant longings by liberals for the adoption of a single-payer national health care system.

Liberal Washington Post columnist Eugene Robinson wrote, “If the Supreme strikes down Obamacare, a single-payer system will go from being politically impossible to being in the long-run fiscally inevitable.” Robinson’s thoughts were echoed by a number of other liberal columnists and by commentators on liberal-leaning MSNBC.

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Unfortunately, no matter how strong the substantive case may be for a single-payer health care system, the politics still preclude it. Even with large Democratic majorities in the House and Senate, Obamacare was difficult to pass despite the fact that the bill was supported by the American Medical Association(AMA) and the insurance industry was in neutral. Today, these powerful interests would launch an all-out campaign against any effort to adopt a single-payer, government-run heath care system

Further, major changes in our health care system are always difficult to achieve because people by and large are satisfied with the quality of their own health care and health insurance. While the number of Americans without health insurance is increasing, most Americans remain insured. Since most Americans are fine with the status quo, a proposed complete overhaul—once attacked by opponents—is unlikely to maintain popularity. Even now, only 36 percent of Americans approve of Obamacare while 47 disapprove, according to a recent CBS News/New York Times poll. Just imagine how unpopular a proposal that could be accurately described as “government run health care” would be.

The liberal wishful thinking about the possibility of single payer is rooted in the disappointment many liberals felt in the jettisoning of the public option component of Obamacare as part of the compromises made in order to pass the bill. Despite the fact that the Congressional Budget Office estimated that this proposed limited government-run health insurance program would only be used by six million Americans by 2019, Obama’s refusal to fight for it took up hours of coverage on MSNBC and thousands of column inches in papers and blogs.

The plain facts are that Obamacare, with all its messy compromises and imperfections, is a landmark accomplishment. Among other important features, it provides nearly universal health care coverage; prevents insurance companies from denying insurance to people with pre-conditions; offers strong incentives for stepped-up primary care and preventive medicine; and puts in place needed cost-containment measures.

It is critically important to many Americans who lack adequate health care that the Supreme Court uphold the law; a law that should be celebrated for how much it will accomplish and not compared to a dream that is not at all likely to ever be realized.

Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. He is an Adjunct Professor of Political Science at the University of Rhode Island.

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