Don’t Count on Single-Payer Comeback Without a Fight

single-payerIf the Supreme Court strikes down the Affordable Care Act (ACA), don’t worry: President Obama will push for a single-payer healthcare system. That’s the liberal spin on what could be a national embarrassment for the former constitutional law professor whose signature legislative achievement could be wiped out in June.

Again and again and again and again liberal pundits tell us that the Democrats will snap out of their centrist slumber if the Supreme Court strikes down the ACA. They’ll be radicalized and have no other choice but to turn to single-payer, so they say.

In “How Obamacare’s Rejection Would Lead to Single Payer,” Josh Barro writes: “SCOTUS striking down the law would also be likely to radicalize Democrats on the health issue… Rejection of Obamacare would likely lead to support for more radical policies among the liberal base and Democratic officeholders. They’ll be mad, and they’ll want to fight back.”

And “…with a bit of political jujitsu,” says Robert Reich, “the President could turn any such defeat into a victory for a single-payer healthcare system – Medicare for all.”

If only. But this line of thinking simply doesn’t fit President Obama’s history of consistently caving to the right for fear of being labeled a far-left socialist. In 2008 the Republicans wouldn’t bite on the public option. So, despite having a Democratic majority in the House and Senate, he moved to the right and supported the individual mandate (something he vehemently opposed before the 2008 election) and still didn’t get one Republican vote.

Those of us supporting a single-payer system must not be fooled by this argument. Winning national single-payer healthcare, no matter what the Supreme Court rules this summer, will be a battle fought tooth and nail against the for-profit health insurance corporations, the American Medical Association, and Big Pharma. It won’t simply be handed to us by President Obama or the Democratic party.

Same goes with the Employee Free Choice Act (dead), or closing Guantanamo (still open), or nixing the Keystone XL pipeline (we’ll build half of it), or ending the war in Iraq (18,000 troops still on the ground).

President Obama is a center-right leader, and we shouldn’t expect anything else.

Historical experience shows that a political defeat for the Obama administration won’t herald a radical shift to the left on healthcare policy. After Clinton lost his health reform battle (not even getting his bill out of committee in 1994) did he take a strong stance on single-payer–even though the single-payer bill in the House at that time had more co-sponsors than his own bill did? No. Instead, all we got was the State Children’s Health Insurance Program (SCHIP), which only covers about half of American children (Geyman, 226). A positive step, to be sure, but far short of an embrace of single-payer.

The overall message here is “do nothing.” Obama’s got this. Just get out and vote for him in November and everything will be fine. Don’t get mad at him and certainly don’t stay home on Election Day.

Don’t fall for it.

The Supreme Court’s decision won’t radicalize the Democrats or the President. Single-payer won’t be their only option. If the ACA goes down Obama will most likely drop the healthcare issue altogether or, less likely, rebrand the public option.

When liberal pundits say Medicare-for-all, they mean Medicare for all to buy–AKA a public option to compete in the market with private insurance. We know the public option won’t reduce costs or be universal or be equitable. Health Care for America Now, the $40 million health reform group, that supposedly backed a public option, and openly campaigned against single-payer, won’t come around so easily either. They’re busy trying to save face by backing Democrats and defending the individual mandate.

We want a truly universal single-payer healthcare system in which everyone in the US, undocumented immigrants included, have access to comprehensive coverage. A system with full women’s health benefits included. A system without copays or deductibles. Without for-profit hospitals, and without private insurance in the mix. As we know too well, the Democrats are quick to use women’s and immigrants’ health as a bargaining chip. We must not allow that.

It’s our job to continue to remind Congress and the President that there is an alternative to the status-quo. It will take a lot more marching, educating, and protesting before they hear us.

So we better keep organizing.

Jeff Muckensturm is on the national staff of Healthcare-NOW!, a national network of single-payer advocates and organizations. Find out more about the single-payer movement at www.Healthcare-Now.org or follow Healthcare-NOW! on Facebook and Twitter.

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About Me

My name is Jeff Muckensturm. I am the Web Coordinator for Healthcare-NOW!. My writing focuses on urban issues from a left perspective. Continue...

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