I want to talk about a losing ideological battle that is being waged on the left in this country by a group of people that I will call (non-pejoratively) “anti-corporatists.” They are hypercritical of the TARP program, wanted to nationalize the banks, want to audit the FED, and fought fervently for a public option even though their true preference was the abolition of the private health care system. But, first, I want to quote Hillary Clinton from her 2000 campaign for Senate.
Q: Would we be better off with a Canadian-style single payer system if it were politically possible?
Clinton: I think our system has so many unique features to it. You know if we were talking 100 years ago, or 200 years ago, before we developed the kind of mixed system that we’ve got of public and private resources, I don’t know, that’s a hypothetical, but given where we are today I think it’s imperative that we take it step by step, and that we build on what works.
And we know that people have responded positively in most parts of the country to CHIP [Children’s Health Insurance Program]. It’s a program that works. We thought it would work. We’ve got some kinks to iron out so we build on it. And then we take a step to get to additional coverage to parents, and a step to get —
So eventually we’ll have people covered but we’ll still keep a lot of choice in the system so that people can choose between different plans. They can have alternatives and options. Americans, as we know, we love choice, we believe that we ought to be able to make decisions about our most important matters in life, and health ranks at the top of that.
So I think that what I’ve outlined today is both financially feasible and politically feasible. And that’s why I’m going with that.
The program that Clinton laid out that day included expanding the CHIP, COBRA, and Medicaid programs, and giving people without access to employer-based heath care a tax credit to cover up to 25% of their premiums. She had previously advocated the expansion of Medicare to people aged 55-64. Does any of that sound familiar to you?
It should, because it is very similar to what she and Edwards and Obama campaigned on in 2008. It is very similar to what Obama is doing now. Obama already expanded the CHIP program.
President Obama signed legislation on Wednesday (Feb. 4th) extending health insurance to millions of low-income children, ending a two-year Democratic effort to enact a bill that former president Bush had vetoed…
…An estimated four million children will gain access to health care through the new law, which passed the House largely along party lines. The Senate passed it last Friday.
Also in February, Obama signed expanded COBRA coverage into law in the stimulus package. Both house’s bills have an expansion of Medicaid coverage. And the Senate briefly thought they had a deal to expand Medicare coverage to people aged 55-64 until Lieberman blew it up. Clinton’s 2000 health care comments anticipated Obama in another way. He, too, argued that single-payer might be a better system (in more definitive language than Clinton) but that we can’t get it done and must attack the problem in a more ad hoc fashion.
Now, you can characterize this position that has been mainstream for a decade now in the upper echelons of the Democratic Party as a simple sell-out or capitulation to the health insurance industry. But you can’t call it a broken promise. The Democrats haven’t been offering single-payer to anyone, much to the frustration of the vast majority of their activists. They have not devised strategies to abolish private insurance, despite the accusations of the Republicans. If you want singe-payer, you need another party or you need to work on the state level as progressives are doing here in Pennsylvania.
Despite his protestations to the contrary, Barack Obama did campaign on a public option. Maybe he didn’t emphasize it too much, but for the people that care about and understand health care policy, he was crystal clear. The attraction of the public option is manifold. It would help hold down premium inflation, it would avoid a situation where people are compelled to purchase private insurance, and it could lead over time to less and less private insurance (i.e., a stealthy way of moving toward single-payer). Because of these attractions, a public option is actually a way to make passing health care reform more popular and better for electoral politics.
