General Discussion
In reply to the discussion: What, realistically, are the odds of America getting Medicare for All, let alone single payer? [View all]zipplewrath
(16,646 posts)You need to put a time context to your question.
Today, who knows. No one has come close to trying since Hillary basically 20 years ago. And "medicare for all" needs some definition too. It was proposed that we "allow" people to purchase medicare "at cost". i.e. no subsidies, charge them the actual cost of providing those policies. They could still have their commercial products if they preferred them. They could have even restricted those policies to either individuals, or to employers smaller than some upper limit. These kinds of offers were popular with a wide variety of the population, both GOP and democrat. The idea for many of "medicare for the other guy" is fairly acceptable if most folks don't think they'll be paying for it. One doesn't have to think very hard to see how such a start would end with something indistiguishable from single payer.
Outside of an immediate context, single payer in some form is coming. I'd say 10 - 20 years. The rate of health care costs is going up so fast that NO ONE can keep up with it. A huge reason for Obama's plan was that it controlled the costs to the GOVERNMENT. And even at that it only slowed the rate of inflation. Health care costs will soon be too expensive for huge portions of the population. The fear of course is that it will be the GOP that brings us single payer, much like they passed the Part D plan.
There is some possibility that the states will bring it to us. Vermont is trying, and some state may wise up and figure out that a great "business incentive" is single payer so that a company that builds a factory or relocates their headquarters to that state can avoid directly absorbing these costs, and instead share them with the larger population. If that starts happening, the states will do it and the feds will follow along.
Could we just "switch" to a pure single payer system now? No, I don't think so, and I don't think we should try. However, the entire point of the "public option" wasn't to "keep the insurance companies honest" it was to allow us to begin setting up the structure of a single payer system, and allow it to grow "organically" as the commercial system collapsed, and the feds had to step in. Unfortunately we didn't have the leadership to get it done.