In chess terms, HRC has provided Sanders with an excellent opportunity for counter play by challenging his single payer plan on the grounds of feasibility. Sanders can now publish one or more scenarios for incremental implementation of single payer, thus exposing Clinton’s “never, ever happen” position as dogmatic defense of the existing dysfunctional system. Here are some avenues he can follow:
1. Phased expansion of Medicare and Medicaid by incrementally shifting age and/or income eligibility thresholds over time.
2. Proposal for a commission, representing all interested parties, charged with developing a multi-year transition plan.
3. Enforcement of uniform service pricing and information technology standards as a condition for providing health services to Federal employees or institutions.
4. Immediate addition of a public option to the existing ACA.
5. A re-employment strategy for displaced health insurance employees, including subsidized retraining and preferential hiring for goverment health administration jobs.
6. Summarizing and publicizing how other nations transitioned from fee-for service to national health care schemes.
7. Policy papers from prominent health care economists proposing a variety of transition plans.
Once Sanders has addressed the transition challenge, HRC’s attack on single payer will backfire and she will bear the burden of explaining support for an usustainable for-profit system. Checkmate!