That's not an encouraging result
That image is the final result of Colorado’s Amendment 69, a 2016 ballot measure that would have established a statewide program to provide universal healthcare coverage and finance healthcare services for Colorado residents. As you can see, it was defeated in a landslide. Even with Presidential year turnout in a blue state carried by Hillary Clinton, scarcely one-fifth of voters supported the measure. Even a strong primary campaign (including a commanding victory in the Colorado Democratic caucuses) by Bernie Sanders, probably the most high-profile single-payer advocate among national politicians, didn’t appear to move the needle. To illustrate, this was the result of another state ballot single-payer (SP) measure in a state with a similar political orientation:
Official results here. Different state, different year, different proposal and different political environment, but an almost exact carbon-copy result. I included this result not as evidence to suggest any grand theory or slag anyone in particular, but instead to show that SP as an issue has pretty tepid support at the ballot box, and that mere positive exposure to the idea doesn’t seem to matter much. I’ve read many excuses for the failure of Colorado Amendment 69, ranging from poor ballot language to health insurance industry spending to non-support from establishment Democrats, but when you lose by almost 60 points in a blue state , you have a problem that better campaign strategy or more resources isn’t going to come close to solving. A defeat that total suggests a deeper structural issue that resists easy explanations or standard solutions.
I take no pleasure in the lagging support for these measures, as I consider health care to be one of my core concerns. It is a disgrace that we have the health care system of a developing country given our levels of wealth, education, and technical expertise. The Affordable Care Act was a big step in the right direction and will be remembered as a major milestone on the road towards universal heath care, but it has substantial limitations. The time is long past for the United States to join the rest of the world in implementing a comprehensive universal health care system, and while I’m somewhat skeptical that single-payer is truly the end-game in health care reform, I’d take it over our current system in a heartbeat.
That all said, I feel quite strongly there is a disconnect between what some people would like to see happen in the next round(s) of health care reform and what is actually achievable given the current political climate (and probably in the near future, too). That reality is problematic for progressives, particularly for those who put a strong emphasis on SP or are perhaps inclined to use it as a litmus test for politicians asking for support. To be clear, there is nothing wrong with having an optimum outcome or end goal in mind, but when people insist on fealty to a specific policy proposal (instead of measurable results) that’s probably non-viable, that is a stance likely to result in both personal frustration and political defeat.
SP supporters object to the notion that the policy is non-starter. They will note, correctly, that polling shows that a majority of Americans favor universal health care, often by wide margins. They will sometimes cite polling that suggests that Americans are open to, or perhaps even prefer, a SP system or something very similar. Here is a good example of a poll that shows strong support for reform that
I, too, am encouraged to see that Americans are receptive to reform, but I feel that many people arguing for SP are overstating the strength of their position. A poll is really only a snapshot in time of public opinion; it really doesn’t tell you much about the depth or durability of support or opposition. A prime example of this phenomenon is gun control, where poll after poll shows wide public support for stiffer background checks, but the institutional clout of the NRA and other similar groups has stifled many attempts at reform.
Here are a couple problems with the idea that generic support for something like SP signals :
First, Health care reform is popular in the abstract but grows more unpopular when attempted:
Link
That’s the polling aggregate on what would become the ACA from Obama’s inauguration through a few weeks post passage. The trend lines are clear. Remember “death panels” and the chaos of the health care town halls? That was all over a bill that largely kept the existing health care system intact and had the support of large influential organizations like the AMA, AARP, AFL-CIO and others (more on that in a bit) Sure, some of that opposition came from the left for not going far enough, but I think it’s would be overly optimistic to think that a SP plan would convert all of that into support without losing some from the center as well. To add a second data point , please note that something very similar happened during Bill Clinton’s ultimately unsuccessful attempt at health care reform during his first two years.
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