It's unfortunate to be a progressive these days. Looking over the political landscape at the wax and wane of the public debate on health care, we see the liberal ships sail from harbor for the great promise land of a new tomorrow, only to wash back up like fish on the shores of the Salton Sea. Debating on the pros and cons of health care policy has slowly taken a back seat to America's favorite national past time, the demonization of those whose opinions are different than their own. Lost amidst the din of McCarthyesque cries of socialism and fascism, two sides draw lines in the sand without ever quite defining for themselves what the consequences will be for crossing it, let alone what the lines are meant to protect in the first place. And all along in the fight, the progressive realizes that neither side really understood what it wanted at all.
Of course, I'm talking about Single Payer. The dreaded words that lead to the slippery slope of Socialism, where Americans wake up, bow to mecca, eat a french baguette, and practice hymns to Hitler while burning statues of Jesus in the square. Tried and true red-blooded Americans will have nothing to do with the forces of evil attempting to infiltrate and destroy the way of life they hold dear. All the while, they will die of untreated or undiagnosed diseases, or perhaps simply suffer through the ills of bankruptcy and failure as their lives are sucked away by some unfortunate but ultimately unavoidable hazard of modern living.
Looking at the left, they claim a "Public Option" is the magic bullet that will bring panacea to the sick health care industry. We draw our line around a government-sponsored program meant to compete with private insurance to keep healthcare down, but whose ultimate fate is to served as a hobbled dark horse to the right-wing desk chewers, who will look down upon the crippled and broken program that they themselves helped to break and speak their loud I-told-you-so's to all who will listen. And they will listen. Tragically, the real option, the real savior of health care in our country is pushed back and relegated to a dark closet, because we have allowed the public option to be so demonized as modern socialism that the Single Payer option would now be treated as a return of modern feudalism, with Obama wielding the crown and dismantling our democracy in a single stroke.
The problems with a Public Option in place of single payer is numerous. It requires enormous amounts of additional legislation to 'get right'. There will be legislation to control how much the government can charge, and legislation controlling how little they can charge. There will be legislation dictating the hoops that ordinary Americans will have to leap through in order to receive the subsidies that will be needed to afford the plan for many who won't be able to pay out of their pocket. There will be new tax laws to cover deductions and payments. There will be pork shoved in left and right under the cover of critical bills that must pass for health care to succeed. And there will be legislation that, much like the credit card industry, will give insurance companies ample time to purge the edge customers before the government mandates go into effect. The price protections against hikes will be too weak, and the burden will fall increasingly on the government plan to cover those whose insurance has forged ever skyward. ANd each legislation passed is often another hurdle in the way of those seeking to get coverage.
Either way, Republicans win, even if they vote for a public option. And they know right now that there is a good chance one will go through anyway, so they are safe to demonize the program, and then benefit for the faults and failures that occur. Higher premiums will drive companies to the cheaper government plan, flooding the system, which will either cave and be picked up again by private insurance, or will lead to massive deficits or tax increases that the Republicans can use to make bold political gains.
The correct route should have been to push the tiered Single-payer plan to begin with. Creating a basic coverage plan for ALL Americans solves the issues inherent with jumping through hoops, while freeing insurance companies to live in free market splendor, providing supplemental insurance for experimental treatments, advanced drugs, room and food upgrades at hospitals, and other perks that basic coverage would not provide. They would be freed from any requirements to sell to anyone they didn't wish to, and would be able to compete interstate with abandon, because the life of our citizens would not be in the hands of those moving their corporate headquarters around to find states with the most unrestrictive insurance requirements. Let the free market work separately from the pool that provides for the well-being and treatment of our citizenry.
I fear we're too late now. By not pushing for a Single Payer system from the beginning, the administration has allowed the very moderate Public Option to be characterized as grossly far left, destroying any hope that I have of seeing a single payer system implemented in any near future.