Opinion: Has The Time Come For Single-Payer?

We read a shocking story on The Intercept the other day, "Top Nancy Pelosi aide privately tells insurance executives not to worry about Democrats pushing 'Medicare for All.'" It is a long piece of detailed reporting that we urge you to read for yourselves.

The Intercept is a left-leaning news site. It can be scabrous about both Democrats and Republicans, and also, now and then, essential. This article, by D.C. correspondent Ryan Grim, is.

It begins with a Power Point presentation The Intercept obtained. It was given by Wendell Primus, who works on health care policy for U.S. House Speaker Pelosi. He gave it to executives of Blue Cross Blue Shield, the huge health insurer, in early December, after Democrats had retaken the U.S. House.

Primus said that Democrats "would be allies to the insurance industry in the fight against single-payer health care." While Democrats are united around the concept of universal coverage, he explained, they see "strengthening the Affordable Care Act as the means to that end."

And so, just like that, we are back in 2016, with Bernie Sanders arguing for single-payer and Hillary Clinton arguing for Obamacare instead.

It was a false choice then and it is today. Still, much has changed in two years.

Our views have evolved. We looked skeptically at single-payer in the past, which means socializing the health care sector of the economy.

Socialism was never going to be our first choice because it means losing the productive capacity of markets, which is what once created the American dream and what continues to be the world's dream.

Since 1990, more than 1 billion people have moved out of extreme poverty worldwide, as Fareed Zakaria recently pointed out. "Inequality, from a global perspective, has declined dramatically." This was not the magic of socialism but of markets.

Yet if markets were going to solve the problems of American access to health care, which seem to grow daily more acute, they would have done so by now. Instead, it is profit-taking in health care that is making the problem of access worse.

The time has come to follow other advanced economies and move to single-payer. It would have been much easier to do when President Eisenhower advocated for it in the 1950s. It would have been easier to do when Teddy Kennedy tried to run on it against Jimmy Carter in the 1980 Democratic primaries. We think it still can be done.

More than that, we think this is one of the great things a great nation can do, one of the big things. We know few people who are happy with their insurance now (let alone the billing). We know many who pay significant premiums and hesitate to seek care because they fear they will not be able to afford it.

We are not afraid of the cost of single-payer because we know that it is unlikely to exceed what Americans spend on health care already. We want them to get what they pay for.

We have seen Democrats step forward in the 2020 race who are open to single-payer, such as Elizabeth Warren and Kamala Harris. It would be nice if the Democratic majority in the House could pass legislation that they can run on – but it will be over our dead bodies, to hear Wendell Primus tell it.

We do not think we have swung to the left of the Democratic Party on this. We think its leadership is stuck in the mud.