The debate has already been framed for us. On the one side, you have the right wingers, claiming that the government is going to have "death panels" to kill old people, and that they are going to ration our health care. On the other, you have the Democrats, claiming that "health care reform" is the only way to go. The system does not work, single payer is not possible at this time, and health care reform will save the currently broken system. Liberals are following along, talking about how important reform is, even if they support single payer.
The system is indeed completely broken. And the right wing claims about the government slaughtering your grandparents are simply ridiculous. But Obama's continually watered down health care reform, even if it were to end up with the "public option," (which it no longer looks like it is going to) is not going to fix it.
Before I get into what is wrong with Obama's plan, let me explain what a single payer plan would do. While the exact cost cutting would obviously depend on the plan, single payer systems in most of the developed world cost half of what they cost here in the U.S., while producing better outcomes. In other words, the country that has the most problems with waste are having that problem because of the private sector, not a supposedly bloated government. Intuitively, it should at least make sense that giant corporations would not be more efficient than government. Add to the fact that corporations are inherently working to make a profit instead of working for the public good, and its easy to understand why the private sector is the least efficient option.
Put simply, yes, you'd be paying more taxes, but you'd be paying half as much for healthcare overall because you wouldn't have to pay for insurance out of pocket.
And of course, it is a myth that you'd have no choice of doctors. Under this program, you could choose any doctor, today, your insurance company chooses your doctor. Also, the waiting times are a myth. Sure, if you're rich, you can buy yourself quicker care in the U.S., but most people wait a long time here too. As Julie Mason explains in the Ottawa Citizen, the U.S. media has fabricated a horror story about Canada's health care system (A reality check on a reality check). A woman who claimed she couldn't get immediate surgery for a brain tumor in Canada and therefore had to get care in the U.S. actually had a benign cyst. While her waiting time would have been completely inappropriate if she was dying from a brain tumor, it was perfectly reasonable because she was not. Of course, the most obvious question regarding a single payer system is: Why are we only talking about Canada? Occasionally, people will criticize the British system, but no one talks about the single payer system in France, Germany, or almost any other developed nation. I wonder if those systems work even better than the Canadian system. However, one thing is certain, people like it so much, they refuse to get rid of it. In Britain, Margaret Thatcher attempted to get rid of their National Healthcare System, but had the same success that Bush had in trying to privatize social security.
Also forget about rationing under single payer. The most significant part of single payer is how healthcare is treated as a right, not a privilege. In other words, rationing by private insurance is precisely the problem that we can get rid of with single payer. Private insurance companies can deny you coverage for any number of reasons, such as a prexisting condition (ie, you have MS, like the author of this post). Of course, this doesn't include the almost 50 million Americans who don't have healthcare at all. But if you have coverage, you could end up with the worst of both worlds, you pay a huge proportion of your paycheck to healthcare, and then not have any money to pay for getting sick when they decide not to cover you.
Here is what would happen if we did in fact have a public option (It appears that Obama is scrapping the idea). For starters, it would only be available to a small percentage of Americans. Because of its limited size, (Jeff Sher estimates on counterpunch that it will cover about 10 million people Jeff Sher: Making a Mess of Health Care Reform) most Americans would be forced to buy private insurance. However, the existence of both options, along with the government being unable to negotiate drug prices, would increase costs instead of reducing them. Of course, these costs would be put on the backs of American workers, because they would be forced to buy insurance under Obama's plan. When Hillary Clinton came up with a similar idea, I felt that this was worse than the current system, and I still do. At least when you pay taxes, it is supposed to go toward the public good. As a general principle, I don't think this is necessarily true, seeing as nearly half of our tax dollars go towards the military. However, in other countries, it has been proven that a single payer system works as a public good.
On the other hand, forcing people to buy private insurance is no different than if the government decided to force everyone to buy a Nintendo Wii. I use this example, because most people who are 30 or over don't want a video game system. The public is no longer pooling their goods together, rather, the government is forcing people to buy a private good. This doesn't fit into a liberal ideology of the government providing for the public good, or a conservative free market ideology of keeping the government out of the market. Personally, I see the government helping the corporations as the anti-democratic status quo.
The government forcing you to buy health insurance is not the only problem with Obama's plan. He is suggesting that he will cut costs. This effectively means that the government would cut medicare and medicaid. Conservatives would suggest that this is likely because government is evil. I will suggest that this is likely because 1. The elite tends to use recessions as an excuse to "cut spending" which always refers to important social spending. 2. Obama can get away with it because he is not a Republican. When liberals complement Clinton on "balancing the budget," do they notice that he did it by cutting social spending, ie. "ending welfare as we know it?" Worse still, I would bet that this would occur regardless of whether health reform passes. In other words, the real "rationing" is completely unrelated to the health reform being proposed.
The cost cutting and forcing everyone to buy insurance appears to still be on the table. The public option does not. Obama has been backing away from the public option over the past weekend. The important thing to understand is that this has nothing to do with public opinion, and certainly nothing to do with spinelessness. If Obama decides not to put a public option in the final bill, it is because he never intended to have it in the first place. This is an old game the Democrats are playing. They put something on the table, let the Republicans rant and rave, and then say that because of Republican ranting and raving, they can't do what they set out to do. From 2004-2006, they complained that they needed a simple majority in Congress, then, when they got that, they complained that they needed 60 Senators, and the presidency, and now that they have that, they claim that there are "blue dog" Democrats who are really Republicans, and that they need a super duper progressive majority and the end of the Republican Party.
Why are the Democrats really siding with the insurance industry? It's because they get the same donations the Republicans who are ranting about socialism get. It's because Obama himself has been bought by big business, and in this case, the insurance industry. According to the Center for Responsive Politics Obama has received $19,462,986 from the Health Sector (Top Contributors to Barack Obama | OpenSecrets). When we realize the obvious, easily researchable truth that it is not just Republicans and Blue Dog Democrats being bought off by the insurance industry, it should be obvious that all the politicians do their bidding. To assume otherwise is to believe that while Republicans are heavily influenced by campaign contributions, Democrats are somehow immune. The reality is that both Obama's "reform" and the status quo serves the health care industry and hurts the American people.
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