"The Public Option as a Kind of Stealth Single-Payer"


There has been much squabbling about the potential of a public option to morph into a de facto single-payer system, with the right taking the "Will too!" position and the left rebutting with a "Will not!"

Those worried about a presto chango argued that when government steps into the health care market and uses the power of the state to artificially lower their own costs, private plans might very well wither and die.

And it looks like that might have been the point all along. Not so much an evil, secret plan, though. More like an admittedly long-shot hope.

The American Prospect's Mark Schmitt fills in some historical facts about the Democrats' strategy, "a real high-wire act—to convince the single-payer advocates, who were the only engaged health care constituency on the left, that they could live with the public option as a kind of stealth single-payer, thus transferring their energy and enthusiasm to this alternative."

Roger Hickey of the Campaign for America's Future…took UC Berkley health care expert Jacob Hacker's idea for "a new public insurance pool modeled after Medicare" and went around to the community of single-payer advocates, making the case that this limited "public option" was the best they could hope for. Ideally, it would someday magically turn into single-payer.

The Dems went gung ho for this strategy, but the general population—which turned out to be just barely astute enough to sense a bait-and-switch (who knew?)—didn't. As even squishier compromises ooze over the horizon, Schmitt mournfully concludes: 

If there is a public plan, it certainly won't be the kind of deal that could "become the dominant player."

To which I—along with my cynical, naysaying friends—reply: Whew.