Single Payer, Public Option, and Practicality

During Howard Dean’s morning panel we finally got into the issue if the left/healthcare reform advocates made a mistake by not making a bigger push for single payer, which might have left the public option a middle ground compromise.

I’d characterize Dean’s answer as a soft yes. Indicating the dismissal of single payer was old thinking. What Dean’s missing is that the issue isn’t people dismissing the idea of single payer, but that people dismiss the single payer politically.

Lots of healthcare advocates will tell you they personally like single payer and then proceed to tell you’d be crazy to pursue politically. It’s not politically practical, it will never happen, focus on realistic proposals, single payer advocates are naive about the political process. Over the last 18 months you heard this kind of talk all the time.

Over the last 3 months all of the corporate efforts have been aimed at killing the public option, while insurance reform has been mostly left alone. Does anybody think that if healthcare reform advocates had left the public option out that healthcare lobbyists would have thanked them for the concession and encouraged their allies to pass the reform package?

I’ll concede at this point that’s not as simple as just proposing something more progressive reforms and shifting the middle. But there are powerful lessons to be learned in this process and I hope when the next round of debate comes around we won’t hear constant calls to not support effective progressive policy ideas, because we need to focus on practical policies with their theoretically strong prospects for passage.


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