Are We Headed for Single Payer Health Care?

It's been interesting to listen to the debate rage over what will happen to the individual health insurance mandate in President Obama's health care reform bill as the issue moves its way up through federal courts. The mandate was recently ruled unconstitutional by one (Bush-appointed) federal judge in Virginia, but was ruled constitutional by a couple of other federal judges. It seems that most pundits agree that this issue is headed for the Supreme Court.

Ezra Klein of the Washington Post noted that Republicans may be doing some long-term damage to their cause by focusing on the individual mandate, which as my last post explained, was originally a Republican idea. To be certain, the mandate is essential to have a health-care system where everyone has coverage but private insurers dominate (Obama's plan). If the Supreme Court ultimately rules the mandate unconstitutional, the only other options for universal coverage will be the single-payer system, as found in Canada, or the fully nationalized system, as found in the United Kingdom. The mandate, as Klein states, is a very "common device" used in several other industrialized countries (including Switzerland and the Netherlands) that ensure universal coverage while relying on private insurers.

Klein makes a convincing argument when he states, "if Republicans get [the insurance mandate] ruled unconstitutional in America, they'd be wise to ask themselves what other options they have: After all, the constitutionality of Medicare is not in question, and that's really the other model we could eventually trend toward."

Another columnist argues:

By fighting the mandate needed to make private insurance solutions work, and doing nothing to ease the health cost burden on everyday Americans, you'll hasten the day when the public throws up its hands and says, "Just give us single-payer and price controls." Don't think the anti-government wave this fall won't reverse itself on health care if the most private sector-oriented health care system on earth keeps delivering the world's costliest, most inefficient care.

The current unrealistic threats by the new Republican-controlled House of Representatives to repeal the 2010 health care reform bill are good political theater, but will likely backfire. Anyone with a rudimentary understanding of how our federal government works, knows that Republicans do not have the numbers they need to repeal. They don't have a veto-proof majority in the House and are in the minority in the Senate. Additionally, the non-partisan Congressional Budget Office, which typically acts as a referee in the partisan atmosphere of Congress, has indicated that a repeal of the health care bill would increase the national deficit by $230 billion.

What is ironic about the last election, which was supposedly about run-away government deficits, is that Republicans have supported positions that drastically increase the national debt. The extension of the Bush-era tax cuts for the rich have added far more to the long-term debt of our nation than Obama's 2009 stimulus plan. The CBO estimated that the health care reform bill would actually decrease the deficit by $143 billion in its first 10 years and $1.2 trillion in the second 10 years. In an upcoming post, I'll go into some of the details of the new law, including its cost savings, but the fact of the matter is that repeal would drive us further into debt, notwithstanding doing nothing to improve our antiquated health care system including helping the tens of millions of uninsured working-class Americans and their families.

Isn't it ironic that the new House majority voted against a measure this week that would have required all Representatives to disclose whether they would accept their government-provided health insurance? As Rep Steve Israel (D-N.Y), stated, "every Republican voted to hide their own government health care, while many of them are pledging to repeal health care for everyone else." Don't we think it is relevant for constituents to know whether their representative is accepting government-sponsored health care? Nonetheless, repeal isn't going to happen. The Supreme Court is really the only mechanism by which the Obama heath care reform bill (and Romneycare) can be annulled at this point. And in the remote chance that occurs, it will probably lead us to something that is actually closer to what conservatives label as "socialized medicine."