America has reached a pivotal point in how we think about and legislate health care. While Republicans in Congress continue down the road of gutting, defunding and privatizing health insurance, many on the left and even some conservatives are swinging toward an approach that just five years ago was politically unthinkable – government-financed health insurance for all.
In June, California’s state Senate passed a bill to establish a single-payer, state-run health insurance plan. Advocates nationwide are pushing back against Assembly Speaker Anthony Rendon for tabling a bill that would be a national model.
Nevada’s Legislature passed a bill to give the state’s 2.8 million residents access to Medicaid, but it was vetoed by the governor. Legislators in Massachusetts, New York, New Jersey and Rhode Island have all proposed single-payer bills.
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Ironically, we have President Donald Trump to thank in part for this radical political shift. Sadly, it took his inept administration’s plans to repeal the Affordable Care Act – and jeopardize the lives and well-being of millions of Americans. Many more Americans now know that we pay more for health care and receive far fewer services and worse health outcomes than other wealthy nations.
But if the threat of Trumpcare breathes new life into single-payer health care, can this lead to real policy change? Not without some serious changes within the Democratic Party’s leadership.
The party that once stood for progressive ideals of inclusion and social justice has repeatedly cried uncle on single payer, blaming logistics, funding or the “political climate.” This is what led President Barack Obama to call single payer unfeasible and what leads top House Democrat Nancy Pelosi to say that the “comfort level” for government-funded health care is “not there yet.”
It makes Gov. Jerry Brown call single payer fiscally impossible, even as he bends over backward to fund a controversial $98 billion bullet train from San Francisco to Los Angeles that would largely serve wealthier residents. For context, the single-payer plan would cost only $33 billion more a year than the state and federal governments already spend on health care, and would provide care for every Californian at no out-of-pocket cost.
The concerns of single-payer skeptics are by no means unfounded; it would be an enormously complex undertaking to switch. Yet we’ve already seen it work with Medicaid and Medicare. The doctors, services and hospitals remain largely the same; it’s the insurance provider that changes. We could also keep private insurers as an option, as Germany and Switzerland do in their government health insurance system.
No, the true obstacle to single payer isn’t feasibility; it’s a lack of political courage.
Obama, Pelosi and Brown all supported single payer earlier in their careers, but now lack the vision and conviction because widespread public support for single payer isn’t already there, gift-wrapped for their political convenience.
The Democratic Party has forgotten what it means to lead, to inspire Americans with policies that will work in the long run, not just those that are easiest to pass. Instead, the party is content with a milquetoast incrementalism that counts success in dollars raised and fellow Democrats elected. And it is costing them. It lost them the 2016 election.
Americans are clamoring for leadership that cares about their well-being and is willing to stick its neck out. If Democrats don’t step up now, money and messaging won’t save them. We’ll have one-party rule, but it won’t be the Democrats.
Harry Snyder is a consumer advocate and lecturer at the University of California, Berkeley, School of Public Health and can be contacted at email@example.com. Courtney Hutchison is a public health policy advocate and graduate student at Bryn Mawr College and can be contacted at Courtney.firstname.lastname@example.org.