Every time Health Care Reform failed in the past, we didn't get something better

[liberalpragmatist]

I see a widespread sentiment on DU that says we should let the current health care bills die and start over with single-payer. Leave aside the question about how single-payer is supposed to pass Congress if a rinky-dink public option is struggling to pass the Senate; leave aside the fact that Bernie Sanders himself has said that there are no more than 10 votes for single-payer in the Senate. Consider the fact that every time a nd. health care drive has failed, we didn't get something more progressive the next time around - we got something LESS progressive. Each time, the lesson has been that the congressional system can't swallow something as radical as what was tried, so it has to be watered down to pass next time around.

In the 1940s, Harry Truman proposed single-payer. He failed.

In the 1960s, JFK and LBJ didn't even try for universal coverage. Instead, they pushed Medicare and Medicaid. (Which took 5 tries to pass.)

In the 1970s, Nixon proposed a system of managed care, a guaranteed benefits plan, and a federal wraparound public plan. Ted Kennedy, in response, sponsored the Kennedy-Mills bill which called for universal coverage through a guaranteed benefits program, administered through private health insurance companies. Both efforts failed.

In the 1990s, Hillary and Bill Clinton proposed an individual mandate, with everybody buying coverage from regional exchanges (so-called "alliances"), and getting a number of options. There was also a strict basic benefits program, whereby every insurer had to offer a government-set basic plan at the same rate. That failed.

So now we're trying to pass a system that basically leaves almost everybody's insurance the same for the time being. It's a far less radical health care plan than what was proposed in the past.

If this fails, the likely result isn't going to be single-payer. It's going to be something like health savings accounts and an incremental expansion of Medicaid and SCHIP.

I know these bills will not be perfect, but they will guarantee coverage for 30 million more Americans, establish a structure that can be expanded upon later, and provide far stronger regulation of insurance companies. And it will hopefully include a public plan that can be expanded in the future as well.

If the current bills pass, I would like to see the following done over the coming years:

(1) Federalize Medicaid and SCHIP.
(2) Open the exchanges, and the public plan, to everyone.
(3) Increase subsidies.

Eventually, then, merge the federalized Medicaid and SCHIP with the public plan and Medicare.

But if we kill the current bills, no one is going to touch health care for years, and the direction will likely be the same as it has been before - with a less progressive bill being championed next time around.