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The Obamacare Rollout Is a Blow to Single Payer



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In the past fortnight, Obamacare’s health-insurance exchanges have delivered the “third world experience” that critics predicted they would. Indeed, so bad has the “trainwreck” rollout been that even staunch allies of the president and his agenda have felt compelled to admit disaster. 

As the Daily Kos’s Jed Lewison observed earlier, conservatives who have full-scale ideological objections to Obamacare should be careful about focusing too much on these technical failures because, with time, those “glitches” may well be resolved, rendering local criticism moot. Lewison is correct: Conservatives oppose Obamacare for a host of good and important reasons, and they must continue to hammer these home above other complaints. Nevertheless, opponents should continue to point at the technical failure of the exchanges, and to remind the public that the launch was such a public disaster. Why? Because this will help against any attempt to parlay a broken program into single-payer.

This is to say that if Obamacare fails structurally, we will start to hear a drumbeat from the Left — and one based upon the argument that Americans can’t have workable universal healthcare while maintaining a diffuse system of private health insurance. Advocates will contend, I suspect, that the for-profit model simply cannot be reconciled with “fairness” and “social justice” and whatever other silly and vague words they choose, and that the government must take over the payment system in consequence. How much success this approach will have is anybody’s guess.

But if Obamacare fails technically, too, and the memories of trying for weeks just to create a government account linger in the minds of the public — perhaps even leading to an embarrassing delay — opponents will have been presented with a strong hammer with which to whack the single-payer mole for years to come. “The government couldn’t even run a website without it turning into the DMV,” they will be able to say. “Do you want them in charge of the whole damn thing?”

Bloomberg’s Megan McArdle has written well of progressives’

belief that Canada is not just some place that has made different choices about access and coverage than the U.S. has, but a sort of health-care utopia where any potentially lifesaving treatment is available to anyone at the drop of a hat … as if nationalizing the health-care system somehow means that you never have to make any difficult choices.

In fact, she observes:

In a world of scarce resources, choices always have to be made. In Canada, those choices are made by the government; in the U.S., by the government and corporations and individuals, depending on the choice.

As someone who lived for 26 years under single-payer — and is a staunch opponent as a result — I can vouch for this. And I am pleased that Americans still tend to have a negative view of single-payer systems. That this instinctive opposition remains was was made pretty obvious by the presiden’ts failure to get his “public option,” and also by great pains to which Obamacare’s architects went in order to try to distance themselves from the charge of “government-run healthcare”: You will be able to keep your doctor, the president said; you will be able to keep your insurance; employer-based insurance won’t be affected; and the system will remain private. Criticisms that the federal government was going to recreate the VA or Medicaid were swatted away as if they were cancerous.

Even with these assurances, the law remains pretty unpopular. That the government has demonstrated so publicly that it is too incompetent to run what is a glorified comparison website — even when given hundreds of millions of dollars and a three-year lead time — cannot have helped the progressive dream of single-payer one bit. Hopefully, Republicans will have the nous to hammer this home over and over and over again during the next few months. Americans hate the DMV. Obamacare’s exchanges are currentlt worse than the DMV. Free marketeers, who may be tempted instead to talk abstractly about how bad things are in countries that most Americans have never visited – let alone lived in – should capitalize on that.



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