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Single-Payer Briar Patch

The professional Obama-hater Dick Morris said today on Fox News that if President Obama is elected to a second term after the Supreme Court strikes down Obamacare (as is looking more likely) then "he’ll move to a single payer system." Morris elaborated: "I think the Supreme Court decision—that I expect—will throw out this mandate, but single payer of course is legal under the taxing authority. Total socialized medicine...." 

Jeez, that would be terrible! Morris reminds me of the Russian sergeant in Woody Allen's Love and Death. "Imagine your loved ones conquered by Napoleon and forced to live under French rule!" he exhorts.

"Do you want them to eat that rich food and those heavy sauces?"


"Do you want them to have soufflé every meal and croissant?"


Single-payer would be a comparable defeat for America. Instead of funneling universal health coverage through private health insurers, the government would have to save money by eliminating the middleman. Instead of requiring everyone to purchase health insurance, which is difficult to enforce, the government would have to provide health insurance automatically, as it already does through Medicare.

The only real difficulty is political. Robert Reich has some thoughts about that, assuming the Supreme Court strikes down the individual mandate and leaves the rest of Obamacare alone. 

[P]rivate insurers will swarm Capitol Hill demanding that the law be amended to remove the requirement that they cover people with pre-existing conditions.
When this happens, Obama and the Democrats should say they're willing to remove that requirement--but only if Medicare is available to all, financed by payroll taxes.
If they did this the public will be behind them--as will the Supreme Court.

This might end up proving a winner even for insurance companies, who could alter their business model to eliminate coverage for serious illness and cover goofy stuff like cosmetic surgery and liposuction instead. Of course that would involve painful restructuring, and some insurance companies would probably go under. But insurers had their chance to support health care reform when it was moving through Congress and they chose instead to oppose it--the only major players in the health care industry to do so. Their opposition helped fan the protest movement that has now brought its argument to the Supreme Court. It was wildly perverse of the insurers to let that happen, because their unregulated business model is unsustainable over the long term. If the Supreme Court strikes down the individual mandate and health insurance companies start going bankrupt from being forced to take all comers, shed no tears. The insurers did it to themselves.