Paul Waldman breaks down the convoluted fight Hillary Clinton and Bernie Sanders are waging over single payer insurance. The short version is that from what we know of Sanders’ earlier preferences, he’d like to consolidate federally subsidized insurance and create a Canadian-style single payer system, administered at the state level.
Clinton says Sanders’s plan would not only be too expensive (contestable), but would empower conservative states to erode their citizens’ health coverage (also contestable). This is to say nothing of the political feasibility question, which she has not yet broached.
But to the extent that most Democrats (presumably including Clinton) think single-payer is a good idea in theory, the spat is a reminder of how odd it is neither of them has made issue of the public option. The fight over the public option dominated the intra-Democratic ideological fight over Obamacare, and many progressives were embittered when it fell out of the final legislation. But the idea had multi-pronged appeal, and addresses all of the issues at the heart of the Clinton/Sanders dispute.
1. It can be administered by the feds.
2. It would reduce federal and individual health expenditures.
3. It can serve as a default plan for the uninsured.
4. It’s an ideal vehicle for migrating toward a single-payer system over time, while mitigating disruption.
And yet, once the White House spiked it, and it failed in the legislative process, liberals mostly abandoned the idea altogether. Very odd.