By Karoun Demirjian
Las Vegas Sun, August 10, 2013
In just about seven weeks, people will be able to start buying Obamacare-approved insurance plans through the new health care exchanges.
But already, Senate Majority Leader Harry Reid is predicting those plans, and the whole system of distributing them, will eventually be moot.
Reid said he thinks the country has to “work our way past” insurance-based health care during a Friday night appearance on Vegas PBS’ program “Nevada Week in Review.”
“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.
When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.”
The idea of introducing a single-payer national health care system to the United States, or even just a public option, sent lawmakers into a tizzy back in 2009, when Reid was negotiating the health care bill.
“We had a real good run at the public option … don’t think we didn’t have a tremendous number of people who wanted a single-payer system,” Reid said on the PBS program, recalling how then-Sen. Joe Lieberman’s opposition to the idea of a public option made them abandon the notion and start from scratch.
Eventually, Reid decided the public option was unworkable.
“We had to get a majority of votes,” Reid said. “In fact, we had to get a little extra in the Senate, we have to get 60.”
Reid cited the post-WWII auto industry labor negotiations that made employer-backed health insurance the norm, remarking that “we’ve never been able to work our way out of that” before predicting that Congress would someday end the insurance-based health care system.
http://www.lasvegassun.com/news/2013/aug/10/reid-says-obamacare-just-step-toward-eventual-sing/
Comment:
By Don McCanne, M.D.
Wow! Senate Majority Leader Harry Reid predicts that Congress will eventually end the private insurance-based financing system, acknowledging that “a tremendous number of people wanted a single-payer system.” What can we make of this?
We can only guess at the politics behind his statements, but the policy implications are monumental. He not only expresses the view, held by both liberals and conservatives, that employer-sponsored plans must be replaced, he also departs from some conservatives by implying that the private insurance-based system should be eliminated, replacing it with a single payer system.
Is this just a sop to single payer advocates? He and the other Democrats have continued to advocate vigorously for Obamacare. They have enough problems with the intense campaign mounted by the Republicans to repeal it. The efforts by single payer activists to educate the nation on the severe policy deficiencies of Obamacare certainly are a thorn in their side as they try to implement the program. If they could get single payer supporters to believe that Obamacare is an incremental step toward single payer, then maybe they could enlist our cooperation, or at least silence us for the time being.
Well, Obamacare departed in an entirely different direction from single payer, expanding the fragmentation and administrative complexity which are the opposite of the efficiencies that a single payer system would bring us. Obamacare is not an incremental step towards single payer.
In the meantime, conservatives will jump on Reid’s comments as proof of the conspiracy theory that all along Obamacare was a ruse to get us to single payer. Some ruse! It sets up a system that requires only a simple bill to remove tax expenditure incentives from employer-sponsored plans, freeing up individuals to rely on their own shopping skills to purchase the “highest quality and lowest cost” plans in the marketplace. We already know from decades of experience with private insurance markets what a terrible idea that is – much higher costs for poorer quality plans. Yet this “ruse” feeds right into the agenda of some conservatives who would keep government out of health care financing as much as possible.
The lesson here is that we cannot sit back and simply allow the “inevitable” transformation from employer-sponsored plans to single payer take place on its own. We still have to overcome the inertia of, “Yes, single pager would be the ideal system, but it’s not politically feasible at this time.” Thus this is not a time to relax because we won the contest of ideas. This is a time to greatly intensify our advocacy efforts so the nation understands why single payer is the reform that really will work.