When I speak to conservatives about health care policy, I�m often asked the question: �Do you think that Obamacare is secretly a step toward single-payer health care?� I always explain that, while progressives may want single-payer, I don�t think that Obamacare is deliberately designed to bring about that outcome. Well, yesterday on PBS� Nevada Week In Review, Senate Majority Leader Harry Reid (D., Nev.) was asked whether his goal was to move Obamacare to a single-payer system. His answer? �Yes, yes. Absolutely, yes.�
In one sense, this isn�t shocking. Reid and many other Democrats, including President Obama, have often stated that their ideal health-care system is one in which the government abolishes the private insurance market. Video of the PBS discussion isn�t yet online, but here�s how Karoun Demirjian of the Las Vegas Sun described it:
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.�
Reid noted that he and other progressives fought hard for a �public option� in the exchanges as a Trojan horse for single-payer, but Democrats didn�t have 60 votes in the Senate to achieve it:
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 sees the tax exclusion for employer-sponsored health insurance as the primary obstacle to single-payer health care:
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.
It�s one of the key things to remember when you look at polls saying that Obamacare is unpopular. A small percentage of the people who oppose Obamacare�around 7-10 percent�oppose it because it doesn�t go far enough.