April 18, 2005

The Single-Payer That Dare Not Speak Its Name

Ezra Klein recounts a famous story about some elderly woman telling John Breaux, "Senator, don't you dare let the government get its hands on my Medicare!" Heh. In light of the fact that, you know, seniors love Medicare, the tale highlights just how conditioned Americans have become to demonize public health care. ("How could anything so good possibly be government-run?") So it's easy to come away from the story feeling dejected and hopeless about the prospects for a national health care program in America.

Except... except... perhaps this is actually an opportunity in disguise! If people a) love Medicare and b) don't actually think of it as a government program, then maybe the solution to quality universal health care is simply to expand Medicare. No use fighting the vast propaganda machine that's been dragging single-payer's name through the mud all these years. Just go around the machine! No one will see it coming! Heck, even George W. Bush likes expanding Medicare, so how could you possibly call it socialism?

Now as it happens, Yale Professor Jacob Hacker has outlined a pretty good proposal for expanding Medicare to cover the uninsured. A small incremental step, yes, but we can all see where this leads down the road. Nudge, nudge, wink, wink. As it also happens, I think Hacker's mostly onto something, and his plan is probably the best "baby step" to get from the bizarre hybrid health system we have now to a system of universal coverage. The only downside is that this idea was also more or less known as "Dennis Kucinich's campaign proposal," which means that "moderate" liberals will flip out. (Another blow: Teddy Kennedy likes it. Quelle horreur!) Nevertheless, it's realistic and doable, it's better than the Center for American Progress' plan, and as Ezra's lovable granny points out, Medicare is basically the one public health-care system that no one actually believes is a national health-care system. And that, friends, is half the battle.

More: Nyuk nyuk.
-- Brad Plumer 4:02 AM || ||