Ian Welsh: Finding Common Ground Between Public Option Advocates and Single Payer Advocates

One of the significant fights on the left has been that between those who believe in a public option, and those who believe in single payer.

Or, perhaps I should say, between those who are willing to take what they can get: public option, vs. those who want to hold out for what they consider the best option, single payer.

So, by way of reconciling what differences can be reconciled, let me ask a question of each side.

Public Option advocates
: If you support the public option and you don’t eventually want single payer of a comprehensive system like the French have, why not?

Single Payer advocates: Are you willing to fight for a public option which could eventually lead to single payer or a comprehensive system like the French one. If not, why not?

At this point what I’m seeing is both sides retreating into moralistic screaming. The public option folks are saying “better to save some lives and if you single payer purists don’t support a public option which will save even a few lives, you’re responsible for those deaths.”

The single payer people are saying “the public option is so watered down that all it will do is discredit real public reform, aka: single payer. You public option folks are settling for so little that the few lives you might save are outweighed by all the lives you won’t save and the damage to the chance at real comprehensive health care reform.”

Both sides are assuming the other side is operating in bad faith. The public option folks assume the single payer folks just want to be pure rather than saving lives, the single payer that the public option folks are just sell outs shilling for a bad bill.

But what I’m seeing, as someone with a foot in each camp, is that both sides are (mostly) sincere.

Now there is one group that can’t be reconciled. People who want a public option so weak it either won’t survive, or can’t be used as the basis for a comprehensive system. Insurance company executives, for example. But also some people in the Obama administration, for example Katherine Sibelius, the health secretary, who said that the plan would be drafted specifically so that it could never become single payer.

But for everyone else, there should be some common ground which can be seized.

(originally posted at Open Left)


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