In Obama's recent speech, he equated the movement to extend Medicare to all Americans with the Canadian single-payer.
There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada’s where we would severely restrict the private insurance market and have the government provide coverage for everyone." ...such a plan "would represent a radical shift that would disrupt the health care most people currently have.
He also reminded his "progressive friends" what apparently the real driving force behind health reform has been about all these years:
"To my progressive friends, I would remind you that for decades the driving force behind reform has been to end insurance company abuses and make coverage affordable to those without it,"
Forgive me, but I'm pretty sure the driving force for the Democratic base has been a universal health care system, and among the most ardent supporters of health care reform on the Left, a government administered universal health reform system.
But, Obama does two things here. He reframes efforts on the Left to reform health care as largely a regulatory effort rather than an effort to expand a federal health care program, and he dismisses single payer supporters as those who only support an all or nothing approach, Medicare for All, now, or nothing. But are either of these assertions true for health care reform advocates on the Left? Not really.
Anthony Weiner has been the most prominent supporter of an expansion of Medicare in the recent health reform debate. Hardly a bleeding heart liberal, Weiner is viewed as a moderate and a protege of Chuck Schumer. Has he argued everyone on Medicare right now? No. Though he favors that approach, largely on pragmatic fiscal grounds, it is the best way to ratchet down health care as a proportion of GDP, but he's said it could be done in stages. Still, he disputes Obama's charge that expanding Medicare is a radical change that would disrupt most Americans health care delivery.:
If Medicare has been such a success, why not extend it? Why not have single-payer plans for 55 year olds? Why not have one for young citizens who just left their parents or college coverage?
So far, the answers we hear to these questions have simply not been very convincing.
At one town meeting the President responded that that he was worried about its "destructiveness."
Really? Americans would still go to the same doctor and the same neighborhood hospital. Sure, they would be able to delete the 1-800 number of their insurance company from their cell phones. And doctors would have to get rid of all those file cabinets full of paperwork while their assistants who spend time fighting with insurance companies would be able to actually speak to patients.
But everyone would adjust, I'm sure.
Now what about Obama's claim that health reform efforts in the recent past have been mostly about ending insurance abuses, and creating affordability for the uninsured? One could argue this point, as Obama has. Bill Clinton's first approach to reforming health care largely left the insurers intact, though it did at least attempt to loosen the link between employment and health coverage via portability. But, after Clinton failed to pass his reforms, he advocated something much simpler, expanding Medicare.
In his new budget request, President Clinton will again ask Congress to open Medicare to people 55 to 64 years old, Administration officials said today.
Though the proposal died in Congress last year, Mr. Clinton will resubmit it, in part because he is concerned about the erosion of private insurance coverage among people 55 to 64, the officials said. Medicare now covers people who are 65 and older or who are disabled.
The number of people without health insurance rose by 4 percent in 1997, to 43.4 million, the Census Bureau said. The number of uninsured people age 55 to 64 rose more sharply, by 7 percent, to 3.2 million....
Senator Daniel Patrick Moynihan, Democrat of New York, introduced a bill to carry out Mr. Clinton's proposal to expand Medicare last year. Under that proposal, people ages 55 to 64 could have bought Medicare coverage by paying premiums of $300 to $400 a month. People 62 to 64 who chose this option would also have had to pay surcharges on their premiums after they reached the standard eligibility age of 65.
The Administration says the proposal is needed because commercial insurance is often unavailable or unaffordable for people age 55 to 64.
Now unless you think Bill Clinton and Anthony Weiner propose something radical and disruptive here, Obama is wrong, or at least selective about those who advocate a larger role for Medicare as essential to health care reform. Obama is choosing to reform health care largely as a regulatory practice, which is fine. The Democrats want a federal role in regulating insurance markets. But there is another path to reforming health care and expanding the federal role. That would be a programmatic path via expanding Medicare.