The click-bait headline reads “Hillary Clinton: single-payer health care will never, ever happen.” But that isn’t quite what she said:
“People who have health emergencies can’t wait for us to have a theoretical debate about some better idea that will never, ever come to pass.”
Much of the reaction to her statement has been to re-hash the reasons why single-payer is a good idea. Which it is, and it’s important to talk about it. But she knows the arguments for single-payer better than anybody. Here, she’s talking about defending the ACA against attempts to destroy it. She is not saying that single-payer is a bad idea, only that getting there involves a walk into Mordor. Think for a moment about the steps on that walk:
- After generations of propaganda demonizing socialism and socialist medicine in particular, a clear majority of Americans would suddenly have to elect representatives who will support it.
- The courts will have to be ready to fend off an endless series of attacks from insurance companies and related industries – and they’re not.
- Hundreds of laws will need to be changed regarding everything from drug pricing to private hospital policies. Picture our congress doing that.
- All while the propaganda machine is turbocharged by virtually unlimited money from vested interests.
Political realism is a bitter pill. I recall that Hillary does have some experience with this specific issue. She tried to institute single-payer back when Bill was President. It was a damn serious effort on both sides. The drug companies, the insurance companies, and any number of conservative orgs mounted what until then had been the biggest lobbying effort in history to stop single-payer. And that was before Citizens United.
On that bitter experience she is saying: you can’t get there from here. And sadly, I agree. First you will need to replace a few Supreme Court justices, and overturn Citizen’s United. That alone may take eight years, before starting the other steps. There are a lot of people who can’t wait that long. Yes, the ACA is a mess, but our country is not politically ready for what it will take to accomplish a clean, Canadian-style system.
The brilliance of a better idea often blinds us to the many painful realities that lie between us and realizing the idea.
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