Coverage under Obamacare has only been live for one day, and already the hills are alive with the sound of the single payer pivot. Michael Moore (Fahrenheit 9/11, Sicko) has an op-ed in the NYT arguing that we need to build on the ACA to set up a single-payer like system. With its mix of praise and blame for the Affordable Care Act, Moore’s piece is a textbook example of the pivot genre:
For many people, the “affordable” part of the Affordable Care Act risks being a cruel joke. The cheapest plan available to a 60-year-old couple making $65,000 a year in Hartford, Conn., will cost $11,800 in annual premiums. And their deductible will be $12,600 […]And yet — I would be remiss if I didn’t say this — Obamacare is a godsend. My friend Donna Smith, who was forced to move into her daughter’s spare room at age 52 because health problems bankrupted her and her husband, Larry, now has cancer again. As she undergoes treatment, at least she won’t be in terror of losing coverage and becoming uninsurable. Under Obamacare, her premium has been cut in half, to $456 per month.Let’s not take a victory lap yet, but build on what there is to get what we deserve: universal quality health care.
Moore’s model for what universal quality health care looks like is Vermont’s single-payer experiment, which will go live in 2017. And he’s not alone. At The New Republic, ACA champion Jonathan Cohn solicited the predictions of eight different health care wonks for Obamacare’s 2014 prospects. One of the participants, Don McCanne of the “Physicians for a National Health Plan”, argues that Obamacare was a success, but it will restrict networks, raise costs, and leave many uninsured—a curious kind of success. He predicts, therefore, that the public will increasingly demand a single-payer system that can address these lingering problems.This is where the debate is going. Obamacare supporters almost universally accepted the ACA as a compromise when it was passed, and they aren’t going to be keep playing defense on the law. They are going to go on offense, pushing for the kind of system they have wanted from the beginning. Even as opponents of the Affordable Care Act continue to fight the law, proponents of the ACA are already suiting up for the next battle.