Beware Democrats: There’s a new litmus test on the way that you’ll have to satisfy if you want to avoid being branded an establishment sellout. It concerns single-payer health care, and while this one can get silly in some quarters, there are serious questions that everyone on the left, from the most moderate Democrat to the most committed leftist, will have to answer.
If your single-payer idea is “what they have in the rest of the industrialized world,” well, that’s not single-payer either.All those other systems have much stronger government regulation than we do, but they all include at least some form of private payment, some more than others.What unites them is that they cover everyone at far lower cost than we do, and they do it through aggressive regulation and price-setting.But it would be absurd to say that someone who favors a version of the British system is a real progressive, while if you favor something like the French system or the Japanese system or the Dutch system then you’re a neoliberal sellout.So as liberals start to think seriously about this issue, it would behoove us all to define exactly the principles and goals that are important; then we can judge what kind of job each competing system does of accomplishing them.Universal coverage is obviously the most important one; everyone has to be covered, full stop. Another is that the system has to be equitable; if people with lower incomes can only afford plans with huge deductibles, it has failed. At a minimum, there has to be a floor of coverage that no one can fall below.
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