I guess I don’t get it. Why is “single payer” seen as such a magic cure by American progressives?

Yes, the current American system sucks and yes the current crop of insurance company funded presidential wannabes don’t want to bite the hand that feeds them. And yes, government can provide health care more efficiently than the private sector.

But “single payer” is merely a payment mechanism. It’s just one component of a good health care system. And it isn’t quite accurate to say Germany and France have single payer systems. Private plans are part of those systems. England definitely doesn’t. They have socialized medicine (doctors work for the state). And Canada, which is lauded as the single payer example, has only slightly better health outcomes than the United States (of course their single payer system helps provide health care coverage MUCH more cheaply).

Single payer is not a panacea. It is a good tool for efficient payment but is only one tool. We also need to develop enough political power to regulate the pharmaceutical company prices, do preventive care, and force some planning on the market. And maybe we should address the absurd salaries of doctors (or just import cheap doctors from overseas- that ought to make the Thomas Friedman adherents apoplectic).

Of course we’d be better off if we got rid of insurance companies. We should also nationalize the energy industry and change our entire cheap food agriculture system. But these goals will require a fundamental shift in the current power dynamic and it don’t look like that’s going to happen anytime soon.

Ask yourself what you have done in the last two months to lay the grassroots political groundwork for taking on a gazillion dollar industry that will shut single payer advocates out of policy discussions in the back rooms of DC and Albany? A good idea goes only so far in politics.

Most Americans have never heard of single payer and are suspicious of government solutions that are imposed on them. You can advocate for single payer just as much as you can advocate for mandatory car pooling and an end to product packaging. But speaking truth to power is not organizing. It might get you into heaven but it won’t budge public policy one iota.

Our system is totally screwed up and if we are really savvy and are able to build a powerful grassroots groundswell we might be able to budge the current system several degrees to the left and shrink the private sector and expand the public sector.

I’d love for the system to work a little bit better. I’m working two jobs while my wife goes back to school and we’re just trying to make it. Health care coverage is a huge problem. I know some upper middle class professionals (who own second homes) and they scoff at the idea of changing the system a little bit. They call it “incrementalism.” I don’t call it incrementalism. I call it health care for my kids.

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