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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Dissing Single-Payer: Wise Strategy or Delaying the Inevitable?

John F. Wasik’s commentary, “No Reason to Demonize U.S. Single-Payer Health” in today’s edition of Bloomberg.com offers a convincing argument that the most promising form of health care reform has been wrongly taken off the table by both the Obama administration and the mainstream media. On Obama’s strategy:

If President Barack Obama wants real change in American health care, he will have to get over the fear of even mentioning single-payer concepts. At his health-care summit last week, only the threat of a demonstration garnered late invitations for Oliver Fein and Congressman John Conyers, two leading proponents of the single-payer plan.
…Obama has said he would keep an open mind on health-care solutions. Yet when asked on March 5 about why he was against single-payer medicine, White House spokesman Robert Gibbs replied: “The president doesn’t believe that’s the best way to achieve the goal of cutting costs and increasing access.”

Wasik supports Rep. John Conyers’ National Health Insurance Act, which has 93 co-sponsors in the House of Reps, and he makes a strong case for the economics behind the plan.
Obama may see single-payer health care reform as a longer-range goal to be achieved in stages. Polls indicate that despite widespread discontent about the current health care system and strong support for single-payer reform, millions of Americans want to keep their current insurance coverage. In a Gallup Poll conducted 11/13-16, for example, 26 percent of respondents said their current coverage was “excellent” and another 41 percent said it was “good.” Obama’s reform team may have concluded that angering them at this stage may imperil reforms that could improve coverage for millions more.
Wasik is dead right however, about the mainstream media’s “sheepish” failure to give single-payer reform a fair hearing. From the Fairness & Accuracy in Reporting study he cites:

Single-payer–a model in which healthcare delivery would remain largely private, but would be paid for by a single federal health insurance fund (much like Medicare provides for seniors, and comparable to Canada’s current system)–polls well with the public, who preferred it two-to-one over a privatized system in a recent survey (New York Times/CBS, 1/11-15/09). But a media consumer in the week leading up to the summit was more likely to read about single-payer from the hostile perspective of conservative columnist Charles Krauthammer than see an op-ed by a single-payer advocate in a major U.S. newspaper.
Over the past week, hundreds of stories in major newspapers and on NBC News, ABC News, CBS News, Fox News, CNN, MSNBC, NPR and PBS’s NewsHour With Jim Lehrer mentioned healthcare reform, according to a search of the Nexis database (2/25/09-3/4/09). Yet all but 18 of these stories made no mention of “single-payer” (or synonyms commonly used by its proponents, such as “Medicare for all,” or the proposed single-payer bill, H.R. 676), and only five included the views of advocates of single-payer–none of which appeared on television.
Of a total of 10 newspaper columns FAIR found that mentioned single-payer, Krauthammer’s syndicated column critical of the concept, published in the Washington Post (2/27/09) and reprinted in four other daily newspapers, accounted for five instances. Only three columns in the study period advocated for a single-payer system (San Diego Union-Tribune, 2/26/09; Boston Globe, 3/1/09; St. Petersburg Times, 3/3/09).
The FAIR study turned up only three mentions of single-payer on the TV outlets surveyed, and two of those references were by TV guests who expressed strong disapproval of it: conservative New York Times columnist David Brooks (NewsHour, 2/27/09) and Republican congressman Darrell Issa (MSNBC’s Hardball, 2/26/09).

And that may be the biggest problem for single-payer advocates — opening up the discussion. The campaign to stigmatize single payer reform as “creeping socialism” is well-underway, and the fear-mongers are ascendant. For now, it’s up to the progressive blogosphere to push the idea on to the front pages and nightly news programs.
Single-payer advocates argue that presidential leadership ought to be about forging consensus, not searching for it and Obama’s best shot at comprehensive health care reform has to be taken sooner, rather than later, while his approval ratings are still high. Yet, Obama’s strategy choices and timing have been pretty good so far. Still, opening up the discussion to include single-payer reform might help make his current proposals more acceptable to moderates. It’s hard to see much of an upside to taking single-payer totally off the table.

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