I've been trying to decide whether or not to link to Krugman's column today. On the one hand, it's a nice restatement of the liberal position on health care. On the other, it's pretty simplistic -- you guys have heard this before. But it does inadvertently make a point that needs to be said louder. Some single payer advocates think the very idea is simple enough, that just bringing it out into the world will give us a comprehensible and broadly supportable strategy. Not so -- single payer is actually quite odd The idea of a government takeover in health care turns folks off, at which point we have to explain that no, the government isn't taking over health care, just all forms of health insurance, and no, that won't change health services, and no, nothing will be different in this wholly new structure where everything is funded differently and there are no more insurance companies. It's all quite counterintuitive.
That's why Medicare-for-All is such a great banner. Medicare happens to be a very good, though deeply underfunded program. It keeps costs down better than the private sector, it enjoys sky-high satisfaction ratings from those on it, its administrative costs are dirt cheap, and so forth. Problem is, the program is on bad financial footing, though that's the government's fault, not the program's. Nevertheless -- Medicare is understandable. People have it already. Seniors protect it like an especially precocious grandchild. It's just normal health care that the government pays for. Simple as that.
Better yet, Republicans can't demonize the idea because it already exists andeverybody's parents and grandparents use it. The commercials on the television just don't trump the matriarch in the living room. So Republicans can go after its financial footing and call it unsustainable, but the first hurdle, the conceptual one, is cleared. That's why if Democrats want to push for single payer, using Medicare, rather than the undefined "single-payer", is the way to go. The final program, of course, could be changed so that nationwide Medicare only looks somewhat like the current incarnation but using a program already in place makes it more likely we'll get to that legislative point.