Time to be counted

There's a lot of guesswork going on about which Democrats are willing to go further than the Rs towards a sustainable healthcare system. That means single-payer — at least in the reality-based world that is based on evidence and past performance.

The three major Democratic candidates are all for covering children and expanding coverage, but neither Barack Obama nor Hillary Clinton will speak in terms of single-payer. John Edwards goes a bit further. His plan includes a public program that would compete with private insurance. Paul Krugman thinks this is a workable avenue to single-payer. A number of other smart observers, on the other hand, think that it would not affect cost-shifting and could not contain costs.

Progressives long ago lost anything but a pragmatic kind of tolerance for Hillary Clinton — much of it based on nostalgia for Bill. That's despite his neo-liberal policies, and rightly so. Anyone still saying that Ds and Rs are the same has not been paying attention for the past six years. We were happier then.

But Obama. Have you heard the man speak? He'll make your heart sense hope and goodness. Obama's not just a competent speaker. He is eloquent in a way that makes you believe it really is morning in America again — an honest, eyes-open sunny day rather than that old Reaganesque "no sacrifices needed, greed is good!" miasma that passed for a sunrise back in the '80s.

On healthcare policy, however, Obama's coming up short.

David Sirota interviewed him last summer, and wrote this:

Obama is all about the art of the possible within the system. “This is a classic conflict within the left: Are you a revolutionary or are you a reformist?” Obama said. “I am less concerned with the labels that are placed on me in terms of what kind of leader I am, and I am more interested in results…. I think within the institutional structures we have, we can significantly improve the life chances of ordinary Americans.” I asked him to give me some specific examples of what he meant. Is a proposal to convert America’s healthcare system to one in which the government is the single payer for all services revolutionary or reformist? “Anything that Canada does can’t be entirely revolutionary–it’s Canada,” Obama joked. “When I drive through Toronto, it doesn’t look like a bunch of Maoists.” Even so, Obama said that although he “would not shy away from a debate about single-payer,” right now he is “not convinced that it is the best way to achieve universal healthcare.”

The Black Agenda Report:

By June 2003, when Obama was a candidate for his current job in the Illinois Democrat primary, we were impolite enough to ask him a direct question about whether he'd support single payer legislation if elected to the U.S. Senate. We asked him: "Do you favor the adoption of a single payer system of universal health care to extend the availability of quality health care to all persons in this country? Will you in the Senate introduce or sponsor legislation toward that end?" Obama's answer was:

"I favor universal health care for all Americans, and intend to introduce or sponsor legislation toward that end in the U.S. Senate, just as I have at the state level."

Already Obama's position on health care had markedly deteriorated. By the following year, Obama was newly elected to the U.S. Senate, and in an interview with BAR's Glen Ford he was asked whether he planned to sponsor the kind of single payer legislation he'd been identified with as a state senator.

Glen Ford: "Are you going to introduce single payer legislation?"

Barack Obama: "No, I am not. Which isn't to say that I'm not interested in the conversation about moving in a direction that expands affordability and accessibility. But my point is that, along that spectrum there are many points that people may arrive at, all of whom affirm the notion that we have a health care crisis that hits our communities much harder than anybody's, but it's everybody's crisis, and we've got to have an agenda in terms of both general health care issues as well as issues like AIDS that are ravaging the African American community."

Obama is at least as distant from single-payer as is Clinton or Edwards.

John Dean and Wesley Clark, on the other hand, have explicitly come out in favor of single-payer. As did Gore in 2002.