23.5 - Single-payer health plans advancing on state level

Single-payer health plans advancing on state level

I have made it I think abundantly clear that I think that in the health care debate our focus should be on health care, not health insurance, and so progressives should be looking beyond even single-payer health insurance - popularly known now as "Medicare for all" - to a national health care system.

Be that as it may, single-payer would still be a massive improvement over what we have now - and support for single-payer among the public is strong and has been growing over the past few years.

For one example, The Economist/YouGov poll, done in early April, found 60% support for "Expanding Medicare to provide health insurance to every American." Even when they re-phrased the question as "Creating a federally funded health insurance system that covered every American," they still got 61% in favor.

When the MorningConsult/Politico poll, also in early April, asked the questionm in perhaps the most pejorative way possible, describing it as a case where "all Americans would get their health insurance from one government plan," they still got 44% in favor to only 36% against.

And while on a national level we still seem bogged down in discussing just how bad the GOPper plan is rather than pushing alternatives, there is some action at the state level.

For one thing, a single-payer plan in California is moving through the legislature. It hit a snag with a recent legislative report that said the plan would cost a good deal more than thought, but legislators are working on ways to finance it.

Even more significant is that on May 16 the New York State Assembly passed a single-payer healthcare bill that is in several ways even broader than "Medicare for all" would be in that it even covers things like dental that Medicare usually does not.

The Assembly has passed similar bills before only to see them die in the state Senate, dominated by more conservative upstate legislators. But this year could - could - be different: At last count, the bill is just one vote shy of majority support in the Senate. And while Andrew Cuomo is neither the liberal nor the leader his father was, still it is expected he would sign it if passed.

Meanwhile, New Jersey is the latest state to see a state-level single-payer proposal introduced.

There are attempts on the national level, don't get me wrong: H.R.676, the "Expanded and Improved Medicare For All Act," now has 112 cosponsors, the largest ever for a single-payer bill. Bernie Sanders is expected to introduce a comparable if not a companion bill, in the Senate.

Still, it has to be admitted that the chances of such bills passing Congress this year are slim at best, which actually overstates the chances. Which is one reason for pushing beyond it: Staking out the territory. Saying "this is where we want to go" instead of "this is where we think we can get in the short term."

Because looking beyond the short term is how you win in the long term.