I love a good provocative title as much as the next writer but it has to at least make some sense, which really doesn’t seem to be the case with Ezra Klein’s new article ‘Ryan May Lead to Single-Payer Health Care.’ As best as I can make sense of the rather strange logic leaps, Klein has basically made yet another total 180 reversal in his previous thinking. He is now arguing that Ryan’s plan, if enacted, would be so bad that at some point in the future it would magically make Democrats adopt single payer. From Klein:
It’s unlikely that the model in the Republican budget will prove sustainable. That legislation would repeal the Affordable Care Act, cut Medicaid by a third and adopt competitive bidding for Medicare. The likely result? The nation’s uninsured population would soar. In the long run — and quite possibly in the short run — that will increase the pressure for a universal system. Because Republicans don’t really have an idea for creating one, Democrats will step into the void.
As a result, Republicans’ long-term interests are probably best served by Democratic success. If the Affordable Care Act is repealed by the next president or rejected by the Supreme Court, Democrats will probably retrench, pursuing a strategy to expand Medicare and Medicaid on the way toward a single-payer system. That approach has, for them, two advantages that will loom quite large after the experience of the Affordable Care Act: It can be passed with 51 votes in the Senate through the budget reconciliation process, and it’s indisputably constitutional.
I guess anything is technically possible, but there is not much basis for this thinking, according Ezra Klein circa 2009-2010. Democrats’ health care reform proposals have become increasingly less progressive over the decades. This is something Klein himself pointed out when telling liberals why they needed to push for the imperfect Affordable Care Act.
In fact, during the entire health care debate Klein repeatedly argued the exact opposite of what he said in today’s column, mainly that allowing the health care situation to get worse or allowing the ACA to fail would end up making more liberal reforms in the future more difficult. From Klein in 2009 telling liberals why they should support the flawed ACA:
The fact that we need to do something does not mean we need to do this. “I would rather see us do nothing now,” Angell concludes, “and have a better chance of trying again later and then doing it right. ”
This is, I think, a misreading of not only the politics of this issue going forward, and also the history of health-care reform going backward. Failure does not bring with it a better chance for future success. It brings a trimming of future ambitions.
Now that Klein seems to be trying to scare conservatives, instead of progressives, into accepting a universal mandate based exchange system, he has completely changed his tune: The ACA being eliminated would now make single payer more likely to happen apparently. This would have been helpful to know in 2009-2010 when he was attacking liberals for opposing the bill.
According to Klein, everyone must love Obamacare because if it fails it will produce whatever you think the scariest possible thing is, be that either no universal health care system at all and/or single payer.