Over at Vox Ezra Klein is making one of the more logically flimsy arguments against single payer I have seen in a long time: “Hobby Lobby shows why single payer could hurt reproductive rights.” From Klein:
A single-payer system heightens the stakes on this kind of decision. The assumption behind some of the Hobby Lobby-based arguments for single payer is that a single-payer system would cover contraception and that would mean everyone’s insurance covers contraception. But a Republican-led government could decide that taxpayer dollars shouldn’t be going to cover contraception at all, and then a single-payer system means no one’s insurance covers contraception.
First, the government currently uses taxpayer money to provide people with insurance through Tricare, Medicare, and the VA; so we don’t need to speculate about what the GOP might do. Republicans already could have used this power to make a moral objection about contraceptive coverage but haven’t. That would be very unpopular.
More importantly, this theoretical concern exists whether or not we adopt single payer. The federal tax dollars are already directly or indirectly paying for part of almost every American’s insurance. Either you have government insurance, government is providing you tax credits via the exchanges, or giving your employer-provided insurance a big tax break.
Congress could easily pass a law that says any insurance plan which gets money from the government or is supported by preferential tax treatment can’t cover X. Congress currently has the power of the purse strings over the entire health insurance market so can easily do whatever they want if they feel so moved.
Klein concludes with this line:
The point here isn’t that single payer is a bad way to structure your health-care system. As other countries show, single-payer systems can work beautifully. But a single-payer system can only be as good as the government that runs it. So how good do you think the US government is?
Given that Medicare has existed for half a century and most people on it are very happy with it, I would say the government can at least do a better job than the horriblle private insurers many Americans are forced to use. Again, we don’t need to speculate about a hypothetical, we can simply look at what already exists.