Single Payer Now? Not So Much.

If every U.S. Senator of the past three decades were polled about which member was the most effective at securing co-sponsors and getting major legislation passed, Edward Kennedy would be ranked at or near the top of the list. That makes this item by Austin Frakt of particular interest as we continue to debate whether the Affordable Care Act was a great achievement, or, a complete sell-out (because universal health care was within easy reach).

Senator Kennedy wrote a “Medicare for All” bill and was able to round up the following number of co-sponsors: Zero. As Austin notes, that’s “pretty far from a filibuster-proof majority”.

Author: Keith Humphreys

Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.

18 thoughts on “Single Payer Now? Not So Much.”

  1. First of all, no one I know hates the president, so think about calming down. (Though I do think a primary challenger could be helpful.) The people who do hate the president hated him on Day 1.

    Second, what year was it when Kennedy took his head count? A lot of people weren’t ready for *any* reform in the mid-90s, because they didn’t understand how health insurance really works. Now, more of us do.

    I don’t think anyone ever said it would be easy. Also, I don’t think you’d even have to make it the only option. You could just open up Medicare to people who were willing to pay for it, and I think a lot would be. Admittedly, right now is probably not the best time to revisit. Maybe after the president gets re-elected.

  2. No, it was a complete sell-out because some kind of “public option” was within reasonable reach for a president willing to live up to his word. Or was he lying. Then or now? Nor do I hate the president. Bless his heart, he seems to be doing the best he can.

  3. I do not hate the President. I recognize that he has achieved much. But I think he has done a poor job on a number of fronts, and what annoys me is that he seems to be unwilling to even state a principle firmly, much less take a strong stand.

    Look at the debt ceiling debate. IMO, Obama never made clear the following essential points:

    1. Raising the is absolutely not the equivalent of giving Obama a blank check to spend as he pleases.
    2. The borrowing is needed to meet government commitments previously made by Congress.
    3. The debt ceiling has been routinely increased many times, incluidng however many under Bush, Reagan, etc.
    4. It has never before been held hostage to ideological objectives.
    5. It was necessary to concede some points, because the GOP, by refusing to raise the ceiling otherwise, was willing to do great harm to the country if it didn’t get its way.

    Instead, he went on about “bipartisan solutions,” and “belt-tightening,” and other nonsense, permitting the Republicans to frame the increase as just another round of wasteful spending, in effect totally obscuring points 1 and 2 above.

    That kind of thing is what drives me nuts.

  4. Senator Kennedy wrote a “Medicare for All” bill and was able to round up the following number of co-sponsors: Zero. As Austin notes, that’s “pretty far from a filibuster-proof majority”.

    When? I can’t tell from Austin Frakt’s post when this was, exactly.

    Not that I disagree with the point that single-payer or “Medicare-for-all” was a realistic (as in having the votes) alternative to the ACA.

  5. Actually the first time Kennedy sponsored a Medicare for All bill (in 1971) his two co-sponsors were Republicans– John Sherman Cooper of Kentucky (Mitch McConnell’s first boss in DC) and William Saxbe of Ohio (who later served as Nixon’s Attorney General).
    http://news.google.com/newspapers?id=NfEwAAAAIBAJ&sjid=fOAFAAAAIBAJ&dq=william-saxbe%20health-insurance&pg=940%2C3016239

    Kennedy would’ve almost certainly gotten the Kennedy-Mills compromise bill (drafted by ex-SSA chief Robert Ball) over to White House for the President’s reluctant signature in 1974 (Nixon or Ford depending on WHEN in 1974) if the AFL-CIO hadn’t screwed the pooch by opposing this universal Medicare bill (with its co-payments and coverage limitations) on the assumption it’d get a bigger better deal passed after the midterms.
    http://www.ssa.gov/history/orals/ball1.html

  6. For those who seem to be suggesting that perhaps Kennedy’s feilure to attract co-sponsors to his Medicare For All proposal was a long time ago, and doesn’t reflect the increased momentum behind health care reform in 2009, it’s worth keeping in mind this: Joe Lieberman, who – casually hate him or truly despise him – had in effect a veto on the health care bill, torpedoed a proposal that he had only a few months earlier written that would have let younger people (55 year olds, iirc) buy into Medicare. Sadly, what was possible was limited to what Holy Joe wouldn’t kill. Which doesn’t include Medicare For All and doesn’t include the Public Option; frankly, it was a miracle it included Health Care, period.

  7. “When? I can’t tell from Austin Frakt’s post when this was, exactly.”
    http://www.govtrack.us/congress/billtext.xpd?bill=s110-1218

    Actually, the 5 year phase in period is Obamaesque in its weakness, Johnson stood up the original Medicare program in less than a year. The section allowing people to enroll in FEHB is lame also. The health insurers are going to oppose this in any event, why throw them a bone in the opening offer? The weakest part is the payroll tax, 7% on employer, 1% (in effect) on employee.
    In 2011 dollars, that’s about $560 billion a year. Levying Medicare taxes above SS’s $106k cap as well as a 15.3% unearned income Medicare tax (Obamacare is to be funded by a 3.8% tax over $250k) would have raised about the same without adding to marginal cost of semi-skilled labor or raising tax rates. Alternately, let Bush tax cuts expire and toss in financial transaction and carbon taxes. The advantage of this approach is amending Medicare is a permissible use of filibuster-proof reconciliation process., Obama could have rammed this through with 50 votes plus Biden before his first August recess. The very fact that its inconceivable that Obama would do something like that is exactly why he was groomed for high office very early.

  8. > Sadly, what was possible was limited to what Holy Joe wouldn’t kill.
    > Which doesn’t include Medicare For All and doesn’t include the Public
    > Option; frankly, it was a miracle it included Health Care, period.

    Good thing the President no one hates refused to back the Democratic candidate for Mr. Lieberman’s seat, and then spent so much political capital supplicating Senator Lieberman(LfC) to ensure his good behavior.

    Cranky

  9. Cranky,
    I take it you are still sore that Obama refused to support Joe’s opponent in the 2006 primary election for Senate in Connecticut – a stance that was hardly unusual among professional Democratic politicians. Obama, like every other significant Democrat, supported the result of the 2006 primary election and backed Joe’s opponent in the general. As to his desperate attempts to keep Joe on side, those were hardly optional given that Joe held a veto.

  10. Warren @1:55,
    That’s an, um, interesting interpretation of the sequence of events. One accepted by the DC Village, to be sure, but hardly anywhere else.

    Cranky

  11. CO: I know that the Pres backed L before the 2006 primary — did he really do so after the primary?

    I’m disappointed but not surprised when people complain generally about the Pres’ conduct in re HCR, but never face the critical point. Was O supposed to go over the heads of senators, and rally the people of Montana, Nebraska, and Louisiana in his favor?

    I like beowulf’s scenario, but think I can name 51 sens who would have voted no.

  12. > CO: I know that the Pres backed L before the 2006 primary — did
    > he really do so after the primary?

    Neither Obama nor Clinton (HR) nor any major Democratic Party insider _openly_ backed the Connecticut for Lieberman Party [1] candidate, no. Did they lift a finger to assist Lamont? No. Did they give Lieberman a standing ovation when he returned to the Senate? Yes. Draw your own conclusions.

    Cranky

    [1] The simple fact the construction of that bogo-party name (“Connecticut for Lieberman” instead of “Lieberman for Connecticut”) should have been a glaring tipoff to Connecticut voters, but apparently not.

  13. Beowolf: Your interpretation of what happened in 1974 is different than Senator Kennedy’s. He said for years that the biggest regret of his career was that he didn’t cooperate with Nixon’s national health insurance proposal, he saw it as a failure on his own part (i.e., didn’t just blame everyone else). Like many Democrats at the time, he thought that post-Watergate they would have the White House and overwhelming liberal majorities in Congress and there was no need to work with Nixon on his proposal.

    All: The speculations above that maybe Kennedy checked into the “Medicare for All” bill some time in the past and then stopped tracking its chances at some point doesn’t do justice either to him or to his amazing staff (one of the very best on the Hill, he treated them very well and they were incredibly loyal and hard working people who stayed with him year after year). I know I am not the only RBCer who has spent time on the Hill, so I think others who visit this site will back me up on this: Senator Kennedy was the kind of elected official who, if he went to a state funeral or state dinner or bill signing or even the most routine DC non-event, would always would have a list in his coat pocket of every key person who was there and every issue he wanted to buttonhole them on and he would work every one of them. The man knew how to get things done as well as anyone who has ever served in the Senate. Even people who hated his politics would tell you that the Senator and his staff knew the pulse of the Senate all the time. Ted Kennedy could have told you the number of votes in the Senate for “Medicare for All” every week of his life up to the very end. If he didn’t believe the votes were there, they weren’t. Period.

  14. All this shows is that the Senate and the people’s representatives have no intention of doing what the People actually want.

  15. should have been a glaring tipoff to Connecticut voters, but apparently not

    You really think voters in CT were in some doubt about what was going on? A coalition of moderate Republicans and moderate Dems chose to stick with a guy they knew very very well. I certainly would not have voter for Lieberman if I had lived in CT. But the choice was plenty clear, and Lamont didn’t lose because some obscure first term guy from Illinois with a funny name stayed home.

    There are plenty of legitimate reasons to be upset with the President. We don’t need to create new ones from straw.

  16. Of course, no one is saying that Obama failed because he didn’t get single-payer. He failed because he didn’t even try to get a public option, which was far more popular than health care reform in general in every poll that I saw. That every single Blue Dog holds veto power over everything in the universe is hardly an excuse for not trying. Maybe they could have been rolled by the combination of a President and public and 55 other Democratic Senators who wanted it. But we didn’t have a President who wanted it. And now we don’t even have it as a campaign issue.

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