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YES! Magazine

Single-Payer Advocates Deserve a Place at the Table

At a town hall meeting in Rio Rancho, New Mexico, this week, President Barack Obama was asked why he has taken single-payer health care off the table.

It's a great question.

Not only have the Obama administration and top Democrats taken the option off the table, they are excluding single-payer advocates from the official forums on health care reform, while advocates of the for-profit medical system turn up and have their say. This in spite of the fact that President Obama has repeatedly admitted that single-payer is good policy. (Single-payer health care is a system, like Canada's, in which the government provide health insurance for everyone. It is simple, straightforward, much lower cost, and it works.)

The Obama administration believes they have a good plan. It includes an option for public coverage so that families can opt for a public health care coverage if they are uninsured or not satisfied with the private insurance they now receive.

At a conference in Washington earlier this year, I asked Jacob Hacker, one of the architects of the plan, why they were not advocating single-payer health care, a system that has proven successful in other industrialized countries, as we showed in a special YES! issue on health care options. Hacker's response was similar to Obama's response in Rio Rancho. People are afraid to give up their employer-provided plan. Although single-payer may be a better system, the private/public plan is more likely to escape the "Harold and Louise" treatment, and is more likely to get adopted than single-payer health care.

It could be that Obama and Hacker are right.

But here's the thing. Right now, the medical-industrial complex is working hard to eliminate the public option. That way, there wouldn't be a public system to compete with them and set a standard for good quality, non-bureaucratic health care. Why would they want to compete? It's great having a monopoly on our health-care dollars.

Since the private insurance lobby is at the table every day, pushing to eliminate the public option, wouldn't it be smart to allow people on the other side -- the single-payer advocates -- to come to the table, too? Then the Obama plan can take the place it belongs, as a centrist compromise.

Allowing people to the left as well as to the right of the Obama position into the discussion is good strategy. And doing so would recognize two important facts -- that single-payer happens to be great policy and it has support from a large number of Americans -- maybe even a majority. In a healthy democracy, a good policy with widespread support should be part of the debate.

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Sarah van Gelder

Sarah van Gelder

Sarah van Gelder is founder and director of, co-founder of YES! Magazine, and author of The Revolution Where You Live: Stories from a 12,000 Mile Journey Through a New America. Follow her blog and connect with Sarah on Twitter: @sarahvangelder

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