General Discussion
In reply to the discussion: "But we couldn't *possibly* have gotten single payer!" [View all]jeff47
(26,549 posts)Single-payer is a very difficult battle at the federal level, due to the overrepresentation of "red" districts - Alabama and California have the same power in the Senate, and since 2010 gerrymandering in the House.
What the ACA does is moves the battle for single-payer to the states. Alabama isn't gonna pass single-payer. But California might. At a minimum, public option should be an easy sale. Vermont is already going single-payer as soon as possible (2018).
Public options will result in de-facto single-payer, since they don't profit. They should end up cheaper than the private options, which will attract customers. Despite conservative claims, they will not produce a mountain of dead bodies, which will attract even more customers. That makes their risk pool larger, and thus better, than the private insurance companies. Which makes them even cheaper, and even more customers. The cycle continues until it drives private insurance out of the state.
Success in the "blue" states makes it much easier to do the same thing in some "purple" states. Success in both "blue" and "purple" makes it a much, much easier federal battle.
Single-payer in 2009/2010 was not going to pass Congress. But the ACA gives us a framework to build it anyway. Yes, it's going to take a while. But we've been working on it for quite a while - single-payer has been proposed in every single Congress since the 1930s. We'll get there, and the ACA is a massive step towards it.