Dog wrote:I thought Obama didn't have the votes to pass a public option and reverted to the current scheme as what could get passed. All knew it was imperfect, but was what could get done and the hope was that once insurance was available to many more people that there was no going back and the system would eventually get fixed. The GOP's fumbling over repeal or repeal/replace has made a public option, even a single payer option more viable than ever now.
Seems to me to be textbook "gradualism".
Not saying gradualism is always the answer, but pointing to healthcare in the US since the ACA as an example of failed gradualism seems wrong.
The public option passed in the House and died in the Senate. In fact, Pelosi had to rally some of the troops to pass the ACA w/out the public option because they were wavering out of anger at its removal (in related news, Pelosi ain't perfect but she was a very good Speaker). Moreover, the Dems voted for the ACA fully aware that an electoral bloodbath would await them on the other side of the vote, which is why compromising was a very tough pill for many Dems in the House of Reps. This is just one of many problems of presenting "dems" as a monolithic bloc ideologically on healthcare. Additionally, there are a lot of reasons the ACA was written as it was, but one of the most significant has been readily apparent from the outset. The lack of GOP embrace of the ACA has created legislative and legal headaches ever since passage ... which is why Obama and the Dems worked *very hard* to craft a bipartisan bill. By and large, the ACA has worked pretty well where states have implemented it as intended, and struggled where states have not implemented it as intended. We can all guess which party controls the latter states.
Needless to say, targeting the Dems for the ills of the US healthcare is a singularly myopic line of critique. The GOP simply does not give a shit about expanding healthcare coverage, and it has never lifted a finger to help and the Dems have never been in a position to unilaterally establish a single payer system.
One of the reasons the public option / single payer option is more viable is because the electorate has shifted considerably since 2008, and the bad faith of the GOP ever since has led to many Dems determining that it is simply not worth it to reach out on healthcare policy. In fact, this ties into wider polarization and partisanship. Essentially, if you're a centrist Dem that desires universal coverage you have no allies to find in the GOP ... so, if you want votes to expand coverage, you need to look to the left. What do we see on the left? Polling consistently showed that a significant chunk of the weak polling for Obamacare was ALWAYS progressives that did not accept it because it did not go far enough. This did not get reported on nearly enough in recent years due to focus on GOP obstruction, but the dynamic we look ahead to on health policy is one where the GOP has effectively maneuvered itself into a position where (short of blowing the system up) it cannot play a constructive role in shaping healthcare policy due to intransigence.
So, this is a moment where (as evidenced by Bernie) Progressives can have real influence on issues (just like hard-right conservatives!) if they learn to play well with others and not demand purity tests for everyone.
Worth adding: The constant mantra about "single payer" is probably one of the more corrosive aspects of the debate on the left right now. The goal should be universal coverage in an efficient and affordable fashion, full stop. Single payer is one of a number of options for achieving that.