HIPCs and Single-Payer

Brad De Long delong at econ.Berkeley.EDU
Tue Sep 22 16:32:06 PDT 1998

>pms wrote:
>> I'm now sure the healthcare debaucle was purposeful. These guys can
>> orchestrate anything!
>On this point, I think leftists should at least consider the possibility (I
>regard it as a strong probability) that the health care debacle was indeed
>purposeful -- but the purpose it served was that of William and Hilary Clinton
>and the capitalist class they have always served with such fawning devotion.
>The actual outcome of that debacle was the destruction of twenty years of
>building up a movement for a real health care system ("single payer" was the
>euphemism used for an approximation to free or cheap medical care for all). Do
>you really believe that the murderer of the brain damaged in order to win
>a New
>Hampshire primary and the man who pledged to end welfare as we know it could
>have really intended to provide decent health care?

I know that I worked like a dog to put together options for the NEC and the DPC, and that as of the fall of 1993 there were only about 35 senators willing to vote for a single-payer system.

The hope was that we could get 60 senators to sign up for the HIPC idea--that essentially the government acts like a big benefits department, and gives everyone the opportunity to have the same (limited) choice among systems of insurers and doctors that employees of large bureaucracies (like U.C. Berkeley) have today. And within the HIPC idea there was a provision that individual states could at their own option replace the HIPCs with a state-run single-payer system.

Those of us who were more skeptical that the HIPCs would work thought that social-democratic and sparsely-populated states would start opting for single-payer, and that the number of single-payer states would grow over time...

But due to a lot of White House incompetence at selling the issue and a lot of insurance-company advertising money on the other side, senate support for even the HIPC idea was down to no more than 45 by August of 1994.

The next time you start a movement for a "real health care system," try to build a movement that will get more than 35 senators willing to vote to establish one.

Brad DeLong

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