I have asserted many times on this list that there is a fundamental disconnect between the political realities that we are told we live under by major media, pundits, and politicians (not to mention a handful of their apologists on this list) and the actual political realities we live under regarding health care.
There is yet another poll out that shows that a strong majority (67%) of Americans think it is a good idea for everyone to have health insurance. [PDF at <http://www.resultsforamerica.org/calendar/files/RFA%20CSI%20Healthcare%20FINAL.pdf>].
This is not a new (arguably this has been consistently true since rudimentary polls nearly 90 years ago showed) but what is pretty unique about this poll is they probe further to see how soft this support is (one of the conventional excuses for Clinton's failure was that while support for universal health insurance was strong it was thin and wilted under industry PR--a position that is somewhat true but only a small part of the story).
56% would be in favor on "national health insurance." This poll finds that 41% say they are for "socialized Medicine" (England is mentioned in the question) and "Canadian-style health care" while only about 33% say they would be definitely against. ("Socialized medicine" gets more "probably against" though than single payer.)
There are a whole range of questions that show massive support for government controls on costs (78% favor strong premium regulation). Even half of the self-identified "conservatives" favor restricting the profits of big pharma.
The interesting thing is to look at how few national politicians support these issues in public ways. The Bush administration has pretty much done nothing to expand access or control costs. None of their ideas appear to be very popular on a policy level. The Kerry campaign picks a handful of semi-popular ideas but chooses to emphasize weak platitudes. Note that he talks about expanding means-tested access to health-care (which is not a bad thing in itself) when the majority of Americans want something far stronger. He talks about reinsurance schemes (not a bad think in itself)to control costs when better ideas and more popular themes are emphasized by average people [the reinsurance idea was one of the least popular ways to control costs in the polls].
I was thinking that the insistence of the right to call any attempt to provide universal health insurance as "socialized medicine" may be inadvertently creating support for it. I know many practical people would be loathe to use the term, but I think in this case it is very pragmatic to speak carefully and intelligently about the benefits and problems of direct state provision of health care. There are problems with single-payer/socialized payment model (both inherent and in application to the US) and any socialized delivery model as well. None of that should make people afraid of exploring these options even though the opposition would be financially strong.
Another reason I think this limiting discourse is such a shame is that I fear that the future Bush administration might start thinking about filling the vacuum left by major Dem proposals with the notion of universal access is what he will deliver by fracturing social insurance with individual financial options. The Heritage Foundation recently endorsed "individual mandates" to cover everybody.
There are wider issues and lessons that can be learned here (most importantly that it is dangerous work to say good and popular ideas are not "politically feasible" because those are self-imposed shackles.
Jim
"Sustained, chronic and long-term stress is linked to low control over life circumstances."
-Michael Marmot