Of course, the election is about much more than that. Sanders has opened and closed the last two debates with well-honed arguments that taking on the corrupting influence of Wall Street would be his first priority. What he has not said in his comments about single payer is that concern for their Wall Street patrons was the reason Democrats took it off the table at the beginning of the health care reform debate in 2009. Their excuse was that it was “unrealistic.” Instead, they offered a bait-and-switch in the form of the Public Option. It was billed as a step to single payer because everyone would choose cheap, comprehensive Medicare-type over the spotty coverage of overpriced private insurance. However, Senator Schumer quickly ended that vain hope when he made a deal to handicap the Public Option so it could not compete with private insurance.
Those who understand the economics of single payer know that the “reform” debate was primarily aimed at bailing out the Wall Street-owned medical insurance industry that was in the process of pricing itself out of existence. This is the “death spiral” of insurance costs: Increasing costs drive people from the market, requiring further increases to maintain shareholder profits and industry executive bonuses, resulting in more people unable to afford insurance. Unchecked, this would soon have led to a situation where average Americans would be paying 50% or more just for insurance premiums. Obviously, this is unsustainable. Enter corporate Democrats, with a “reform” that guarantees millions more customers for the insurance industry, subsidized by taxes that go directly into the pockets of Wall Street investors.
Many rank-and-file Democrats failed to ask themselves what the suppression of the debate about single payer said about the chances of eventually electing a Democratic majority that would put the interests of people over profit. The answer is that the Democratic leadership, being dependent on Wall Street to control the White House, is insufficiently willing to challenge the corruption of the system. Until we find leaders in the party who will, there is no reason to expect anything to change.
Reforming campaign finance would make achieving single payer and accomplishing the rest of the progressive agenda possible. The alternative is abandoning hope of getting what we need in exchange for what we can get, in the name of “pragmatism.” In using this as a selling point for her candidacy, Clinton is apparently arguing that truly representative democracy is a naïve notion. Elect her, she says, and she will use her experience navigating the existing corrupt system to fight for small, incremental victories that do not challenge the corporate takeover of American government and the economy.
Clinton claims that her experience will enable her to guide us gradually in the general direction of where we need to go. It would be very interesting to hear how she plans to do this in the face of a hostile Congress that is likely to continue to be dominated by Republicans who have a visceral hatred for her. Would Democratic chances be any worse with a “socialist” who has explained that all he means by the term is someone who will fight for all Americans, rather than compromise principle on the altar of expediency?
Sanders cannot pass single payer by himself, but neither can Clinton honestly promise to deliver any meaningful reforms of the Byzantine, unaffordable and woefully inadequate system of Obamacare. It will take a mass movement of Americans demanding their government put their interests over corporate profit to get real health care reform.