Indiana will hold its primary on May 6. The KPC Media Group, a collection of dailies and weeklies in NE Indiana, interviewed Obama. Here's their Q&A on healthcare:
KPC: Health care is an important issue for most voters. More and more physicians are turning to national health insurance as a solution to our health insurance coverage gaps. According to a survey reported last month by Indiana University, of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program such as “Medicare for all” to insure all Americans. Why do you think your plan which continues our current patchwork of both public and private insurance is better than expanding Medicare into a “Medicare for all” universal health insurance plan?
Obama: I have said in the past if I were designing a system from scratch I would probably prefer a single-payer system. I think the administrative advantages are significant and by having patients in a single system they are much more likely to benefit from preventive care because the person providing the care has an incentive (to keep people in the system well). There are significant advantages.
The problem is we are not starting from scratch. A sizable percentage of the population gets health insurance from their employers and I think we are going to have to see changed attitudes before we would see a single payer system. I also think there is some advantage to the marketplace being involved and increased competition. So I have said if you are in an employer based plan currently, then we will work with your employer to lower premiums. If you don’t have health insurance then you can buy into a plan that is similar to the plan I have as a member of Congress, and there won’t be exclusions for preexisting conditions. If you can’t afford the plan, then we will subsidize you.
There will be tight regulations on insurers to make sure that we are reimbursing for preventive services, that we are emphasizing the management of the care of the chronically ill more effectively and that we are investing in information technology to reduce bureaucracy, reduce error and improve quality. If we do all those things, we can save as much as $100 - $150 billion per year that we can then use to subsidize those currently without care. These principles have to be applied to Medicare and Medicaid, as well...
This is the most effective way to provide the help people need immediately, and I think this is something we can accomplish within my first term as president of the United States of America.
Interesting that KPC quotes the very significant recent poll showing a clear majority of doctors (at last!) favoring single payer. Too bad KPC does not also cite one of the polls showing that a clear majority of citizens (not just doctors) also favors single payer, and has for some time.
Barack responds with his standard answer: "if I were designing a system from scratch I would probably prefer a single-payer system." ["Probably?" He came out strongly for single payer in 2003. What's happened since?] He then as usual goes on to say in essence that the reason we can't have it is that we already have something else. The illogic of this is staggering. Can you imagine saying that about passing the Civil Rights Act in 1964, or granting suffrage to women before it was done?
Too bad KPC let him off the hook so easily, instead of boring in with followup questions. When he says "I think we are going to have to see changed attitudes before we would see a single payer system," he implies he is referring to the attitudes of citizens, but that can't be right: the polls show they want single payer. Can't be the doctors either, as the poll cited by KPC shows.
So exactly whose "attitudes" is he talking about? The insurance companies? Never. They will never favor letting go of their $950 billion per year revenue stream.
The only "attitudes" that need to change are those of politicians, like himself, who are either already bought by the insurance companies or who fear their wrath. Joe Biden was at least honest about this: he does not advocate single payer for fear of being "eaten alive by Harry and Louise."
KPC also lets him get away with the standard red herrings about "the marketplace" and "competition," and therefore, among other things, to gloss over the incredible inefficiency of the private insurance based system, which will be even worse when more heavily "regulated", as he proposes. But what's most wrong here is the very idea that healthcare is suitable for "the marketplace". If it were, it would not need the subsidies and mandates he proposes to add: additional patches to the present patchwork.
When even a free market champion like Friedrich Hayek accepted that collective action, not "the free market" is likely to be the best solution for healthcare, why does KPC let anyone advocate otherwise without at least questioning that advocacy?
Both sad and puzzling about the healthcare position taken by both Hillary and Barack is how damaging it is likely to be to their party's prospects in the general election. As fragile as a house of cards, it will be swiftly demolished by attacks from both left and right, and will serve only to distract from serious Republican vulnerabilities.