“The time has come”: ObamaCare architect Max Baucus endorses single-payer

It was just last month that Reason’s Peter Suderman sent the tweet below. Thirty-nine days later, Bernie Sanders is set to introduce a “Medicare for all” bill backed by big-name Dems like Kamala Harris and Elizabeth Warren while Republicans Lindsey Graham and Bill Cassidy are pushing a bill that would let individual states keep ObamaCare in place.

My friends, “the future” is now.

The future of health policy politics is Republicans defending something like Obamacare and Democrats pushing for something like single-payer

— Peter Suderman (@petersuderman) August 2, 2017

Why is it a big deal that Max Baucus has now come around as well? Well, it’s not just that he was one of the architects of O-Care in 2009 as head of the Senate Finance Committee, making his “evolution” towards socialized medicine particularly noteworthy. It’s that Baucus was one of the bulwarks *against* single-payer in the Senate at the time. Leftists begged him to seize the moment eight years ago, when Democrats enjoyed a filibuster-proof majority, and push Medicare for all. No dice, he said. The country’s not ready for it. It won’t pass and Democrats might get wiped out in the midterms for even trying. In the end they got wiped out in the midterms anyway and large chunks of the country do now appear to be ready for it — including Republicans, so long as the small matter of cost isn’t emphasized.

“I just think the time has come,” Baucus told NBC News Friday, after stunning healthcare observers earlier in the day by seemingly coming around on single-payer at a public forum. “Back in ’09, we were not ready to address it. It would never have passed. Here we are nine years later, I think it’s time to hopefully have a very serious good faith look at it.”…

“I started out by saying everything is on the table,” Baucus recalled. “But I did make an exception and that was single-payer. I said, nope, we’re not going to put single-payer on the table. Why? In my judgement, America was just not there … It’s branded as socialistic by too many people.”…

Baucus compared the issue’s evolution to that of gay rights. “It’s anathema for a long time, and then suddenly — acceptance,” he said.

Yeah, although the issues are far afield from each other, I think there’s something to what he says about single-payer and gay marriage. The same goes for marijuana legalization. Subjects that for many years seemed like political third-rails are now suddenly safe to touch as public opinion rapidly “evolves.” The fact that young left-leaning adults are replacing older more conservative ones in the population helps explain why; look at any poll on gay marriage and legalizing weed and you’ll see how much movement there’s been over just the past 10 years. Wider cultural exposure for gays and marijuana use has made people more comfortable with both as well. In the case of single-payer, though, I wonder if attitudes have changed dramatically or if it’s more a matter of post-Reagan Washington having mistakenly assumed for years that the country is more conservative than it really is and wouldn’t consider it. Remember this poll?

Wanting the feds to guarantee universal coverage isn’t the same as wanting the feds to be America’s only insurer but they’re related insofar as both show enthusiasm for a bigger role for Uncle Sam in the industry insurance. And there’s nothing new about that enthusiasm, as you can see: Americans were actually more likely to support a federal responsibility to guarantee coverage at the end of the Clinton era than they are now. The numbers shrank during the Obama era as Republicans revolted against O and left-wing designs on the insurance industry, but now that our guy is in charge instead of their guy and the country has seen firsthand that ObamaCare isn’t a panacea for problems with health insurance, the public’s ready for a second look at the feds wading in. With Sanders, Warren, and Harris all now publicly in favor of single-payer and centrist Dems like Baucus under pressure from the base to follow along, it’s a cinch that the 2020 Democratic nominee will back Medicare for all, whoever he or she might be.

Which raises two questions. One: When will Barack Obama formally endorse single-payer? Right, right, I know — he already did years ago. But he didn’t as president. Despite his rhetoric about the “fierce urgency of now,” he was in the Baucus camp. What I’m asking is, when will he endorse replacing his own signature program with Medicare for all? That’s a knotty legacy problem for O insofar as he stands to lose no matter what he does. If he stands stubbornly with ObamaCare, he risks seeming out of touch on a core part of the left’s agenda and wedded to a subpar program for no better reason than that it bears his name. If he abandons ObamaCare, he all but admits that his own efforts as president to remake health insurance were subpar and too timid, eventually erased by loud-and-proud socialists like Sanders.

He’s going to need to abandon it sooner rather than later, though, as it’s unthinkable that Obama would allow himself to end up as a thorn in the left’s side as it gears up for a serious legislative push on this. (That’s another echo of gay marriage. O will “evolve” by publicly embracing an opinion he’s long held privately whether he’s ready to or not.) Presumably he’ll end up trying to square the circle by saying that ObamaCare was a necessary step towards the ultimate goal of single-payer. Which, ironically, would put him right in line with a criticism made repeatedly by conservatives when O-Care passed in 2010. We screamed endlessly that ObamaCare was ultimately just a trojan horse for Medicare for all, that it would encourage the public to view insurance as an entitlement and prepare the political ground for fully socialized medicine when O-Care itself inevitably ran into problems. And here we are. How’s that prediction looking in 2017?

The other question: When do Schumer and Pelosi start leaning on Trump about single-payer? They can’t do it now, as Trump is still too wedded to the GOP and conservative support to make it feasible. But they also can’t wait too long, as their window for making deals with POTUS will close if and when Mueller produces something incriminating on Russiagate and the left begins to howl about impeachment. What they need is some confidence-building measures, as quickly as possible: If Schumer thinks there’s a chance of bringing Trump on board with single-payer, that would be worth funding the wall for him in exchange for a DREAM amnesty. It’d also be worth handing Trump some sort of win on tax reform. Show the president that working with Democrats not only will let him accomplish Big Things but will please the media to no end and you’ll have him set up for compromise on the biggest, most media-pleasing legislative initiative of ’em all. If Schumer hasn’t sounded out Trump on single-payer yet, he will soon.

Here’s red-state centrist Democrat Jon Tester sounding pretty sanguine about a government takeover of health care, which seems superficially surprising but really isn’t. It was never any secret what Dems really wanted out of insurance reform, and it sure as sh*t wasn’t subsidies for insurance companies.