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Commentary By Avik Roy

Sen. Reid: Obamacare 'Absolutely' A Step Toward A Single-Payer System

When I speak to conservatives about health care policy, I’m often asked the question: “Do you think that Obamacare is secretly a step toward single-payer health care?” I always explain that, while progressives may want single-payer, I don’t think that Obamacare is deliberately designed to bring about that outcome. Well, yesterday on PBS’ Nevada Week In Review, Senate Majority Leader Harry Reid (D., Nev.) was asked whether his goal was to move Obamacare to a single-payer system. His answer? “Yes, yes. Absolutely, yes.”

In one sense, this isn’t shocking. Reid and many other Democrats, including President Obama, have often stated that their ideal health-care system is one in which the government abolishes the private insurance market. Video of the PBS discussion isn’t yet online, but here’s how Karoun Demirjian of the Las Vegas Sun described it:

“Reid said he thinks the country has to “work our way past” insurance-based health care during a Friday night appearance on Vegas PBS’ program “Nevada Week in Review.”

“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said.

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.””

Reid noted that he and other progressives fought hard for a “public option” in the exchanges as a Trojan horse for single-payer, but Democrats didn’t have 60 votes in the Senate to achieve it:

“The idea of introducing a single-payer national health care system to the United States, or even just a public option, sent lawmakers into a tizzy back in 2009, when Reid was negotiating the health care bill.

“We had a real good run at the public option … don’t think we didn’t have a tremendous number of people who wanted a single-payer system,” Reid said on the PBS program, recalling how then-Sen. Joe Lieberman’s opposition to the idea of a public option made them abandon the notion and start from scratch.

Eventually, Reid decided the public option was unworkable.

“We had to get a majority of votes,” Reid said. “In fact, we had to get a little extra in the Senate, we have to get 60.””

Reid sees the tax exclusion for employer-sponsored health insurance as the primary obstacle to single-payer health care:

“Reid cited the post-WWII auto industry labor negotiations that made employer-backed health insurance the norm, remarking that “we’ve never been able to work our way out of that” before predicting that Congress would someday end the insurance-based health care system.”

It’s one of the key things to remember when you look at polls saying that Obamacare is unpopular. A small percentage of the people who oppose Obamacare—around 7-10 percent—oppose it because it doesn’t go far enough.

This piece originally appeared in Forbes

This piece originally appeared in Forbes