Here are some facts:
- I am an advocate of single payer health care. In fact, much of my chapter on health care in my first book, Hostile Takeover, advocated for single-payer health care.
- Most progressives, and many millions of Americans, support the concept of a single-payer health care system.
- Those in Congress, like Sen. Max Baucus (D-MT), who refuse to consider single payer in the debate over health care are the enemies of single payer.
- Those in the United States, like me, who support single payer, but also would support a robust public option in a non-single payer universal health care system, are not the enemies of single payer.
- Just because public option plans haven't been structured or implemented well in the past, doesn't mean they can't be structured or implemented well in the future.
- There is dual value in pushing hard for single-payer: It can get us close to (or perhaps even immediately achieve) a single-payer system. It can also make sure that if we don't get single-payer, we get something that's still very good like a robust public option that will ultimately lead to single payer.
The second-to-last point is particularly important: I've found in my work on health care that professional advocates of single payer seem to believe their biggest enemies are those who support single payer, but short of that, would also support a robust public option in a non-single payer universal system. These advocates seem like they actually want enemies, rather than wanting to build as broad a coalition as possible.
I'm not really sure why this is, other than the fact that some people just need to feel like they are in a fox hole with the entire world against them. While I agree that much of the political Establishment is against single payer, I don't believe that there has to be some sort of mutually exclusive situation whereby you are either "for it or against it." You can be for single-payer, but also, short of single-payer, also for a public option - and you can simultaneously support the vigorous, uncompromising push from single payer advocates as helpful to moving the country in the right direction on health care.
In sum, those who are working their asses off to create real, meaningful and progressive health care reform - whether single payer, or a robust public option - have enough enemies as it is, without having to create more enemies amongst themselves unnecessarily.