Krugman does a good job reminding progressives that politically viable solutions are better than idealogically perfect ones, especially when it comes to large, polarizing issues like healthcare:
... some progressives — by and large people who supported Bernie Sanders in the primaries — are already trying to revive one of his signature proposals: expanding Medicare to cover everyone. Some even want to make support for single-payer a litmus test for Democratic candidates.
So it’s time for a little pushback. A commitment to universal health coverage — bringing in the people currently falling through Obamacare’s cracks — should definitely be a litmus test. But single-payer, while it has many virtues, isn’t the only way to get there; it would be much harder politically than its advocates acknowledge; and there are more important priorities.
The key point to understand about universal coverage is that we know a lot about what it takes, because every other wealthy country has it. How do they do it? Actually, lots of different ways.
Look at the latest report by the nonpartisan Commonwealth Fund, comparing health care performance among advanced nations. America is at the bottom; the top three performers are Britain, Australia, and the Netherlands. And the thing is, these three leaders have very different systems.
Krugman then goes on to point out that the Dutch system works quite well, and is quite similar to the Affordable Care Act, suggesting that improving the A.C.A. is the best path forward. I tend to agree, and hope that my Bernie-supporting friends won't be lured by the temptation of idealogical purity, and will instead embrace the rational, steady progress that comes with compromise and pragmatism. After all, its what made the Obama administration work!
I have nothing against single-payer; it’s what I’d support if we were starting fresh. But we aren’t: Getting there from here would be very hard, and might not accomplish much more than a more modest, incremental approach. Even idealists need to set priorities....
Well said. Well said, indeed.