Indeed. That was always the secret hope of ObamaCare fans, although many of them made no bones about it. But I’m stoic about this after the last election. Before 2016, conservatives saw the battle over single-payer as Armageddon between the small-government and big-government visions for America. What we learned last year is that there really is no “small-government vision” anymore outside of a 25 percent “conservatarian” rump of the GOP. All the parties are arguing over at this point is how big government will get, and how soon.
But then, reactionaries will tell you that that’s what the parties have been doing at least since Bush 43, if not since Reagan. If conservatism doesn’t actually conserve, the fight should shift to what sort of big government you want your big government to be. It’s not a coincidence that the alt-right supports single-payer, you know.
And they’re not alone among Republican voters in doing so. Remember this from last month?
That’s the share of people who favor “expanding Medicare to provide health insurance to every American,” a.k.a. single-payer. Sixty percent at least somewhat support the idea. Among Republicans, it’s 46/38. We’re only a few moves away from checkmate.
Which moves, though? Chris Wallace presses Krauthammer to describe how he thinks we’ll get to single-payer so soon. I think he’s right in broad terms: With ObamaCare having dissatisfied so many and whatever the hell Republicans end up passing destined to dissatisfy many others, the Overton window will move towards more radical reforms to health care. Either we’ll go radically individualistic or radically collectivist, and it’s not hard to predict which way that wind is likely to blow. The trojan horse is the public option: If the left can force private insurers to compete with an entity which, unlike them, can afford to lose money in providing health insurance (at least in the short term), the competition won’t last long. Clear out the private insurers one by one and eventually the feds are the only game in town.
Krauthammer might be a little pessimistic in his timeline, especially if Trump wins reelection, but I don’t know. Trump’s own fondness for single-payer systems is no secret. Right now he’s constrained by the prospect of a reelection campaign and the need to present himself to the right as more or less conservative (although why he feels that compulsion, I don’t know), but he won’t be come 2021. If he wins a second term, ends up stuck with a Democratic Congress, and the GOP’s replacement for ObamaCare is performing badly, would he make a deal with Pelosi and Schumer to build a public option — especially if it polled well? Sure, why not? We may not see full single-payer in seven years but the momentum should be even less reversible then than it is now. It’s mainly a question of whether a new Democratic president will provide the next push or whether Trump himself will.