More Moulton: I'm on single-payer now ... and you shouldn't be

Maybe the 19th time is the charm? Jazz wrote earlier about Rep. Seth Moulton’s entry into the crowded Democratic presidential primary, but at least Moulton’s carving out a somewhat unique spot in the field. “I’m not a socialist,” the Massachusetts Democrat told George Stephanopoulos on Good Morning America, “I’m a Democrat.”

Count Moulton off the single-payer bandwagon, too:

On Monday, he sought to set himself apart from the ever-growing pack of Democratic candidates, many of whom have more Washington experience and star power, saying on “GMA,” “I’m not a socialist. I’m a Democrat. And I want to make that clear. Maybe that’s a differentiator in this race.”

He used health care as an example.

“I think I’m the only candidate who actually gets single payer health care,” he said, adding that he’s on a single payer plan himself through the Department of Veterans Affairs. “And I’ll tell you, it’s not perfect. So if I’m elected, I’m not going to force you off your private health care plan.”

While Moulton’s personal experience certainly speaks to the issue of single-payer health care, it’s hardly necessary. The VA has had decades of scandals in delivering care to veterans, and then in covering up those failures while its executives benefit from manipulated incentive metrics. Former VA Secretary Eric Shinseki got the boot in disgrace over the wait-time fraud several years ago, but Shinseki got the job in the first place in order to reform the VA from its previous record of failures. Despite the high degree of scrutiny those scandals received, there seems to be little progress on reforming the system.

But wait, Moulton’s progressive critics will claim, Medicare for All isn’t single payer! In the VA, providers are employed by the system; Medicare operates on a reimbursement basis to providers who willingly participate in the system. That’s true as it stands now, but that won’t remain true for long if Medicare for All passes. Under that system, most private health insurance will get crowded out of the market, and every provider will either have to operate within the system or on a cash-only basis. That will leave one system for the wealthy and single-payer for the rest of us, with the same kind of accountability found in the VA and the Indian Health Service — and little choice for anyone, patients or providers alike.

Besides, making that distinction would be disingenuous at best. Medicare for All advocates want a single-payer system and often use national-health service models from other countries that enforce single payer, such as the UK and Canada. (And Cuba in a few nutty instances.) Moulton knows this, and not just because he’s opted to stay in the VA system in order to keep an eye on its operations.

So yes, as Jazz wrote today, the Democratic primary looks like a clown car. At least this clown has a somewhat different act.