Barack Obama in Jacobin Magazine

On Health Care: 2009: preferred single-payer if were starting from scratch

In 2009, Obama said that if the US was starting its health care system over from scratch, he would prefer a "single-payer" system--what would later became known as Medicare for All. But because we weren't "starting from scratch," what Obama actually proposed was a market-based patchwork of regulations. He never actually explained why the fact that we weren't "starting from scratch" meant that we can't switch to single-payer health care now. And it says a lot about the dismal political landscape of 2009 that hardly anyone at the time challenged him on that point.

Obama's original proposal at least included a public option that would compete with private health insurance plans. This always would have been something much less than a half measure. Americans poor enough to qualify for Medicaid have long had a "public option"--and many doctors don't take it.

Even so, a public option would be better than nothing. But Obama abandoned the public option by the time the ACA's final form took shape.

Source: Jacobin e-zine, "Medicare for All" Jun 9, 2023

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