Gruber at Harvard Before Vermont's Fail: Single-Payer Won't Happen Unless It Succeeds in Some States

December 26th, 2014 10:28 AM

Earlier this morning, I posted on Vermont's abandonment of its attempt to impose and implement a "single-payer" (i.e., government-controlled) healthcare system, and on how muted the press coverage has been.

It's difficult to overstate how devastating the Green Mountain State's blowup is to the left's oft-stated long-term goal of imposing single-payer, occasionally referred to a "Medicare for all," on the entire nation. This goes a long way towards explaining the light press coverage. President Barack Obama, Harry Reid, Barney Frank and Nancy Pelosi are among those who are on record asserting that they want — and expect — that nationwide single-payer will happen. Another such person is the now familiar and infamous Jonathan Gruber, an admitted architect (when it was convenient) of the Affordable Care Act, aka Obamacare.

In the following video excerpt, taken from an "October 2, 2014 panel on "Taking Stock of Health Reform" held at Harvard's Radcliffe Institute for Advanced Study, Gruber told an audience why what Vermont was trying was so important (HT Rich Weinstein; yes that Rich Weinstein):

Transcript (beginning at 0:42):

Panel Member: So there's a group of states in the Northwest that have, I don't know how serious it is, talked about a regional public option idea. So when we come around to healthcare reform again, it's going to be a robust agenda. And there will be state you could point to and say, "Look, single-payer worked here. The costs are lower," the argument you just made, lower administrative costs, and there will be other options on the egalitarian side of the ledger.

Panel Moderator Theda Skocpol: Public option's your code.

Panel Member: Right, exactly.

Jonathan Gruber: So two points. Let me be stronger. There is simply no way we are going to get single-payer at the national level in the near future. Now, we have empirical proof of that because, uh, Jacob Hacker thought of a clever way to test this proposition, which was the public option, which is to say, "Let's put it on the table, we'll have private choice and public choice." If the Democrats are right and the public's better it will wipe out the private choices. If the Republicans are right, the government choice will wilt. And both sides were afraid that the other was right. So neither side wanted it.

And basically, the bottom line is, there simply isn't support there. That said, I think it's very important, this comes to what was just said, it's very important her recognize the fallacy of something which I frequently hear, which is, "Well, if Obamacare fails, next we'll go to single-payer."

That is absolutely backwards. Every single health reform effort moved to the right. Okay, and basically, the only - If you like single-payer, then Obamacare has to succeed. Because unless Obamacare succeeds, the less we get the state experiments like in Vermont and other states, single-payer is never happening.

So the notion that in some sense there are people who oppose Obamacare because they want single-payer. That is absolutely backwards. And I think that's very important to keep in mind.

Skocpol: Well, I want to say though, that "Obamacare succeeds" means partly that people push in states where the door is more open, either for a single-payer approach, or for co-ops or public options that can demonstrate that systems that are not based on private health insurance can reduce costs more effectively. And this law has a lot of room for such experimentation, and is soon going to have more. So it really offers the opportunity of creating what is the road by which single-payer came to Canada. First it happened in provinces, and then it was nationalized.

The fact is that only 13 states and DC even have their own exchanges now, which would seem to be a prerequisite for even thinking about imposing single-payer. Several states — at least Maryland, Massachusetts, Nevada and Oregon — have deemed it necessary to abandon their own failed exchanges after spending at least a half-billion dollars in failed efforts to even get them to function properly.

At the longer video of the entire event, the person who introduced Gruber called him a person who "has sometimes been called the father, or y'know maybe the grandfather of Obamacare." As just seen, he, with the help of the panel's moderator, predicted that single-payer will only come about if states can show that it works. Vermont was seen as the best chance for that, and it has imploded.

Despite what the panelist quoted early in the transcript said, no other state is seriously looking at a public option or single-payer, because no other state's exchange is even now functioning as well as envisioned. The prospects for a successful single-payer attempt in any of the remaining states with their own exchanges.

No wonder the left-dominated press is only giving cursory coverage to this story.

Cross-posted at