Now It Can Be Told: Ezra Klein Admits Public Option was 'Bridge to Single-Payer'


Thursday, Vox’s Ezra Klein admitted Democrats saw the public option as a “bridge to single-payer.” While this is now common knowledge on the right, it was dismissed and treated as an “illegitimate” argument by everyone from President Obama down before the bill passed. Here’s Klein’s take today [emphasis added]:

The argument over the public option was slippery and frustrating because there were really two different public options — a strong and a weak one — and both supporters and detractors switched which one they were talking about constantly.

The strong public option would have paid Medicare rates for services and, in doing, save more than $100 billion over 10 years.
This is the public option that supporters were talking about when they
said the public option would save huge amounts of money and possibly
provide a bridge to single payer
. It was also the public option that
detractors were talking about when they said the public option was a
backdoor plan to implement single payer
and it would put many private
insurers out of businesses. This public option never came anywhere close
to becoming law.

The other public option was just a normal insurer that was run by the
government. It would pay prices similar to what the other insurers
paid, and it wasn’t projected to save much money, sign up many people,
or pose much of a threat to traditional insurers. This public option
almost did become law.

Back in 2009 when reform was still being debated this admission would have constituted a very significant story. Recall that the President was barnstorming the U.S. presenting his plan as an attempt to foster “choice and competition.” He explicitly denied that there was any plan for a government takeover. He called such claims “illegitimate” and said opposition to the public option wasn’t “based on any evidence.” The President thought it ridiculous that anyone would insinuate the public option was “somehow a Trojan horse for a single-payer system.” Ezra Klein knew the President was being utterly disingenuous and said nothing (more on that in a moment).

For the record, Klein’s explanation about the two versions of the public option is a distraction for at least two reasons. First, the core of the public option was establishing a public entity to compete with private plans on the new health exchanges. Rates could be adjusted over time. Jacob Hacker, the father of the public option, said Medicare payment rates (the strong version) were not a necessary part of his plan:

I’ve never argued that the public plan should necessarily pay Medicare
rates. I’ve said that it should be paying rates that elicit voluntary
participation on the part of providers, but I do think that we should be
building off of the basic structure of payments that Medicare already
has, especially on the hospital side, and I think that it’s really up
for debate and compromise about how close to private rates those
payments would be.

But second and more importantly, even if the “weak” public option couldn’t give Democrats what they wanted (at least not as quickly) that’s no excuse for Klein et al to never mention what Democrats were trying to achieve. The goal was the story. In fact it was the biggest untold story of the year. And yet years later Klein wants to write a “Democrats failed to get bridge to
single-payer” story without having ever written a “Democrats seek public
option bridge to single-payer” story. That takes some real audacity.

Even after my friend and co-blogger Morgen Richmond found video (see
below) of Klein calling the public option a “sneaky strategy” to get
to single-payer, Klein continued to deny it was true. Not only deny it, Klein mocked the idea, calling it the “underpants gnomes theory of single-payer.” It was through this kind of disregard for the truth that “government takeover” became the Lie of the Year instead of the openly acknowledged fact it is now.

How significant might the truth have been five years ago? It’s impossible to know but there’s no doubt it would have undercut the President’s claims and therefore his perceived truthfulness. That’s something which should have happened long before it finally did in 2013 over another big lie, i.e. “if you like your plan, you can keep it.” It also would have been hard for Democrats to frame those opposing the bill as “extremists” once it became known their goal was transforming the U.S. health care system into Canada’s system without telling the voters.

The passage of the bill was such a close thing. It wouldn’t have taken much more to stop it completely. And that’s probably why no one on the left talked about it openly. Ezra Klein understood exactly what was at stake (again, watch the clip). At some point he just decided to put winning first.


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