Senator Harkin Was Wrong

Sarah Kliff is right. Just as Obamacare is showing itself to be a great success, it is coming under fire from some unlikely quarters...often Democrats. A lot of people have spoken out against Sen. Schumer's criticism - including Paul Krugman. But not as many have challenged what Sen. Tom Harkin said.

“We had the power to do it in a way that would have simplified health care, made it more efficient and made it less costly, and we didn’t do it,” Harkin reportedly told The Hill in a piece published Wednesday. “So I look back and say we should have either done it the correct way or not done anything at all.”

He added: “What we did is we muddle[d] through and we got a system that is complex, convoluted, needs probably some corrections and still rewards the insurance companies extensively."...

But looking back at the early years of the Obama administration, Harkin said Democrats should have pursued “single-payer right from the get-go or at least put a public option. … We had the votes to do that and we blew it."

When he says "we had the votes," one can only assume that he is referring to the seven months between the swearing in of Sen. Al Franken and Sen. Scott Brown when the Democrats had 60 votes to bypass a Republican filibuster. But there were never 60 votes for single payer. Back in March 2010, the Senate's biggest single payer supporter - Bernie Sanders - said it had 8-10 votes.

I remember very well the moment I realized that the public option wasn't going to pass. It was the day Sen. Blanche Lincoln went on the Senate floor and said she would vote against the ACA if it contained a public option. There were other Senate Democrats who opposed it (i.e., Sen. Lieberman), but once that kind of commitment is made on the Senate floor, there's no going back. So even the public option didn't have the votes.

Just as Romneycare in Massachusetts was the model for Obamacare, the state of Vermont will provide a testing ground for single payer. The question its advocates rarely discuss is "how will it be paid for." In the next couple of weeks we'll find out how Vermont's Gov. Shumlin will answer that question. He needs to come up with $2 billion. Rumors are that he will include an employer payroll tax (probably around 8%) combined with with a progressive tax for residents.

While its likely true that those funds will "replace roughly the same amount in premiums and out-of-pocket costs currently paid by Vermonters toward health care," that kind of re-shuffling of who pays what will produce winners and losers. Vermont legislators will probably be hearing a lot from the losers.

So on both political and policy grounds, Sen. Harkin was wrong. There might come a time when single payer is possible in this country. But 2009/2010 was not the time. To suggest that is should have been single payer or nothing at all would have ensured the latter...and 10 million people without health insurance today.