# Are there any good reasons why Democrats should not support single-payer universal healthcare?

**URL:** <https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638>\
**Category:** Politics & Elections\
**Created:** [December 14, 2024, 9:21pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638 "2024-12-14T21:21:41Z")\
**Posts on this page:** 20\
**Page:** 4

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**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [December 21, 2024, 3:34pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/61 "2024-12-21T15:34:30Z")

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> [@kenobi\_65](#):
>
> I strongly suspect that most people who are happy with their private insurance have never really had to “pressure test” it (e.g., a high-risk pregnancy, a complex disease, etc.)

We’ve pressure-tested our private insurance (through my employer via anthem blue cross). It’s done well for us for the most part, with very little friction. One source of irritation has been a few times where they forced my wife to get generic prescriptions, because of reasons…and then they’d change their view later, and let her have what she needed. We’ve had a clinic provider get their wires crossed in billing us once, and tried to extract and extra $3000 from us for a surgery where we’d already paid our deductible. We had already paid the $3000, which we can easily afford, but many can not. Anthem helped us set the errant provider straight. But it’s just an example of how crazy everything in the system is. It’s an insane health insurance system.

I have good private insurance, IMO. But there’s enough hassle in it for me to understand the problems that some others might have. And we have plenty of deductibles & co-pays, such that I’d some others might have affordability problems. In a typical year, we probably pay out about $3000 in co-pays/deductibles. Last year was probably $6000 due to the surgery I mentioned above. This is on top of the cost of the premiums, where our employer pays about 75% of that cost.

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**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\
**Post date:** [December 21, 2024, 6:22pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/62 "2024-12-21T18:22:36Z")

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> [@Thudlow\_Boink](#):
>
> The way this is worded, it makes it sound like you think Democrats _could_ pass UHC if they **wanted to** (emphasis mine) —they’d just pay a “price” for doing so.

Late reply, but yes, there were recent times when they could. Democrats had the presidency and control of both houses of Congress in 2009-2010, and also in 2021.

The 2009 Senate majority, in particular, was especially large. But Democrats weren’t even willing to pass a public health-insurance option, let alone single-payer.

The key obstacle was that they didn’t **want** to do single-payer.

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**Author:** ![Zoobi](https://avatars.discourse-cdn.com/v4/letter/z/13edae/32.png) [@Zoobi](https://boards.straightdope.com/u/Zoobi)\
**Post date:** [December 21, 2024, 6:26pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/63 "2024-12-21T18:26:12Z")

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This does not reflect reality. I’m sorry, but it’s simply untrue that it was possible to push it through Republican resistance.

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**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\
**Post date:** [December 21, 2024, 6:30pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/64 "2024-12-21T18:30:24Z")

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We’re just going to have to disagree. With a 60-seat Senate majority in 2009, the Ds could have nuclear-optioned away the filibuster. The key thing is that they didn’t **want** to. Nobody was even pushing for single-payer UHC. The most the Ds were even willing to do was just ACA, which was only a relatively minor modification to the existing system.

I don’t want to turn this into a hundredth Obamacare thread. But the Ds most certainly had the majority to run roughshod **if they wanted to.**

Let me put it another way: If Republicans held a 60-seat Senate majority, does anyone imagine that they wouldn’t or couldn’t get things done, as opposed to saying, “Well, that minority Democratic resistance is just too strong despite them having 20 fewer senators than us?”

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**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\
**Post date:** [December 21, 2024, 6:54pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/65 "2024-12-21T18:54:56Z")

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Except on this issue, the Dems did not have a 60 seat majority, because Joe Lieberman opposed the public option and would not vote for it:

> During debate on the [Patient Protection and Affordable Care Act](https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act), Lieberman opposed the public option. As the crucial 60th vote needed to pass the legislation, his opposition to the public option was critical for its removal from the resulting bill.[[7]](https://en.wikipedia.org/wiki/Joe_Lieberman#cite_note-auto-7)

> [@Velocity](#):
>
> Nobody was even pushing for single-payer UHC.

It was being considered, but was taken out because of Lieberman.

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**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\
**Post date:** [December 21, 2024, 9:21pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/66 "2024-12-21T21:21:46Z")

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> [@Velocity](#):
>
> The 2009 Senate majority, in particular, was especially large.

> [@Zoobi](#):
>
> This does not reflect reality. I’m sorry, but it’s simply untrue that it was possible to push it through Republican resistance.

Right.

> [@Velocity](#):
>
> We’re just going to have to disagree. With a 60-seat Senate majority in 2009,

They didnt have 60 votes, They had 55 most of the time. Thus, any such bill would be Filibustered. For a couple months they had 58+2, which should have been good enough but there’s always a Manchin or two. In this case, Lieberman, but likely someone else would have joined him.

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**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [December 22, 2024, 3:55am UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/67 "2024-12-22T03:55:34Z")

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> [@DrDeth](#):
>
> They didnt have 60 votes, They had 55 most of the time. Thus, any such bill would be Filibustered. For a couple months they had 58+2, which should have been good enough but there’s always a Manchin or two. In this case, Lieberman, but likely someone else would have joined him.

This just goes to show how difficult healthcare reform is. Think about it in these terms:

1. Republicans want no healthcare reform other than to destroy anything they think that the Dems like or want. It’s part of their “own the libs” strategy.

2. So, Dems are the only party that will lift a finger to help average people with healthcare.

3. But we can only make it happen when we have control of the White House and both houses of Congress.

4. Except, in the Senate, we have to overcome a filibuster, or we’re forced to pass legislation using only reconciliation rules, which put limits on what we can do.

5. The chance of #3 happening comes along only occasionally. We had it in 2009-2011, and again in 2021-2023.

6. We could nuke the filibuster. But we don’t have enough Dems who want to do that.

7. Even an incremental reform built on a Republican idea (Romney-care & Heritage) is hard to do because of all the above.

So, it just goes to prove how hard politically healthcare reform is in general, and it will make single-payer even harder. Note that I haven’t even mentioned above all the lobbyist pressure we’d get if we tried to do single-payer.

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**Author:** ![DeadTreasSecretaries](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/deadtreassecretaries/32/4817_2.png) [@DeadTreasSecretaries](https://boards.straightdope.com/u/DeadTreasSecretaries)\
**Post date:** [December 22, 2024, 6:14am UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/68 "2024-12-22T06:14:16Z")

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I mean there were 60 senators in the democratic caucus in 2009. This seems like vehement agreeing about the democrats not passing a public option because democrats didn’t want to pass a public option.

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**Author:** ![survinga](https://avatars.discourse-cdn.com/v4/letter/s/cab0a1/32.png) [@survinga](https://boards.straightdope.com/u/survinga)\
**Post date:** [December 22, 2024, 11:50am UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/69 "2024-12-22T11:50:45Z")

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There was vehement agreement that they had to pass something. But that “something” would not be acceptable to Joe Lieberman unless the public option was not included. He would have filibustered the ACA otherwise. In order to stop that, and keep the 60, they stripped it out. This wasn’t a “hey, we all don’t want a public option”. This was a “hey, Joe doesn’t want the public option and we can’t pass the bill without his vote.”

[https://www.commonwealthfund.org/publications/newsletter-article/senate-democrats-drop-public-option-woo-lieberman-and-liberals-howl](https://www.commonwealthfund.org/publications/newsletter-article/senate-democrats-drop-public-option-woo-lieberman-and-liberals-howl)

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**Author:** ![DeadTreasSecretaries](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/deadtreassecretaries/32/4817_2.png) [@DeadTreasSecretaries](https://boards.straightdope.com/u/DeadTreasSecretaries)\
**Post date:** [December 22, 2024, 3:00pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/70 "2024-12-22T15:00:56Z")

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I mean people in this thread are vehemently agreeing about how democrats in 2009 didn’t pass a public option because of their own caucus opposing it.

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**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\
**Post date:** [December 22, 2024, 3:50pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/71 "2024-12-22T15:50:39Z")

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> [@DeadTreasSecretaries](#):
>
> I mean there were 60 senators in the democratic caucus in 2009. This seems like vehement agreeing about the democrats not passing a public option because democrats didn’t want to pass a public option.

There’s not true party discipline in the US system. If 55 Democrats want to pass the public option, and 5 didn’t, there was nothing that the 55 could do.

But then to expand that and say the “Democrats” didn’t want to pass it is unfair to the 55 and inaccurate.

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**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\
**Post date:** [December 22, 2024, 3:53pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/72 "2024-12-22T15:53:58Z")

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> [@DeadTreasSecretaries](#):
>
> I mean there were 60 senators in the democratic caucus in 2009. This seems like vehement agreeing about the democrats not passing a public option because democrats didn’t want to pass a public option.

As has been already noted – no, the issue was that it was not true that they would have been able to get all 60 to vote for it, and at least one (Joe Lieberman) had specifically said he would not vote in favor of it.

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**Author:** ![DeadTreasSecretaries](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/deadtreassecretaries/32/4817_2.png) [@DeadTreasSecretaries](https://boards.straightdope.com/u/DeadTreasSecretaries)\
**Post date:** [December 22, 2024, 3:55pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/73 "2024-12-22T15:55:02Z")

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Yes I agree that democrats didn’t pass a public option because people in the democratic caucus opposed it.

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**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\
**Post date:** [December 22, 2024, 3:56pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/74 "2024-12-22T15:56:51Z")

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> [@DeadTreasSecretaries](#):
>
> because people in the democratic caucus opposed it

To be clear: because a small subset (apparently as few as only one senator) opposed it.

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**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\
**Post date:** [December 22, 2024, 3:57pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/75 "2024-12-22T15:57:02Z")

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What Kenobi said

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**Author:** ![DeadTreasSecretaries](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/deadtreassecretaries/32/4817_2.png) [@DeadTreasSecretaries](https://boards.straightdope.com/u/DeadTreasSecretaries)\
**Post date:** [December 22, 2024, 3:57pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/76 "2024-12-22T15:57:56Z")

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Right, as opposed to this claim:

> [@Zoobi](#):
>
> This does not reflect reality. I’m sorry, but it’s simply untrue that it was possible to push it through Republican resistance.

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**Author:** ![Zoobi](https://avatars.discourse-cdn.com/v4/letter/z/13edae/32.png) [@Zoobi](https://boards.straightdope.com/u/Zoobi)\
**Post date:** [December 22, 2024, 4:02pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/77 "2024-12-22T16:02:25Z")

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I’m not sure what gotcha you think you scored, just if it made you happy go for it.

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**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\
**Post date:** [December 22, 2024, 9:07pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/78 "2024-12-22T21:07:13Z")

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> [@survinga](#):
>
> The chance of #3 happening comes along only occasionally. We had it in 2009-2011, and again in 2021-2023.

But only for a month or so, not long enough to pass such a complicated bill.

> [@survinga](#):
>
> So, it just goes to prove how hard politically healthcare reform is in general, and it will make single-payer even harder

Right.

> [@DeadTreasSecretaries](#):
>
> I mean there were 60 senators in the democratic caucus in 2009.

For a couple of months.

> [@Northern\_Piper](#):
>
> But then to expand that and say the “Democrats” didn’t want to pass it is unfair to the 55 and inaccurate.

Right.

> [@DeadTreasSecretaries](#):
>
> Yes I agree that democrats didn’t pass a public option because people in the democratic caucus opposed it.

It wasnt even necessary for Lieberman to oppose it, the 60 majority was very short lived. So first the bill has to pass the House, then Senate, then reconciliation. This isnt something that takes a month.

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**Author:** ![Mr.Duality](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mr.duality/32/4098_2.png) [@Mr.Duality](https://boards.straightdope.com/u/Mr.Duality)\
**Post date:** [December 22, 2024, 9:32pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/79 "2024-12-22T21:32:04Z")

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I’d like to know how influential money from lobbyists was in that situation. Particularly, lobbyists for health insurance and pharmaceutical companies.

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**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\
**Post date:** [December 22, 2024, 9:34pm UTC](https://boards.straightdope.com/t/are-there-any-good-reasons-why-democrats-should-not-support-single-payer-universal-healthcare/1011638/80 "2024-12-22T21:34:25Z")

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Not much. They knew they didnt have the votes to start with.

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