# Court puts U.S. on path to single payer

**URL:** <https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632>\
**Category:** Politics & Elections\
**Created:** [June 28, 2012, 10:04pm UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632 "2012-06-28T22:04:41Z")\
**Posts on this page:** 7\
**Page:** 1

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**Author:** ![bahia\_hombre](https://avatars.discourse-cdn.com/v4/letter/b/87869e/32.png) [@bahia\_hombre](https://boards.straightdope.com/u/bahia_hombre)\
**Post date:** [June 28, 2012, 10:04pm UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632/1 "2012-06-28T22:04:41Z")

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[http://www.baltimoresun.com/news/opinion/oped/bs-ed-health-care-morici-20120628,0,49509.story](http://www.baltimoresun.com/news/opinion/oped/bs-ed-health-care-morici-20120628,0,49509.story)

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**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\
**Post date:** [June 28, 2012, 10:06pm UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632/2 "2012-06-28T22:06:03Z")

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Care to post a little more, **bahia hombre**? Do you agree or disagree with the editorial? Would single-payer be a good thing or a bad thing?

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**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\
**Post date:** [June 28, 2012, 10:56pm UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632/3 "2012-06-28T22:56:47Z")

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I don’t get that article.

> [@](#):
>
> Although many people believe the legislation provides for no “public option,” the ACA requires the Office of Personnel Management to sponsor, through private firms, two health plans, and those plans are indeed public options that will be advantaged by larger taxpayer contributions and exemptions from critical regulations imposed on private insurers.

That is an oxymoron. Health plans done through the private sector are not public options. The public option was a public plan tied to medicare. A big reason it was taken out is medicare reimburses at lower rates than private insurance, so the storyline described in the OP was likely to happen. I saw studies showing close to 50% of people would be on the public option plan by the 2020s since it was 20-30% cheaper than private insurance (I think the quotes were $5000 a year for a private insurance plan, $3900 for a public option tied to medicare for coverage for a single adult).

I think the article in question is describing Co-ops, which are not the same as a public option tied to medicare.

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**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\
**Post date:** [June 29, 2012, 12:18am UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632/4 "2012-06-29T00:18:10Z")

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It may happen eventually, but because of public impatience with being forced to subsidize the grossly-inefficient and under-regulated insurance companies, in comparison with the highly-effective and easily-expanded Medicare. Blocking that will be the massive contributions (of those same taxpayer dollars) to the campaign chests of the key legislators, of course.

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**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\
**Post date:** [July 11, 2012, 4:25am UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632/5 "2012-07-11T04:25:39Z")

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For what it’s worth, there’s a grain of truth in the article. My wife (who is an employee benefits outsourcing analyst) notes that the general feeling in the industry is that small-to-medium employers will end up dumping all of their employees on the state exchanges with a check for whatever amount they used to pay to underwrite their health insurance directly.

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**Author:** ![MilTan](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@MilTan](https://boards.straightdope.com/u/MilTan)\
**Post date:** [July 11, 2012, 5:01am UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632/6 "2012-07-11T05:01:47Z")

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> [@Really\_Not\_All\_That\_Bright](#):
>
> For what it’s worth, there’s a grain of truth in the article. My wife (who is an employee benefits outsourcing analyst) notes that the general feeling in the industry is that small-to-medium employers will end up dumping all of their employees on the state exchanges with a check for whatever amount they used to pay to underwrite their health insurance directly.

Which, oddly enough, is what Republicans _want to do anyway_. The centerpiece of John McCain’s health care plan was to eliminate the tax break for employer-provided health insurance in an attempt to decouple health insurance from employment. That would result in almost exactly the same situation as this, except worse (since there wouldn’t be the highly regulated exchanges that let individuals purchase insurance as though they belonged to larger groups).

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**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\
**Post date:** [July 14, 2012, 12:12pm UTC](https://boards.straightdope.com/t/court-puts-u-s-on-path-to-single-payer/626632/7 "2012-07-14T12:12:47Z")

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It won’t lead to single payer. Unless the ACA is repealed, that’s our health care system for the next 100 years. Inertia is powerful when it comes to entitlements. No country with a national health care system has ever gone from multi payer to single payer. And only one, the Netherlands, has ever gone from single payer to multi payer. Once a nation creates a universal system, they tend to stick with it for the most part.
