No, the Fall of ObamaCare Won’t Lead to Single Payer Health Care

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So the Supreme Court arguments over the 2010 health law didn’t go quite the way that liberals expected. In response, a number of them seem to be attempting to console themselves with the notion that in the long run, a loss would actually be a win: If the Court overturns all or part of ObamaCare now, the argument goes, it will build support for true single-payer health care. Here’s UCLA law professor Adam Winkler making a strong version of the case in article by TPM’s Sahil Kapur:

“Conservatives may find that they weren’t careful about what they wished for in opposing ‘Obamacare,’” Adam Winkler, a constitutional law professor at UCLA School of Law, told TPM. “The economic, social and political pressure for health care reform aren’t going to just disappear. There’s a reason every major industrialized country has national health care. If the Supreme Court invalidates the Affordable Care Act, we are likely to see a government takeover of health care in the next decade.”

…“The defenders of federalism will be rewarded with an even bigger federal government,” Winkler said. “Wouldn’t that be ironic?”

If it’s really the case that liberals stand to win if the law goes down, then shouldn’t ObamaCare’s backers be hoping that the Supreme Court rules against the law? I suspect I don’t see them rooting for the law to be overturned for a reason.

Still, Winkler isn’t the only one making some version of this case. The Nation’s George Zornickdeclared last week that “if the mandate falls, single payer awaits.” Columnist Eugene Robinson similarlypredicted that if the mandate falls, “a much more far-reaching overhaul of the health care system will be inevitable.” The “only alternative” Robinson sees to ObamaCare? A single-payer system.

If only there were alternatives to columnists (and presidents) who can’t believe that there are health policy alternatives to increasing the government’s control over the system. The United States has been steadily ratcheting up regulation of the health sector for nearly 50 years. At this point, the government is responsible for almost half of all health spending. Isn’t it at least possible that the problems with the health system are not caused by too little government interference but by too much? Liberal health wonks frequently insist that they mostly want to make the system smarter and more effective, but they and their predecessors have been saying the same thing about every reform for decades—and yet it always seems that yet another fix, another tweak, another technocratic reform is necessary to finally rationalize the system.

The good news is that single payer isn’t the lineup should any part of ObamaCare fall—at least not in the foreseeable future. The critics Kapur quotes, both supporters of the 2010 health law, do a good job explaining why:

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Get the government totally out of health care and it will be affordable once again.

That is the only solution.

(Thus, it won’t be done as it would work and that would be too logical).