One video is worth a thousand words (or, as in this column, about 730). The video in question, put together by a group called Verum Serum, shows public statements by three advocates of single-payer (government monopoly) health insurance explaining that a health care bill with a "government option" would move America toward a single-payer government health care system. You may not have heard of the first two, Rep. Jan Schakowsky and professor Jacob Hacker. But you have heard of the third, President Barack Obama.
Schakowsky is a left-wing Democrat from the north side of Chicago and adjacent suburbs and, as chief deputy whip, part of the House Democratic leadership. The video shows her speaking to an enthusiastic group last April. She cites an insurance company spokesman as saying, "A public option will put the private insurance industry out of business and lead to single-payer." The audience cheers. "My single-payer friends," she goes on, "he was right." Later she adds, "This is not a principled fight. This is a fight about strategy for getting there, and I believe we will."
Schakowsky sounds self-assured but angry, perhaps because her husband, Robert Creamer, served five months in prison a few years ago for bank fraud and failure to pay withholding taxes. Hacker, Yale's Stanley B. Resor Professor of Political Science, sounds friendly and cheerful in appearances recorded in January 2007 and July 2008. With a government option plan, he says in 2007, "You can at least make the claim that there's a competitive system between the public and the private sector," but he predicts that the government option "would eliminate the small group insurance."
Speaking of the government option in 2008, he says, "Someone told me this was a Trojan horse for single-payer. Well, it's not a Trojan horse, right? It's just right there. I'm telling you. We're going to get there, over time, slowly, but we'll move away from reliance on employer-based health insurance as we should, but we'll do it in a way that we're not going to frighten people into thinking they're going to lose their private insurance. We're going to give them a choice of public and private insurance when they're in the pool, and we're going to let them keep their private employer-based insurance if their employer continues to provide it."
Of course, there's no guarantee employers will. Many employers, single-payer advocates hope, will be happy to let their employees go onto the government plan. The Lewin Group, cited often by various analysts, estimates that a government-option plan, depending on how the law is written, could move as many as 100 million households off private insurance and onto the government plan in a few years.
Obama has never made his ultimate goal a secret; it's the same as Schakowsky's and Hacker's. The video shows him saying in October 2003, when he was running for the U.S. Senate, "I happen to be a proponent of a single-payer health care program." He adds, "We may not get there immediately," noting the Democrats must "take back" the White House and both houses of Congress -- a condition fulfilled last Jan. 20.
Campaigning for president in May 2007, he says, "But I don't think we're going to be able to eliminate employer coverage immediately." That seems to imply that his goal remains the same as it was in 2003. "There's going to be potentially some transition process -- I can envision a decade out, or 15 years out, or 20 years out, where we've got a much more portable system." Which of course government health insurance would be. You couldn't get away from it. The president's defenders depict this video and others like it as a patchwork of irrelevant and misleading statements. They also cite Obama's oft-repeated pledges that any health care bill he would sign would let you keep the insurance you have. They don't address the point, raised by Hacker, that you can't keep it if your employer stops offering it.
But, as Schakowsky says, "This is not a principled fight." Schakowsky, Hacker and Obama believe, out of idealism but also perhaps for crass political reasons, that America would be better off with a single-payer system like Canada's or Britain's. But they realize that they're operating in a country where most voters don't agree. The video helps us understand how they're seeking to reach their single-payer goal through government-option stealth.