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Comment by lsiebert | Hacker News Reader

Well strictly speaking, if Obama could have passed single payer, he would have. He went with a compromise based on a republican idea and negotiated with the insurers to get their support. The thing is, expensive as it is, you have the ability to get health coverage. The ACA made health care affordable to people who previously couldn't afford it at all, particularly the working poor through medicaid expansions.

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He had two years of full Democratic control of Congress. He didn't even try to get single payer, didn't even try to get the "public option".

Obama's disastrous politics are a result of going into every debate starting at the "compromise" position, and then getting dragged further right. Just go back to his 2004 DNC speech, it lays out exactly how he's going to fail.

He had just a couple of months of full Democratic control. Due to Al Franken not being seated right away, Robert Byrd being ill, and Ted Kennedy dying, the Democrats didn't have a supermajority until September of 2009. They then lost that supermajority in February 2010 when Scott Brown was sworn in.

I do agree that Obama tended to negotiate badly by compromising before it was even needed, but that "two years of full Democratic control" thing gets repeated so often, and it's annoyingly wrong.

As they proved later, they didn't need a Supermajority in the Senate -- they just changed Senate rules. It was passed with a simple majority.

Are you talking about the use of reconciliation to get the final version through?

The Democrats went into the debate compromising with moderates within its own caucus. Joe Lieberman threatened to filibuster if a public option was added to the bill and effectively killed any chance of passing some form of HR 676 (originally introduced by Democrats in 2003, it was floated around early in the healthcare debates of 2009). So the Senate began working on a Republican plan that was introduced in Massachusetts under Mitt Romney. However Mitch McConnel convinced his caucus to not support the bill in any way and succeeded in stopping moderate Republicans from breaking rank.

This debate went on like that for a good while, with Democrats negotiating to keep moderates like Ben Nelson (Cornhusker Kickback, if anyone remembers) and Joe Lieberman from defecting. The Democrats were then dealt a blow by the death of Ted Kennedy and subsequent election of Republican Scott Brown to his seat in the Senate. With Brown's swearing in, the Democrats' caucus would have lost the filibuster-proof majority it enjoyed.

I just want to point out that a long debate was expected, and it would have likely gone on for another year had Kennedy's seat not been won by Scott Brown. The Senate's bill, which became the ACA, had to be the one implemented otherwise the Democrats would not have succeeded at any version of healthcare reform. Obama's '"compromise" position' was to encourage a bill that was not single-payer and could keep Blue Dogs on board.

I mean what should he have done? Kneecap Democrats who didn't fall in line?

Joe Lieberman threatened to filibuster any bill that had a public option. We wouldn't have had the votes to pass single payer, even when the Democrats controlled both the House and the Senate.

So let him filibuster and let the whole world judge him.

I heard Hillary Clinton, when first lady, got a mandate from her husband to lead health-care reform, and tried precisely the strategy of not compromising in the hope that no one would actually vote against universal health care with the world watching.

It failed, legislators just voted against it and carried on with their day. No noticeable public blowback against them.

Are you kidding? Harry Reid had to resort to procedural maneuvers to get the ACA passed – single payer would have been laughed out of the room.

Obama never had full Democratic control of the Senate.

Lieberman caucused with the Senate Democrats. He had lost his Democratic primary and ran+won as an independent. In fact, he'd endorsed McCain in 2008 (after Obama campaigned for him in 2006).

Lieberman had and used a line item veto over everything that was passed by the Democrats because the Republicans uniformly opposed anything that was proposed. It took a supermajority to pass the ACA and it only barely passed because of Republican opposition.

> if Obama could have passed single payer

But he gave up before even trying. Way to move the Overton window.

LOL. They had to drop the public option just to get the Democrats to in the Senate to vote for the bill. Single payer would not have gotten anywhere.

Never mind that it's the Congress that passes bills, not the President.

Obama could not have introduced Single Payer. There is just no political will in the US to do that. None. The medical industry is in one form or another is 1/6th of the US economy, you can't change that overnight.

Because Joe Lieberman refused to support it. Without his support there was no chance of single payer passing.

I think there is a good point here, though. By compromising early and relatively privately, it never became a real topic of conversation amongst normal every day Americans. Maybe if Obama had come out as a fire-breathing liberal supporting single payer ("Medicare for all!") and used his bully pulpit to make everybody hear about it, we could have had a better discussion. Sure, it might have kept the ACA from happening, but maybe in the long run it would have given us better results.

Anytime you make a compromise, there's always the possibility that maybe you could have held out for more.

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