The Biggest Reason No Single Payer

-- by Dave Johnson

I think the main reason we don't have significant public pressure for a "single-payer" option in the health care reform process is because supporters of "single-payer" insist on calling it "single-payer."

If they had branded it "Medicare-for-all" it would have been a no-brainer. It might have already passed, avoiding all this fighting and back-and-forth.

OK, listen. People love Medicare. They know what it is. They know it works. That is all you need to know. If you call what you want "Medicare-for-All" you can pass whatever you want to pass and people will support it.

But no one understands what "single-payer" means. Every single time you talk about it you have to start out explaining what you mean. From scratch. and then you have to explain, from scratch, why it is a good thing. From scratch. Every single time.

If you talk to regular people out there, mostly they have no idea what it means. But it sounds sort of scary. I have talked to people who, upon hearing the term, think it means that a single person will have to pay for all their own medical care. That is how far away from winning the argument you being when you use the words "single-payer" to describe what you want.

This is a classic problem, where policy wonks don't understand basic communications. In computers I referred to it as the "designed by Linux engineers syndrome." To this day I still encounter Linux-only fanatics who insist that the command line is so powerful that no one should ever use graphical interfaces...

I have written about this before and I received comments like "well, what we want isn't exactly Medicare. Medicare has its own problems, so..."

Give it a break. Compromise a little. Use language that regular people respond to.

Call it "Medicare For All"!

Posted by Dave Johnson at August 2, 2009 5:36 PM