The announcement on Saturday about Biden as the Obama VP choice should be generally positive for health care. It will now be fascinating to see whom McCain selects. While Biden has been mainly focused on foreign affairs in the Senate, he has always supported expanding access and protecting the patient-physician relationship. While his dad was briefly affluent as a young man, he lost his wealth and remained a struggling lower middle class person during all of Biden’s life. The senator has been generally supportive of employer coverage. We will need to assure both members of this team that we can preserve a private sector and still contain costs without resorting to a single payer. More than half of health care is already under government control, and it’s not exactly perfect. And, more and more powerful unions are uniting again to press for a single payer, Medicare-for-All solution. In fact, the nation’s largest union, AFSCME (American Federation of State, County, and Municipal Employees), which has been an employer mandate advocate mostly, just signed on to Conyer’s HR 676, the main Congressional single payer vehicle.

Obama, faced with this pressure, was quoted this week by the Wall Street Journal as supporting a single payer model. But, one must dig a bit deeper to see what he really said. Basically, he believes we need to go ahead with a more pluralistic approach (non-single payer) now, given the way the current system is configured. I see this as an attempt to appease single payer advocates among Dems (there are many), while forging a different direction. The big insurers are investing heavily in the Democratic party to protect themselves. But if we don’t make progress with the pluralistic approach soon, an army of single payer advocates, in the name of Ted Kennedy, are poised to move forward.  

ACC commented to USA Today about our views on both candidates’ positions thus far. What are your thoughts?