A Project of The Annenberg Public Policy Center

Campaigning on Single Payer?


 On “Meet the Press” on June 28, former presidential candidate and Massachusetts Gov. Mitt Romney falsely claimed that President Obama had called for a “single-payer” health care system on the campaign trail:

Romney: President Obama, when he was campaigning, said he wanted a single-payer system.

We debunked this falsehood when Sen. John McCain said it during the third presidential debate. McCain claimed that “as he said, his object is a single payer system.” But as a presidential candidate, Obama didn’t say that at all. And the plan he proposed wasn’t a single-payer system, one in which everyone is covered by health insurance through the government. As we said in our Oct. 16 article, Obama said at a town hall meeting in Albuquerque last summer that a single payer system would “probably” be his first choice “if” he were “designing a system from scratch.” But instead, he said, his “attitude is let’s build up the system we got, let’s make it more efficient, we may be over time – as we make the system more efficient and everybody’s covered – decide that there are other ways for us to provide care more effectively.”

Six years ago, Obama did say at an AFL-CIO forum that he was “a proponent of a single-payer universal health care program.” But that was 2003, and that’s not what he campaigned on as a presidential candidate. He has recently taken heat from single-payer advocates for not including them in discussions about overhauling the health care system.

At a May 14 town hall in Rio Rancho, New Mexico, the president was asked why a single-payer plan had been taken off the table. His response was similar to what he had said while campaigning:

Obama, May 14: If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense. That’s the kind of system that you have in most industrialized countries around the world.

The only problem is that we’re not starting from scratch. We have historically a tradition of employer-based health care. And although there are a lot of people who are not satisfied with their health care, the truth is, is that the vast majority of people currently get health care from their employers and you’ve got this system that’s already in place. We don’t want a huge disruption as we go into health care reform where suddenly we’re trying to completely reinvent one-sixth of the economy.

So what I’ve said is, let’s set up a system where if you already have health care through your employer and you’re happy with it, you don’t have to change doctors, you don’t have to change plans — nothing changes. If you don’t have health care or you’re highly unsatisfied with your health care, then let’s give you choices, let’s give you options, including a public plan that you could enroll in and sign up for. That’s been my proposal.