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What is the status of movement toward Single-Payer?

Although the idea of a single payer system is still not accepted by a majority of Americans, a small majority of Americans favor the idea of healthcare as a government responsibility. According to a Pew Research Center Survey in January, 60 percent of Americans agree that government is responsible to ensure health coverage to all Americans, compared to 38 percent who feel government is not responsible. This is an opinion most strongly held by Democratic leaning citizens (more than 80 percent) than Republican leaning Americans (32 percent), and most strongly held by lower income Americans (74 percent) than more affluent Americans (53 percent).

Government Responsibility for Healthcare:

Although a majority of Americans believe that government should be responsible for healthcare, only 28 percent favor government actually offering health insurance. That's about equal to the percentage who believe that health insurance should be provided by a mix of public and private contributions (29 percent). In other words, the solution offered by the current Affordable Care Act (ACA) is more or less in line with about 29 percent of the population. A Kaiser Family Foundation survey shows that what most people care about is lowering premiums (67 percent) and the cost of prescription drugs (61 percent).

Single Payer As a Compromise?

A Gallup poll in May 2016 found that (at that time) a single payer health care system would be the most popular option compared to keeping the ACA in place. This is because Republicans so disfavor the ACA that they would accept a single payer system more than keeping it. In April, 2017, A Morning Consult Poll found that a plurality of Americans (44 percent) prefer a single payer system compared to a slightly smaller percentage (36 percent) who oppose it. For several months rumors were circulating about a bi-partisan effort to devise a single payer system, but nothing came of it. Right now, of course, a record-high proportion of Americans are receiving government-provided health care already, seniors, veterans, people with disabilities, people below the poverty line, etc.. Many Americans are asking, why not the rest of us?

The idea of a single payer health care system is gradually evolving in both parties as a third way for those who don't want the ACA and those who feel the ACA was a weak compromise from the beginning. The health care idea that was once the anathema for the GOP is now an idea some of its voters support. GOP law makers are heading to their districts to wave after wave of angry town halls because of their party's wounded efforts at ACA repeal and replace. Jason Chaffetz of Utah has already announced that he intends to retire from congress largely because of these failures. A year ago, a Gallup Poll of GOP voters found 40 percent support for a single payer system. In March, 2017, F.H. Buckley, the chief author of Donald Trump's acceptance speech at the Republican Convention, urged Trump to embrace a single-payer system. From alt-right conservatives to center-right conservatives are now moving into the embrace of a single payer system.

Legislative Starts and Stops:

Early this year, a group of 50 House Democrats introduced an actual bill that would establish a one-payer system to replace the ACA, "The Expanded and Improved Medicare for All Act." This was just the latest in a nearly annual single payer bills that everyone knew had no chance of passage. The majority of congress seems to be hard pressed to make Medicare into a premium-supported program and shrinking it, rather than expanding it.

In the Senate, Bernie Sanders continues to push for a "Medicare-for-all, single-payer" plan. He criticizes the ACA and urges bi-partisan support in the face of the Republican failure to come up with a successful replacement for it. In California, Democratic are advocating a Bernie Sanders inspired bill to establish a statewide single payer health care system.

The question around single-payer health care is how fractured is the growing consensus?