ObamaCare’s Next Act

Clinton and Obama revive the ‘public option’ road to single payer.

July 12, 2016 7:07 p.m. ET

Bernie Sanders formalized the Democratic Party’s left turn on Tuesday, finally endorsing Hillary Clinton and praising her for embracing so many of his ideas. “We have begun a political revolution to transform America, and that revolution continues,” the Vermont socialist said—and the latest evidence for his boast is the revival of ObamaCare’s “public option.”

This liberal ambition—a new health-care entitlement akin to Medicare for all middle-class Americans under age 65—couldn’t pass a Democratic Congress in 2010. Mrs. Clinton revived the public option over the weekend, and now President Obama is also lending his support, in an op-ed that appears under his byline in this week’s Journal of the American Medical Association.

Mr. Obama’s hails the “substantial progress” his namesake law has achieved but calls for higher subsidies and drug price controls. He adds that “Congress should revisit a public plan to compete alongside private insurers,” which he writes will “deliver care more cost-effectively” and help “areas of the country where competition is limited.”

Mr. Obama is re-endorsing what he had hoped in 2010 would be a way station for government-run single payer that would gradually wipe out anything resembling private insurance. Insurers can’t outbid a “free” program that is open to all or most and has the unlimited access to the Treasury that Medicare enjoys. A market exodus would be inevitable.

Democrats claim this would merely be another choice, but they tried a trial-run public option with ObamaCare’s co-ops, which were given up-front federal cash infusions and then were supposed to operate like normal companies. Of the original 24 co-ops, only nine are alive—and most of the survivors are ailing.

The “first lesson” of ObamaCare, Mr. Obama muses, is that “any change is difficult, but it is especially difficult in the face of hyper-partisanship.” He means Republicans, naturally, but the real history is that centrist Democrats consigned the public option to a death panel. The bill was already deeply unpopular with voters and the health industry was disinclined to be put out of business, so the White House tried to summon a softer-focus image.

Even after jettisoning the public option, ObamaCare passed the Senate with a bare 60-vote majority and the House 219-212, though Democrats commanded their largest majorities since the Great Society. Republicans couldn’t stop anything, but they did oppose the public option for the same reasons as the business community and moderate Democrats: Over time, its radicalism would annex all of U.S. health-care finance.

Democrats denied that ObamaCare was the next step to single payer, but now they have resumed their march to government-run health care, as everyone knew they would.