The technique of a mass movement aims to infect people with a malady and then offer the movement as a cure. Eric Hoffer
Obamacare and Single Payer have one very important thing in common. Neither is about medical care, although one is about money. As I have discussed extensively, Obamacare is a political payoff designed to shift the burden of paying for medical care from the administrations allies(unions and big business) to the politically weak(states, young workers, and small businesses). Single Payer, on the other hand, is a philosophy regarding the role of government applied to the healthcare market. The motivation of it's advocates is neither economic nor tied to the health of Americans. Single Payer is a remedy for a fundamental failure of American society, the unequal access to healthcare.
The academics and political progressives who support Single Payer are motivated by the concept of "fairness." To these true believers, ensuring fair and equal access across economic, social and racial classes is both a moral imperative and the primary goal of government. The inescapable inequality of our free market medical care is a moral outrage in itself, independent and completely divorced from actual medical outcomes. The fact that wealth can purchase better doctors, hospitals and drugs is seen as a violation of basic human rights.
Guaranteeing fairness across all levels of society dictates the need for central control of spending, resource allocation, and choices about medical care. This philosophy mandates that if a treatment is available to one, it must be available to all. More importantly, even if the one can afford better care, it is unacceptable to purchase it, at least within the governing country. This rationale justifies countries like Great Britain and Canada to denying expensive drugs to cancer patients, making patients wait six months to see a specialist, or supporting euthanasia.
Of course, top down allocation of resources can also substantially reduce medical costs. Rationing is easier, more efficient and less arbitrary when performed on a national basis. However it is crucial to understand that for many supporters, cost is secondary to the overarching goal of fairness. Those discussing healthcare policy are frequently unaware of the depth of the chasm separating the many sides in this argument. Many of the supporters of Single Payer see it as a crusade to repair American society. In contrast some conservatives see Single Payer as a Communist plot, but most people just view it as an alternative insurance structure.
My biggest problem with healthcare reform is the duplicity and deceit that has characterized the discussion from all sides of the issue. Politicians, pundits, and advocates are actively deceiving the American people about their true goals and motivations. Single Payer advocates are guilty as well. They are using a financial justification to impose their political philosophy which may be antithetical to a majority of Americans. Solving our healthcare problems will not be easy or cheap, but at the very least, the real motivations of this movement need to be understood by everyone.