Opponents of single payer are moral monsters on par with AHCA proponents

Matt Bruenig
3 min readMar 18, 2017

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The Republican health care plan, the American Health Care Act (AHCA), was unveiled recently. Its major provisions include changing the refundable tax credits of Obamacare so that they are more generous to younger people and less generous to older people and so that they are more generous to higher income people and less generous to lower income people. On top of that, the AHCA also cuts Medicaid substantially.

As a result of these changes, the CBO estimates that by 2026, 24 million more people would be uninsured relative to current law. The liberal reaction to this proposal has been rightly horrified.

Here’s Ezra Klein’s reaction, which was typical of the liberal thinksphere in general:

The Congressional Budget Office’s analysis of the GOP’s American Health Care Act is one of the most singularly devastating documents I’ve seen in American politics. For a thorough explanation of the findings, read Sarah Kliff’s explainer. But here is the one-sentence summary: Under the GOP’s bill, the more help you need, the less you get.

The choice between the Obamacare status quo and the AHCA future, if CBO is believed, is a choice between having 24 million people with health insurance or 24 million people without health insurance. When confronted with that choice, those that would choose AHCA over Obamacare are moral monsters. They are selecting a society with greater misery, greater suffering, and greater death.

What if the choice was different though? What if the choice was between Obamacare and single-payer health insurance? How would the moral situation change?

For Waldman, the change from Obamacare to single-payer health care is akin to remodeling your kitchen: a mostly cosmetic change that is better, but not strictly necessary. This too seems to be a widespread liberal sentiment, especially during the primary campaign of 2016 where single-payer was widely rejected by the conservative wing of the Democratic party and voted down (in favor of Obamacare) when it was proposed for the Democratic party platform.

But in reality, the choice between single-payer and Obamacare is on par with the choice between Obamacare and AHCA. That is, a decision to favor AHCA over Obamacare is at least as horrific as the decision to favor Obamacare over single-payer.

But don’t take my word for it. Just look in the very same CBO report that shows how bad AHCA is:

In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.

The difference between Obamacare and AHCA is 24 million uninsured people while the difference between single-payer and Obamacare is 28 million uninsured people. If you favor Obamacare over single-payer or dismiss single-payer as relatively unimportant, then you are a moral monster at least on par with the AHCA proponents you condemn.

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Matt Bruenig
Matt Bruenig

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