Despite the poor shape of the American health system, public preference is the limiting factor in how far we can change the system.

Ezra Klein notes the lessons learned from 1994, saying that there is a status-quo bias, and that people “want more options,” and “don’t want to be forced out of their current arrangements.”

This is one reason why something radical, like a single-payer health system, won’t take off. When you consider that the majority of Americans are happy with their health care plans, reformers need to face the fact that it’s not doctors, hospitals, or the health insurance industry that’s impeding reform efforts.

It’s the people themselves, or as Ezra puts it, “a lot of very bad policy limits are the product of public preferences.”

And it’s refreshingly honest to hear a progressive reformer admit that.