Zealous supporters of a single payer system, such as PNHP, can be as inflexible and intolerant of alternative approaches to health reform as some socially conservative groups on the right are of abortion and gay marriage.

It will be interesting to see if they will budge in their narrow views on health reform. The ACP’s Bob Doherty quotes health policy heavyweight Jacob Hacker in emphasizing that the success of any major reform passing depends on whether single payer advocates are willing to compromise:

A successful effort this time “will require updated strategies including a greater willingness to compromise on means, yet greater clarity on ends” and “serious efforts to bring on board … reformers who support a universal Medicare plan, to provide them with the guarantees and arguments they need to embrace a less inspiring but more politically palatable approach.”

Over at Health Beat, a blog with moderate, rational left-of-center views, Niko Karvounis points out that most nationalized health systems – including the UK, Germany and the Netherlands – incorporate some degree of private insurance presence:

This might not be enough for some single-payer folks who have an ideological objection to seeing health care coverage offered by anyone but the federal government. But these people need to realize this: the international health care systems that they so often cite as models for change all incorporate a role for private and non-governmental insurance.

It would be tragically ironic if the intolerance of the single payer advocates were to blame for the downfall of major health care reform in the Obama era.

topics: single payer, health reform