Senate Democratic Leader Harry Reid recently made clear what conservatives have long suspected: that he and other Democrats, including the president and key officials, see ObamaCare as a stepping stone to single payer, government-controlled health care.
Reid told a television interviewer, "Don't think we didn't have a tremendous number of people who wanted single payer system."
But, he added, it didn't happen because "you know, we have to get the majority of the votes and we weren't able to do that."
A single payer system would involve the government paying for all health care costs and abolishing the private insurance market.
Reid’s comments have revived discussion of the prospect of a government-run health care system. Despite the problems it has been encountering recently, ObamaCare is only partially run by the government.
In May 2009, the president said, "I think that the idea of moving towards a single payer system could very well make sense."
As far back as 2007, Kathleen Sebelius -- who went on to become his Health and Human Services Secretary, who oversees implementation of ObamaCare -- said, "I'm all for a single payer system eventually. I think that (what) we have to do is work with what we've got until we close the gap."
What do people actually mean by single payer?
“What they really mean is putting everybody under one big government insurance program and almost always, on the left, they're talking about Medicare," says John Goodman of the National Center for Policy Analysis in Dallas.
Michael Tanner of the Cato Institute adds dryly that "Medicare does pretty well, considering it's only $42 trillion in debt by the most optimistic scenarios. So I'm not sure I'd want to pile a bunch of more people on that particular Titanic."
Analysts note single payer systems in other countries do hold down costs -- but by rationing care.
"If you look to, say, Great Britain," says Tanner, "there are 115,000 people today who have waited longer than 18 weeks for admission to the hospitals. In Canada, the waiting list to get in to see a physician of your choice can be as many as 800,000 people at one time."
And Goodman notes that the "typical wait for a normal procedure in Canada is four months. For a hip replacement or knee replacement, the wait is 10 months and some people are waiting more than a year for knee replacement."
In fact, some people in great pain or even with serious illnesses are forced to wait.Tanner notes that even "the Supreme Court of Canada in 2005...said some people in Canada died a result of being on the waiting list."