I recently read a good article about single-payer healthcare at http://www.truthout.org/issues_06/020508HA.shtml, and it prompted me to imagine one reason more Americans aren't actively seeking such a system here.
In British Columbia, which the author cites from her own experience, income taxes are about 10% higher than in the U.S. to cover health care for everyone. It is not perfect, but it is a very economical, and equitable, system. Here in the U.S., 47 million people have no coverage at all, and even those who do have to argue constantly with their insurance carriers, in whose interest it is to deny coverage whenever possible. This is a highly inefficient, and inequitable, system. These facts are not really in dispute.
However, in the U.S., those of us whose employers currently pay the lion's share of our health insurance premiums would probably pay more out of pocket for health care if our income taxes went up 10% to cover it, even if our co-payments and the fraction of the premiums we now pay disappeared. In principle, of course, our employers could then pay us some of the difference (but no guarantees!), and there would be other benefits -- everyone would be covered, healthcare professionals could practice medicine instead of insurance triage, and so forth. But I suspect the general lack of enthusiasm for change in much of the comfortably employed and insured population (which includes most of those who vote) stems from a vague fear, perhaps not unfounded, that it will cost them.
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Though probably true at the margins, that explanation of widespread resistance to change strikes me as too dependent on rational choice. What's more likely, in my view, is that US voters are both entirely ignorant of health-care options/facts (failed education and media) and susceptible to corporate propaganda in favor of the status quo (successful corporate media and schooling).
Perhaps you are correct. It couldn't hurt, however, to anticipate concerns about out-of-pocket costs for key constitutents, if and when we have the serious national conversation we need about the issue. Legislation, or public commitments by employers, to revert some of the savings of a universal plan to employees could prove pivotal in a campaign (and many corporations have admitted that the present system is hurting them badly -- something like 15% of the price of a new car from Detroit goes for health insurance for employees -- though what they propose may not be what we really need...).
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