November 14, 2002
Gore Supports Single-Payer
On a stage in a synagogue on New York's Upper West Side
Wednesday night, Gore made this stunning announcement
to several hundred people in response to a question
from the event's host.
Gore suggested he was hesitant to reveal his position at
this forum - but then declared that he had come "reluctantly"
to the conclusion that single-payer is the best solution to
the nation's health insurance crisis.
Long supported by the left, single-payer plans involve all
money spent on health care being collected by some public
agency or trust fund, which then pays for comprehensive
coverage, delivered privately and publicly, for all
Issues of taxation, quality of care, availability of care,
and medical innovation are all implicated in such a system,
with Canada's plan often used as the basis for understanding
For Gore, this represents a shocking switch. Although many
of the people who worked with Hillary Clinton and Ira Magaziner
on the Clinton health care plan at the start of the Clinton/Gore
Administration were intellectually and morally sympathetic to
single-payer, it was rejected as being simply too radical and too
big a political target.
Even Bill Bradley, who frequently charged Gore during the
2000 presidential primary with being timid on finding health
care solutions, disappointed many of his own supporters by not
coming out for single-payer.
And if Gore is a presidential candidate for 2004, this gambit
would allow him to outflank on the left even Vermont Gov. Howard
Dean, whose calls for massive new spending on health care so far
do not include support for single-payer.
Gore's decision to go public with his new position could be
viewed as part of his reported avowal to speak more from the
heart on big issues he cares about, feeling less encumbered by
what polls and focus groups might say is popular.
Some surely will see Gore's switch as part of a series of
calculated moves perhaps intended lock up the left wing of the
Democratic party in hopes of securing the party's presidential
Others will say that Gore isn't even necessarily running for
president, and is feeling liberated enough to speak his mind
and take bold policy positions deriving from his nearly
unparalleled experience in, and knowledge of, a range of foreign
and domestic policy issues.
It is surely the case, though, that potential 2004 rivals
Gephardt, Edwards, Kerry, Lieberman, Dean, and Daschle can all
be expected now to take positions in relation to single-payer.