There are conservative reasons why Romneycare was backed by conservatives.
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But more recently Obama said:
I have not said that I was a single-payer supporter because, frankly, we historically have had a employer-based system in this country with private insurers, and for us to transition to a system like that I believe would be too disruptive.
I think he meant what he said earlier and he meant what he said later. It just depends on what the meaning of “system like that” and a value on just how disruptive is “too disruptive.” I won’t attempt to parse his words. The proof is in the Affordable Healthcare Act. It has disrupted and it will continue to disrupt. “That system” is exactly what we got. And “that system” will, if left unchecked, get us what he wanted in 2003 — a system with just the right amount of “disruptive.”
The fact is, Obamacare was originally going to be single payer. It was going to be European — as close to it as Congress would allow. But that was curbed. What they got, instead — what we got, instead — was the first step. Obamacare. The first step toward single-payer, universal healthcare coverage. That’s a lot bigger than just under 10%, and it is a heckuva lot more disruptive.
And that is the crucial difference. Romney never said, never touted, never promised that “we may not get [single-payer] immediately” or even a little later than immediately. Much of the criticism against Romneycare is deserved, as is the scrutiny. But Romneycare is not Obamacare because Obamacare is just getting started.
One was an end in and of itself. The other is (still) a means to an end.