In 2007
‘If you’re starting from scratch,’ he [Obama] says, ‘then a single-payer system’-a government-managed system like Canada’s, which disconnects health insurance from employment-’would probably make sense. But we’ve got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that’s not so disruptive that people feel like suddenly what they’ve known for most of their lives is thrown by the wayside.’
New Yorker, May 7, 2007
At a roundtable with a handful of invited guests at Lindy’s Diner in Keene, Obama said if he were starting from scratch, he would probably propose a single payer health care system, but because of existing infrastructure, he created a proposal to improve the current system.
Concord Monitor, August 14, 2007
In 2008
Here’s the bottom line. If I were designing a system from scratch I would probably set up a single-payer system…But we’re not designing a system from scratch…And when we had a healthcare forum before I set up my healthcare plan here in Iowa there was a lot of resistance to a single-payer system. So what I believe is we should set up a series of choices….Over time it may be that we end up transitioning to such a system. For now, I just want to make sure every American is covered…I don’t want to wait for that perfect system…The one thing you should ask about the candidates though is who’s gonna have the capacity to actually deliver on the change?…I believe I’ve got a better capacity to break the gridlock and attract both Independents and Republicans to work together.
Seniors Town Hall, Ames, Iowa, January 5, 2008
“I have been entirely consistent in my position on health care. What I said . . . is if I were designing a system from scratch, I would set up a single-payer system.” But given the existing health care system, such a change would be impractical, he said.
Democratic Debate, Manchester, New Hampshire, January 5, 2008
I never said that we should try to go ahead and get single-payer [health insurance system]. What I said was that if I were starting from scratch, if we didn’t have a system in which employers had typically provided health care, I would probably go with a single-payer system.
Democratic Debate, Myrtle Beach, South Carolina, January 22, 2008
“If I were designing a system from scratch, I would probably go ahead with a single-payer system,” Obama told some 1,800 people at a town-hall style meeting on the economy.
“Given that a lot of people work for insurance companies, a lot of people work for HMOs. You’ve got a whole system of institutions that have been set up,” he said at a roundtable discussion with women Monday morning after a voter asked, “Why not single payer?”
“People don’t have time to wait,” Obama said. “They need relief now. So my attitude is let’s build up the system we got, let’s make it more efficient, we may be over time—as we make the system more efficient and everybody’s covered—decide that there are other ways for us to provide care more effectively.”
Town Hall/Women’s Round Table, Albuquerque, New Mexico, August 18, 2008
And in 2009, as President
If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense. That’s the kind of system that you have in most industrialized countries around the world.
The only problem is that we’re not starting from scratch. We have historically a tradition of employer-based health care. And although there are a lot of people who are not satisfied with their health care, the truth is, is that the vast majority of people currently get health care from their employers and you’ve got this system that’s already in place. We don’t want a huge disruption as we go into health care reform where suddenly we’re trying to completely reinvent one-sixth of the economy.
So what I’ve said is, let’s set up a system where if you already have health care through your employer and you’re happy with it, you don’t have to change doctors, you don’t have to change plans — nothing changes. If you don’t have health care or you’re highly unsatisfied with your health care, then let’s give you choices, let’s give you options, including a public plan that you could enroll in and sign up for. That’s been my proposal.
Town Hall, Rio Rancho, New Mexico, May 15, 2009