There’s nothing smart in surrendering bargaining power for policy details
While we are taking lessons from the ugly compromises FDR accepted in order to get Social Security passed, we might also consider other events. FDR, you probably don’t recall because it has oddly been erased from conversational history, pursued almost as an idée fixe a cap on incomes of $25,000 (call it $360K in today’s money). The idea was as divisive then as it would be today, and despite dogged efforts, the proposal did not succeed. But, as Sam Pizzigati reminds us
[T]he setbacks the Roosevelt administration had suffered on the $25,000 salary cap executive order, on pay-as-you-go tax forgiveness, and the Revenue Act veto were obscuring a much more fundamental reality…
Roosevelt’s relentless drive to make sure the war created “not a single war millionaire” had made an incredible difference. His refusal to take “no” for an answer on his $25,000 income cap proposal had kept the entire war finance debate revolving around the rich and how much they ought to be paying in taxes. Conservatives didn’t want that debate. They wanted a national sales tax that would shunt the war’s heavy burden onto average Americans, but FDR’s aggressive advocacy for equity never allowed a sales tax to gain traction. Roosevelt would not get all he wanted on the tax equity front. But he did get plenty, enough to deliver against plutocracy a staggering knockdown.
The odds of enacting decent single-payer health care in the United States, given the broad range of powerful and not always unsympathetic stakeholders in the current system, are modest. But a modest chance is very different from no chance at all. The deep aversion among current stakeholders that makes single payer politically hard also makes any chance it might happen a potent motivator for those same stakeholders to accept or even propose meaningful alternatives. Taking single payer off the table, promising to build from the status quo, leaves the comfortable with nothing to fear from the many people for whom American health care remains a nightmare. It strikes me as more a license for inaction than a sensible plan of action.
(Dean Baker has made a similar point.)