Today I had lunch with Wal-Mart CEO Lee Scott, SEIU president Andy Stern, and the disembodied head of Arnold Schwarzenegger. Let me explain.

The event was a conference on the "crisis" in our nation’s health care, sponsored by the Better Health Care Together Coalition, a group of unions, businesses and politicians who want some sort of health care reform (no, it’s not much more specific than that). I’ll address, in a longer upcoming article, this coalition, the involvement of Wal-Mart and major labor unions in it, and the folks who were protesting outside. I’m keeping an open mind about all that. For today, I simply want to note the curiously compulsive way that some speakers — particularly Governors Ed Rendell of Pennsylvania and Terminator Arnie (who attended by satellite, so the live attendees were overshadowed by his enormous grinning visage on either side of the podium) — kept evoking the specter of a "single payer" (Canadian-style) plan, and then dismissing it without giving any real reasons.

Governor Rendell repeatedly said reform should be "comprehensive, not piecemeal" and that "now is the time to get it all done." He pointed out how favorably other countries’ health care systems compared to that of the United States, noting that Scandanavian countries have few hospital-acquired infections, and that Canadians have a longer life expectancy. (Those countries have single-payer health care systems.) Yet more than once, he said "you don’t go to single payer." At one point, Rendell dismissed the single payer plan by saying that none of the major presidential candidates were calling for it (as if businesses and major constituency organizations like unions have no role to play in shaping candidates’ agendas). When someone from the podium mentioned Dennis Kucinich — who does favor single-payer — Rendell joked that no "taller" candidates were talking about it. Arnie, luridly weird as usual, with his off the cuff ruminations (E.g., "No dictatorship, no feudal system, has ever been as powerful as the United States," "I like to be where the aahction is," and "it is fun to bring everyone together!"), randomly offered that single payer was impossible because in California the government provides health care to prisoners and "it doesn’t work even with everybody locked up." 

There was an intriguing sense of optimism in the room — much like the momentum among many different players right now to address the climate change problem. But come on, the edgiest, most outside-the-box thing these titans can do is get labor and business leaders together on the same podium (an achievement for which they kept congratulating themselves)? That’s hardly novel throughout much of the rest of the world. It was as if many in the room knew single-payer might in some ways be a better system — cheaper for business, less economic hardship on the average person, a healthier population, lower overall costs — but had tacitly agreed not to take it seriously. Massive pressure from the public might help change their minds, or at least provoke some genuine debate on the issue, but failing that, we’re probably going to just see more of the very "piecemeal" solutions that the Pennsylvania governor decried.