In other statements, Obama has spoken favorably of single-payer in concept, but always adding qualifiers.
In February 2004, about a month before the primary election in the U.S. Senate race, the Associated Press reported the stance of all the candidates on universal health care. "Obama says he supports the idea of universal health care but does not think a single-payer government system is feasible. He says the government should be the health care provider of last resort for the uninsured." In a rundown of all the candidates' positions, the Associated Press summarized Obama's position as "Support, but 'probably not at this stage,' a single-payer government system."
In his book The Audacity of Hope , published in October 2006 when he was a U.S. senator, Obama described single-payer as the hope of the left, while those on the right wanted a market-based approach. "It's time we broke this impasse by acknowledging a few simple truths," Obama wrote, suggesting a system much like the one he supports today.
In April 2007, a few months after he declared his candidacy for presidency, the Chicago Tribune reported, "Obama has pledged that, if elected, all Americans would have health-care coverage by the end of his first term. He has said he is reluctant to switch to a 'single-payer' national health insurance system because of the difficulty in making a quick transition from the employer-based private system."
At his town halls as president, he routinely answers questions about single-payer by saying he would favor it if he were starting a system "from scratch." But he consistently adds that's not the goal of the current reform. "For us to transition completely from an employer-based system of private insurance to a single-payer system could be hugely disruptive, and my attitude has been that we should be able to find a way to create a uniquely American solution to this problem that controls costs but preserves the innovation that is introduced in part with a free-market system," Obama said in Annandale, Va., on July 1, 2009.
But the video strikes a very different tone from the remarks above.
To find out more about the video, we tracked down some of the people who worked on health care reform with Obama when he was a state senator in Illinois. Dr. Quentin Young said he has followed Obama's career since Obama first decided to run for state senator in 1995; he lives in Obama's Hyde Park neighborhood in Chicago. A longtime activist in health care matters, Young left his medical practice a few years ago to volunteer full time for Physicians for a National Health Program, a Chicago-based advocacy group for single-payer. The group features Obama as part of its Web site.
Young is an ardent supporter for single-payer, he said, because private insurers have an incentive to deprive people of care. "They do what they're supposed to do, which is maximize revenue, so they can pay their investors and their executives. Their profits are breathtaking and obscene" he said. "And you wonder why the health system is so costly."