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Journal of Health Politics, Policy and Law 2009 34(4):531-542; DOI:10.1215/03616878-2009-014
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Single Payer—Good Metaphor, Bad Politics

Deborah Stone

Dartmouth College

Health insurance reform requires political solutions, not technocratic fixes. Single payer frames the problem as a grossly inefficient bursar's office. Great political leadership means reframing the problem as a faulty social compact, rewriting the compact, and making everybody play by the new rules. Most of all, great leadership means explaining in powerful language why participating in the new social compact would fulfill both enlightened self-interest and social responsibility.


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