The biggest secret of politics in the United States is that a majority of the population is to the left of both major parties. This can be amply demonstrated by comparing public opinion on a host of issues to the policies pushed by corporate and political elites. Whether it’s US aggression overseas, raising taxes on corporations and the super-rich, expanding social services or any number of other issues, there is a vast disconnect between the people and those who purport to represent them.

This perhaps more than anything explains the widespread lack of public interest in voting. Rather than a result of apathy or ignorance, as many elite pundits arrogantly assert, public withdrawal from the electoral process is actually an informed choice. Since the policies of both major parties are generally in opposition to the will of the public, people often rightly view voting as a lose-lose proposition. As a result, voter turn-out in the United States is significantly lower than anywhere else in the industrialized world, plus millions who do vote – perhaps even a majority – do so with little enthusiasm.

On no issue is the disconnect between elites and the public more striking than health care. For decades, public opinion has favored a single payer system such as exists in every other industrialized country. Simultaneously, corporate elites and their representatives in the two major parties have been waging an unrelenting war on the people’s right to comprehensive health care. Their goals, among others, are to privatize Medicare, destroy Medicaid, and shift the cost of employment-based plans in both the public and private sectors to workers via rising co-pays, deductibles and premiums even as coverage diminishes.

The disconnect between the people and elites is what lends the so-called discussion about the Patient Protection and Affordable Care Act (PPACA) now before the Supreme Court such a comical tone. Amidst all the pathetic cries about Obamacare, nowhere is it mentioned that millions of those who oppose PPACA do so not because it’s a Marxist-Leninist attack on individual liberty, but because they favor single payer and recognize the law as a sell-out to the insurance and pharmaceutical industries. President Obama did not call on those who live and work on the frontlines of the health care crisis – nurses, social workers, public health advocates, the uninsured, those with insurance who have been denied necessary care – to write the bill. He handed that task over to members of the insurance industry, and they have been salivating since its passage at the billions of dollars in additional profits they will reap if and when PPACA goes into effect.

The Democrats’ claim that there was no political will for a public option, let alone single payer, was Elite Speak for those of us in charge don’t care a wit what the public wants. No one who’s paying the slightest bit of attention should have expected otherwise. Candidate Obama received $25 million in campaign contributions from the insurance industry in 2008, after all, roughly four times as much as John McCain. And as many nine-year olds understand (not to mention most anyone not in the employ of Fox News), Met Life, Big Pharma and the rest of the ruling class are not in the business of financing Marxist-Leninist revolution.

Following the lead of the rest of the world is off the table in the boardrooms of the super rich even though the lack of a single payer system has been an important factor in the decline in the competitiveness of US industry (Swedish, Japanese and German automakers, for example, do not have to pay a dime for workers’ health insurance). Instead, the super rich pursue a two-pronged plan of moving production to countries where workers are paid subsistence wages and have few rights, on the one hand, while attacking the living standards of those domestic industrial workers who remain. Alongside plant closures and union-busting, the massive shift of the costs of employer health plans to workers has been a major piece of the unprecedented upward redistribution of wealth that’s occurred in this country over the last forty years.

Regardless of what the Supreme Court decides on the PPACA, our wholly inadequate health care system will likely worsen in every way over the short term. Costs to the public will rise, more and more care will be denied, needed services will remain at inadequate levels or disappear altogether, women, people of color and children will be disproportionately impacted, and the overall result will be a further deterioration in living standards for the vast majority. Meanwhile, the super-rich and the political class that serves them (and which enjoys top notch, government-financed health insurance) party all the way to the bank.

Momentum for a single payer system is far from dead, however. Like all efforts for social justice, the push for single payer received a tremendous infusion of energy from the Occupy Wall Street phenomenon. Occupy has shone much-needed light on who it is that really owns this country. If that light continues to grow brighter, real health care reforms – not to mention many other necessary changes – are still a possibility.