“I happen to be a proponent of a Single-payer universal health care plan. I see no reason why the United States – the wealthiest country in the history of the world – is spending 14% of its Gross National Product on health care and cannot provide basic health insurance to everybody.”

Those are Barack Obama’s words, spoken in 2003.

During a speech to a joint-session of Congress on September 9th, Obama distanced himself from the Single-payer system, referring to it as a “radical shift that would disrupt the health care most people currently have.”

Keep in mind that the “health care most people currently have” happens to be terrible. Among industrialized democracies, our system is an embarrassing outlier, even more so because we spend the highest GDP percentage on health. A disruption is precisely what’s needed.

I don’t fault Obama simply because he changed his stance. If an idea doesn’t work, it should be refined – or abandoned.

Nor do I fault him for attempting reform that’s “politically realistic.” While I would prefer a revolution in health care, I know that reform could provide critical relief for millions of struggling Americans.

But I do fault Obama for his seemingly eager capitulations. In 2003, he supported a Single-payer plan. A few months ago, he instead insisted on a Public Option. But now even the Public Option comes draped in a white flag.

Why does the president continually slide-step to the Right? Poll after poll after poll, going back decades, shows that an overwhelming majority of the population believes the health care system needs to be overhauled or fundamentally reshaped. A majority also thinks the government should be responsible for guaranteeing universal health care, with most wanting the government to provide it.

Yet, despite the backing of the public, and despite the fact his party controls the White House, the Senate and the House, Obama proposed a convoluted hodgepodge of concessions – all of which do little to address the system’s inherent deficiency: It’s for-profit structure. The plan would attempt to expand coverage through insurance companies, which would have the opportunity to “compete for millions of new customers.”

Some liberals, weary from decades of political defeat, praise Obama for offering these scraps of reform, and I join them in being pleased that a more humane system could soon be realized. But we’re deluding ourselves if we think this plan doesn’t represent another defeat.

The real winners are sitting in offices at major health insurance companies like Aetna, UnitedHealth Group and Wellpoint. The stock prices for all three went up the day after Obama’s speech, and they have been making impressive gains in the last three months as Single-payer and the Public Option have faded from the agenda.

These companies know they won’t be punished for years of reaping exploitative profits from the sick and the dying. Rather, they’ll likely see a wave of new profits as health coverage is expanded under their management. Somehow that’s praised as pragmatic reform, instead of being criticized as more evidence of the population’s insignificance in domestic policy.

If we allow these companies to continue running health care, we’ll inevitably find that they value our lives only to the extent that we pay them.