It’s been awhile since Obama’s proposal for universal health care was replaced by a compromise known as the Affordable Care Act. Despite detractors from the right and left, Obamacare’s sell–that the Act would give millions of uninsured Americans coverage–appeased many. But now, as we wait to hear the Supreme Court’s decision on the constitutionality of the Affordable Care Act, some have begun to whisper of a second chance for a single-payer system.

If the Supreme Court declares the Affordable Care Act’s individual mandate unconstitutional, single-payer will almost certainly be back on the table, writes Yes! Magazine’s Sarah van Gelder (citing Labor Secretary Robert Reich and columnist Rick Ungar of Forbes Magazine). Van Gelder argues that single-payer is what Americans want. “In poll after poll, a majority of Americans have expressed support for single-payer health care or national health insurance.”

This may be the chance to get it, but proponents will have to make their voices heard. “[I]t would be a long and difficult process,” reasons Arnold Relman in The American Prospect, “that would be bitterly opposed by the private insurance industry and its friends […] Nevertheless, there are reasons I believe this transformation has at least a chance of becoming reality.” With an informed, engaged public and strong support from doctors, Relman writes, single-payer advocates stand a fighting chance to win the attention of legislators and outweigh the influence of lobbyists.

The stakes may be higher than ever, since a single-payer system would save Americans $570 billion, reports economist Gerald Friedman in Dollars & Sense. Though a single-payer system "would raise some costs by providing access to care for those currently uninsured or under-insured, it would save much larger sums by eliminating insurance middlemen and radically simplifying payment to doctors and hospitals. While providing superior health care, a single-payer system would save as much as $570 billion now wasted on administrative overhead and monopoly profits.” In the midst of a recession, with great need to invest in renewable energy sources, education, sustainable transportation, and local food systems, Americans may have a chance to do more with their money than line the pockets of insurance company shareholders.

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Image by Keith Ellison, licensed under Creative Commons.