I'm not so sure its all that far. Sure, it would be nuts for Obama to start bashing the system he set up and move to another idea, but when I see some liberals arguing online how "Obama was crazy to listen to conservatives" and how cooperative he was setting up a conservative health care system designed by Mitt Romney and the Heritage foundation rather than the single payer Canadian model he wanted I can see how such a move is possible. You also have a bit more confidence in the people than me. Have you see some recent man in the street style interviews lately? Its absolutely amazing how clueless and devoid of knowledge the people are after watching reality shows and discussing the latest scandal like the Miley Cyrus twerking or whatever they call it. Its more important for the people to discuss Cyrus sticking out her tongue like a basset hound than it is to be concerned about issues that really matter.
Make no mistake, I have no faith in the common sense of the American public as a group. I do however have faith in their self-interested nature. I don't mean that to disparage people at large. Quite the contrary. I think the predictable self-interested behavior of people is generally a good thing.
It takes some huge and obvious problem for that nature to kick in and actually motivate citizens to impact policy and/or elections but this issue is just such a thing.
What's going to cause people to recoil from this, or at least away from single-payer alternatives, are the things that mostly haven't kicked in yet. Insurance companies are canceling plans by the hundreds of thousands. The premiums that were supposed to go down, or at worst stay the same, for those who already had insurance are actually going up. In some cases dramatically. Those who have to sign up or who want to sign up, generally can't still.
These are the big obvious things that will actually draw people's ire. Whatever your position on this Presidency, most of its issues so far (the various scandals, the foreign policy blunders) have been arcane issues that don't hit citizens' personal self interest. Not so with this.
If they can get it fixed in a hurry and the early indications about the structural issues with the demographics of the population who are actually signing up turn out to be wrong, they'll be able to fix this and in the long run it probably won't be that big of a deal politically. But those are two GIANT ifs. Most indications are that it won't be fixed quickly (meaning they'll have to take some action to avoid penalizing people early next year for not using a system that doesn't work) and, the bigger problem that isn't getting much attention yet, is that the demographic issues of those signing up put this thing on a path to collapsing. They are massively behind where they need to be on signups and what information there is so far says that the majority of people who are signing up are either Medicare recipients (who are essentially being directed right back onto Medicare) or are those who can't get a policy anywhere else because of medical history or pre-existing conditions.
In other words, the expensive side of the population is signing up in droves. The profitable side of the system is NOT signing up at all which, if not corrected, will cause this thing to fall apart under a wave of skyrocketing premiums that, and this is key, will be passed on to everyone with an insurance policy, not just those who get their insurance through the exchanges. The entirety of the individual mandate was to give insurance companies a way to avoid losing money in the face of all the new coverage requirements (particular treatments, no denying pre-existing conditions, etc). If the individual mandate is ignored by those whom it applies to, ACA explodes.
These are the things that make the switch to single payer a bridge too far. This is doubly true when you compare the results that people will feel with the very well known and well publicized statements about the impact of Obamacare on the healthcare market.
- If you like your insurance, you can keep it.
- If you like your doctor, you can keep him.
- We will lower premiums for the average family by $2,500 a year.
People remember those. Those are the kind of big ticket promises that, if broken, change elections.
Should they be unable to fix the system quickly or should they fail to correct the structural flaws in the system (both reasonable predictions given the current state today) this will massively impact individuals' and families' wallets and runs counter to the very obvious promises the laws backers put forward. Those two combined, but particularly the first one, are exactly what motivates the American public.