Where once the left could onlydream of a hybrid system like Obamacare, today politicians areopenly calling for a system where the government is the onlyhealth-insurance provider. (Image: Shutterstock)

Things are shifting in the economic policy world. John Cochrane,an economist at the Hoover Institution and a staunch free-marketer,has been a leading critic of Obamacare and an advocate of alaissez-faire approach to health care. But in arecent blog post, he expressed sympathy for the idea of a single-payer health system:

A single provider or payer [that]anyone in trouble can use, supported by taxes … while allowing avibrant completely competitive free market in private health careon top of that, is not such a terrible idea. … A single bureaucracythat hands out vouchers, pays full market costs, or pays partiallybut allows doctors to charge whatever they want on top of thatwould work.

Related: Single-payer gains momentum among AMAdoctors

This is actually closer to a public option (though Cochrane alsosuggests a system of government-run hospitals and clinics similarto the Veterans Health Administration).

Cochrane's endorsement of government-provided universal healthcare seems to mark an important milestone. Just nine years ago,during the debate over the Affordable Care Act, the notion ofuniversal health care was itself considered radical — Obamacare wasan enormous, complex compromise, and the public option wasconsidered a bridge too far. Now there seems to be a spreadingrealization that the government needs to do more, not less — tosimplify the U.S. health-care system, if nothing else.

Where once the left could only dream of a hybrid system likeObamacare, today politicians like congressional candidateAlexandria Ocasio-Cortez and U.S. Senator Bernie Sanders are openlycalling for a system where the government is the onlyhealth-insurance provider. Meanwhile, center-left leaders arerushing to come up with compromise proposals that preserve somerole for private insurers.

Some of these proposals amount to extensions or reinforcementsof the Obamacare system; some are more ambitious. My personalfavorite is Medicare X, proposed by Senators Michael Bennet and TimKaine, which would allow any American to buy into a somewhatexpanded version of the current Medicare system. That system wouldleverage Medicare's proven ability to hold down costs, whileoffering consumers a menu of choices — basically, Cochrane'sidea.

Health care isn't the only issue where the Overton Window — orthe range of ideas deemed worthy of consideration — has shifted tothe left. The idea of a federal job guarantee, once considered aradical proposal, is now a centerpiece of Ocasio-Cortez's platform.And as with health care, center-left leaders are coming up withcompromise proposals that move somewhat in the direction of the bignew socialist idea.

California Democratic Representative Ro Khanna has released aplan that would use a combination of government jobs andprivate-sector employment subsidies to launch a multipronged attackon unemployment and underemployment — not the most urgent ofpolicies with unemployment as low as it is now, but very useful tohave in place when the next recession comes. His plan would findjobs for workers who are out of work for 90 days or more,attempting to place them in the private or nonprofit sectors, andprovide subsidies to encourage this. It would offer temporarygovernment employment, but only for those who couldn't find jobselsewhere. The plan also provides funding for cities to experimentwith full public job-guarantee programs of the kind Sanders hascalled for.

Khanna's plan seems like a good one. Private-sector employmentsubsidies have a track record of success — evidence shows that theyboost workers' likelihood of employment years after the policyfinishes. The U.S. also had good success with a smaller job subsidyprogram during the Great Recession. And the idea of experimentingwith Sanders-style job guarantees at the local level is a good one,since it would provide more data on whether that sort of programcan work in the U.S. Senator Cory Booker has also proposed thesekinds of experiments.

It's great that people on the center-left — and even some on thecenter-right — are advancing sensible proposals like Medicare X andKhanna's jobs plan. These plans would allow the country to movetoward a more egalitarian society at a deliberate pace, rather thana breakneck rush. Countries like Denmark that have built successfulsocial democracies have not done it with guillotines andrevolution, but with a series of measured reforms. Meanwhile,modern-day countries like Venezuela that have gone in for a moreradical approach have often ended up as basket cases. It'sobviously better to be Denmark than Venezuela.

Measured reforms allow a country to “cross the river by feelingthe stones,” as Chinese reformer Deng Xiaoping once put it.Deliberation allows policy makers to find out what works, to getdata and feedback, to understand both the drawbacks and the furtheropportunities their initiatives create, and to experiment withlocalized approaches. They are, in short, a smart way to improve acountry.

Meanwhile, the more dramatic proposals of socialists likeOcasio-Cortez and Sanders have their place in a healthy debate ofideas, although that doesn't mean they should be enacted. Instead,they should serve as guiding compasses for reformers to follow —stylized depictions of egalitarian ideas to be moved toward ratherthan fully realized.

This column does not necessarily reflect the opinion of theeditorial board or Bloomberg LP and its owners.

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