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Flavio (San Francisco, CA)

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My main interest is discussing the role of the health care fight in the broader context of advancing a progressive agenda. I also urge unity between SinglePayer and non-SinglePayer progressives.

In response to Nick Skala's "Hold out for Single Payer"

By Flavio - Jun 13th, 2009 at 9:02 pm EDT

1.
This health care fight has a dual nature. One goal is to reform the health care system so that we foster health equity in the country. The other goal lies in the political situation in Washington. Last november's victory was a very positive, very exciting, and very hopeful defeat of the most reactionary, most cynical, and most destructive elements of the right wing. Their defeat ushered not only the first African American President in our nation's history, but also a myriad of opportunities to advance a broad progressive agenda that includes healthcare reform in addition to protecting collective bargaining rights, immigration reform, educaiton funding, energy policy, peace, etc. I think both SP and public option folks can agree that it is senseless to be single-issue minded when it comes to health, given all the social determinants of illness.

Importantly, with our victory last november we actually created a path to winning a SP system. While we fought for SP in the dark Bush years, we knew that there was NO way to muster veto-proof support for HR676. Now, we dont have to. We can actually see a political path to winning SP. However, that path is not immediate. I cite Ellen's posting on the House of Representatives Math. We need 218 votes to pass anything in the House, and there are only 206 non-blue dog democrats. To pass anything in this session, we need at least 12 Blue Dogs or Republicans. We know we cannot win these for HR676 or HR1200. In fact, HR676 has 78 sponsors right now...140 short of the necessary 218.

What will absolutely close the door to SP is a right-wing come back in the midterm elections. If we loose ground in 2010, SP will be ever more difficult to win that it is now. Like it or not, this is how our democracy works. So, Nick, it's not just winning for the sake of winning. I am a strong SP supporter, but I believe that our success in winning SP depends on Obama remaining strong and getting stronger. A defeat for the President and the public option folks is not only a defeat for THEM, it's a major defeat for US because it puts us on terrible footing for the coming elections. Furthermore, if we lose on this health care fight, it will be much harder for us to win on tons of other issues that, for our patients, are equally important: immigration reform, education funding, incarceration policy, food policy, affirmative action, occupational safety, environmental safety, reproductive choice, marriage equality, judicial appointments, NLRB appointments, the role of science in policy formulation, etc.

What is critical now is for all progressive health care activists, SP and non-SP, to come together and fight to get the most advanced demand we can right now and consolidate/expand the victory of last november. If we don't do this together, we will all lose.

2.
Older SP activists will remember that they too were once called sell-outs for willing to compromise on a national health service and fight "only" for SP. In fact, as recently as 2005-2006, activists were fighting for HR3000, the "Josephine Butler United States Health Service Act" introduced by Rep Barbara Lee (D-CA). The act "Establishes the United States Health Service as an independent executive branch entity to provide health care and supplemental health services to all individuals within the United States."
Now if we are committed to, as Nick says, "remedying the systemic defects that cause their patients to suffer and die", than clearly we should be working for HR3000, and not the inferior HR676, which would allow the continuation of the patchwork of for-profit hospitals, dialysis centers, off-site surgi-centers, for-profit imaging, physician self-referrals, non-negotiating with device- and pharmaceutical-manufactureres, and so on. If we are serious towards creating health equity in this country, we all know we have to go way beyond HR676. So 15 years ago, why did SP folks "sell out" and react against their more dogmatic friends who were fighting for a solution they were convinced could never win in America? Is it because they stopped caring? Or maybe because they desired a political victory more than real reform for their patients? Why abandon what they know, as evidence shows, works for something more politically feasible? I think the answer is because politics exist and it matters. I reject the notion that HR676 supporters care less, or "get it less", than HR3000 supporters.

We make the most advanced demand when we can, fight to win it, and in the process build a movement that can make even more advanced demands in the future. In the aftermath of the Obama victory, there is a huge opportunity to grow our movement, win a robust public option, win single payer, and, yes, win beyond!

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