WurfWhile

“Let’s not confuse genuinely grass roots single payer efforts with HCAN. HCAN, in its statements of principles, takes single payer off the table from the outset. So, while they state the problems correctly, they’re not pushing the one solution that we know can work.”

A commenter on the WurfWhile.com post “Yes We HCAN!”

“The private insurance industry, as it functions today, clearly must be replaced with a system that works. So what is the solution proposed by the HCAN coalition? Let’s replace the private insurance industry with… the private insurance industry.
….
The members of Physicians for a National Health Program would take a more ‘doctorly’ approach toward reform. While the HCAN coalition is recommending placebo therapy, we would point out that effective treatment is available: a single payer national health program.”

Dr. Don McCanne, Senior Health Policy Fellow and former President of Physicians for a National Health Program (PNHP)

“$40 miilion [sic] dollars is being spent by K-Street professionals to tell the American people that the disaster of the U.S. health care system is due to the for-profit private insurance companies…. It is single payer language about the failure and evil of the for profit private insurance companies. But then they chicken out on their remedy…. But since HCAN is not really making a call to action, policy is not what this is about.
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What it really is, is about building mailing lists and fundraising and get-out-the vote for November. It is a $40 million investment in party organizing. Think of it as the Democratic messaging counterpart to the National Rifle Association. In addition, the campaign is going to take advantage of MoveOn.org’s massive data files to reach out to like-minded supporters and officials promised to work in Democratic and Republican districts alike.
….
But… gee… all that money, and no real call to specific action, except to compromise and take single payer off the table without even a fight. Now, imagine if they did everything the same, but also included in their $40 million blitz an option ask Americans to on call their Congresspeople to sign onto HR-676.”

DrSteveB

I worked in 2005-6 with Democracy for Illinois and Illinois-based Physicians for a National Health Program (PNHP) to put a universal health care referendum on the Illinois ballot. The timing was difficult - we were getting a late start if we went for a referendum in 2006 - and we had a variety of fears about waiting to put it on the ballot in 2007 or 2008. We collectively decided to go for it, but in the end just didn’t have enough signatures to make it (I believe the referendum required around a half million signatures to be safe). I learned a lot in the process and came away with a tremendous respect for single-payer activists and PNHP. One of the things I learned, however, was how crucial it is to have access to the resources necessary to do the job. When you think of successful grassroots movements, like the civil rights movement, you think of church-based organizing and the decades it took to achieve success. We wanted to achieve massive organizing within about a year - and in the end we didn’t have the resources in volunteers, organizational connections and, yes, money to do it.

What strikes me about the three quotations I start with above is how they really encapsulate the single-payer problem in the upcoming universal health care debate. Single-payer advocates are often dedicated and strong-willed grassroots activists for their cause - but they are as of now marginalized in the policy discussion, with a public that doesn’t really understand its options. Single-payer advocates have already lost the crucial framing of the current universal health care political debate because as noted the compromises for ’some sort of universal health care’ are what’s on the table - not adherence to single-payer, or we walk away. The time to win the debate was before, or at worst, during the Democratic primary. Part of why single-payer advocates have lost for now, I suspect, is because they lack the resources of “K-Street professionals” and are, as a group, not as experienced or skilled at “building mailing lists and fundraising and get[ting]-out-the vote for November.” Look at Massachusetts’ recent reform, or what happened much earlier in 2002 in Oregon, where single-payer forces lost massively,

“The early groundwork that was needed to build a coalition of Oregon supporters well in advance of an election wasn’t done. A handful of volunteers working with ‘bailing twine and duct tape’ - and [under $100,000] - were up against a well-organized opposition funded by allies with [$1.4 million war chest].”
[See also here.]

If single-payer advocacy organizations had the resources to get their message out, they likely would win. The single-payer advocates’ strength is that they are right - and Americans have borne a substantial cost for our system being so wrong so long. Lower costs, not morality, will likely dictate that we get single-payer health coverage later. Morality, not to mention economic competition, is why we should have it sooner.

You can get active with PNHP here.