The U.S. House of Representatives has committed to bringing single-payer healthcare to a vote following summer recess. Stranger things have happened, greater obstacles have been overcome, than what would be involved in winning that vote, winning in the Senate, and compelling the president to sign the bill. We have a moral responsibility to put everything we have into trying; and even a near-victory will advance the cause.
But it is important to recognize exactly how that promise of a floor vote on single-payer came to be, what else is at stake, and what we are up against. Being properly informed, I think, will not diminish by one iota the ferocity of our campaign for justice, but it will alter our strategy by adding a secondary demand to it. For those either too mentally feeble, or — much more commonly — who imagine their fellow citizens to be too mentally feeble, to keep two tiny things in their heads at once, I don’t know what to say other than: please throw away your television.
When Antonio Gramsci referred to the pessimism of the intellect and optimism of the will, I think he meant to renounce the idea that one can best campaign for justice if filled up with false beliefs that victory will be easy. I think one can best campaign for justice if one knows exactly what one is up against but doesn’t give a damn how grim that picture appears.
So, here’s the truth. Congress is not voting on single-payer healthcare purely because we forced it to, or because the bill is (prior to our shaking the country up this summer) even remotely likely to pass. Our advocacy for single-payer has had an impact. We’re a big reason why some congress members are fighting for a public option. Whether or not you consider any of the current versions of public option worth the paper they’re written on, the fact is they’d be weaker without the public demand for single-payer, and were that demand stronger so would the public option be. Our work has also led to passage in the House Education and Labor Committee of an amendment that would make it easier for states to create single-payer systems. And our advocacy led to the promise of a floor vote on single payer in the fall.
But the floor vote was negotiated as an alternative to a vote in the Energy and Commerce Committee. We lost the opportunity to have a vote there. And the Democratic Party leadership, which largely takes its orders from the White House on this, was not so much afraid that single-payer would win on the merits, as that it would pass because Republicans voted for it purely out of spite. The Democratic “leaders” badly wanted to get a bill out of that committee before August, a bill that would at least vaguely resemble the bills passed by two other House committees. Rather than risk failing in that goal, they preferred to allow a floor vote later that would not interfere with the bill they want to pass, and which itself — at least in their minds — would be extremely unlikely to succeed.
Allowing such a vote would have another positive side-effect from the point of view of those in charge: it would overwhelmingly distract attention from the state single-payer language passed by the Education and Labor Committee. From their point of view, national single-payer will not pass on the floor this year, not with them whipping hard against it and the Republicans opposing it. But if the language on allowing states to do state-level single-payer is left in the bill that they whip for and pass, it’s unlikely to cost them any Blue Dog votes, and it’s likely to result in a number of states fairly quickly taking actions that accelerate public awareness of the shortcomings of the federal reforms.
From the point of view of people who really want to get our population better healthcare and who have not been purchased by insurance, drug, and hospital companies, lobbying for Yes votes on single-payer AND lobbying to leave the states language in the non-single-payer bill (or at least allow a vote on it) seems to make a lot of sense. We’re saying that we want single-payer nationally, but that if they won’t give it to us right away, we at least want states to be left free to lead the way. Canada arrived at its system after a province led the way, and the first state likely to create single-payer, California, is about the same size as Canada. If Canada’s system does so much good, why would we deny the same to California?
For those lobbying directly for a public option, it also makes perfect sense to demand freedom for states to do better faster. If the goal is providing more people with better healthcare, if the goal is not to avoid making the federal government look second best, if the goal is not to achieve a perverse hyper-simplicity of “messaging,” then including the state single-payer language in August demands is the way to go.
Does mentioning allowing states to do single-payer subtract from demanding that the nation do it? I can’t see how.
Does avoiding the topic risk tossing aside our best chance at advancing the cause? Absolutely.
Here’s the message we should have: We demand national single-payer or at least the right for states to do it.
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