Single-Payer Health Coverage, HCAN And Health Care Reform:
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...
Let's look at the assumptions here.
While it is true that the civil rights revolution was years in the making, at no time did it have significant funding. It is true that the Democratic party put civil rights in the platform in 1948, but no candidate for President ever ran on a civil rights platform, until 1964 after the passage of the Civil Rights Act. JFK certainly did not run on a civil rights platform. FDR did not run on a platform of collective bargaining and massive social programs. The Wagner Act and the Civil Rights Act came out of grassroots direct action campaigns that were poorly funded.
But let's take a more recent example. Trans Africa's campaign for sanctions against apartheid South Africa was launched on Thanksgiving 1984, right after the second Reagan landslide, while he still had a Republican Senate. After a series of demonstrations across the nation, and weekly demonstrations at the SA embassy, Trans Africa won and Reagan signed the sanctions legislation.
There is a lesson there for single payer advocates.
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I added in the links from the quote BDB
People might as well be able to go look at them.
If they weren't wrong, they wouldn't need so much money!
[ ] Very tepidly voting for Obama [ ] ?????. [ ] Any mullah-sucking billionaire-teabagging torture-loving pus-encrusted spawn of Cthulhu, bless his (R) heart.
"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi
If they weren’t wrong, they wouldn’t need so much money!
that is a great line
thanks for the help with the html, I was just too lazy to put in all the links.
Blah blah
I probably wasn't popular on the last thread since I don't see a problem with the two-step approach (public-private competition-->single payer). I don't think we are ready politically, but that doesn't mean I am not for advocating strongly for single payer. I think we need to build support for various modes of implementing single payer, how folks will transition, etc. Abstractly, SP is on solid ground but that's not enough, IMO. The two step approach will help build the case and demonstrate implementation. That's my reasoning. But advocating for SP upfront is part of the strategy for me.
That may or may not make me a defeatist.
Not a popularity contest!
Write what you believe and write well (and don't ask others to write what you would write, if only you had the time... ;-)).
And I'm just worried we'll get stuck on step one. Anyone know the history? Was Medicare step one, and then we got stuck?
[ ] Very tepidly voting for Obama [ ] ?????. [ ] Any mullah-sucking billionaire-teabagging torture-loving pus-encrusted spawn of Cthulhu, bless his (R) heart.
"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi
I'm reading some of the history now,
in Jill Quadagno's book One Nation Uninsured. I'm still back in the fifties, but just jumped ahead and scanned a bit of the chapter on the aftermath of Medicare. I can't sum up what I see there easily--there's an interesting combination of the contingent and the perhaps hidden necessary. Here's a quick, superficial summary of my quick, superficial scan:
Medicare was passed in 1965. Soon it was clear that medical costs were going through the roof, which put the issue of national health insurance back on the table. Amazingly, during the first Nixon administration the policy expert Oscar Ewing said, "Of course, it's inevitable; it's going to come because people need it." The director of the National Association of Blue Shield Plans said, "The remarkable thing is the virtual absence at this point of publicly stated opposition in some form." Walter Reuther pushed for it; Ted Kennedy introduced a couple of bills for what seems to have been single payer; Nixon proposed an alternative with an employer mandate. There was a sense of inevitability.
So what happened? Well, there was a hell of a lot of political and social uproar over various other issues around that time, to put it mildly. Ted Kennedy got caught up in Chappaquiddick. Nixon got caught up in Watergate. Wilbur Mills, who was a legislative powerhouse and sometime ally of Kennedy, got caught in the Fannie Flagg scandal. Everybody was exercised about Vietnam.
Still, President Ford proposed national health insurance as the most important piece of domestic legislation for his first year. But the economy tanked, the oil crisis happened, and proponents settled for a piecemeal approach; there was no sustained public demand for national health insurance given everything else that was going on.
Kind of scarily similar to where we are now, in some ways.
If Medicare had not been passed in 1965, would it have gone any better for national health insurance? There's no clear answer. Quite possibly, we'd have gotten Medicare in the '70s, or we'd have gotten nothing at all.
Incidentally, Ted Kennedy has been there on this issue for a long time. Wouldn't it be great if he could see his efforts come to fruition before that brain tumor gets him?
Policy not party!
Popular, shmopular.
Disagreement (politely expressed) helps me think.
Policy not party!
Kennedy
Incidentally, Ted Kennedy has been there on this issue for a long time. Wouldn’t it be great if he could see his efforts come to fruition before that brain tumor gets him?
I am worried that Kennedy will permit Obama to flummox him into passing some piece meal drivel just so Kennedy can get his name on something rather than insisting on single payer. And the rest of the Senate will defer to Kennedy, unless we can find another champion in the Senate. Kennedy is chair of the Health committee, so that makes it trickier.
Kennedy killed Carter's hospital cost containment legislation, can't remember the details now.
Just like NCLB...
... where Bush suckered Kennedy into that Bipartisan
Clusterfuck
.
[ ] Very tepidly voting for Obama [ ] ?????. [ ] Any mullah-sucking billionaire-teabagging torture-loving pus-encrusted spawn of Cthulhu, bless his (R) heart.
"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi
Kennedy and Carter
Continuing with my skim of Jill Quadagno's book:
During his campaign, Carter "reluctantly promised to pursue national health insurance" in response to the unions, who were "pushed" by Kennedy. After the inauguration, Carter promised support for whatever Kennedy would come up with as long as it included a role for the insurance companies.
But because of inflation, Carter had to tackle cost containment first. There are four pages on this struggle, where Carter was opposed by the hospitals, doctors, and "key business groups," but Kennedy isn't mentioned here, so I can't provide any details on that.
At long last Carter proposed a plan to achieve universal coverage in stages, to placate the unions and Kennedy, but the sticking point was that he wouldn't agree to an automatic kick-in for each stage. Kennedy proposed his own plan, as well as declaring his candidacy for president. Carter countered with his (not universal, a large role for private insurance). Finally they agreed on a compromise bill, but national health insurance became a dead issue with the Iran crisis and the collapse of Carter's approval.
I'm starting to get a takeaway lesson here--I think DCblogger's emphasis on a relentless movement pushing for single payer is just right. We seem to have lost out due to a short national attention span almost as much as because of the political opposition.
But we have to be a lot more relentless and a lot louder and maybe somewhat rude. If it's not already too late.
Policy not party!