[Peace-discuss] Single Payer: Which Way Forward?

[David Johnson]

To say that there's a political disconnect in the fight for a national
single payer health care delivery system is to state the obvious. We will
NEVER obtain Single Payer in the U.S. unless the Medicare for All movement
begins to realize the political realities and start a movement that
resembles the scale and confrontation to power that the civil rights
movement of the 1960's did.

 

Single Payer: Which Way Forward?

By Ed Grystar, Dissident Voice. 

January 19, 2021 


| Popular Resistance


 <https://popularresistance.org/strategize/> Strategize!

To say that there's a political disconnect in the fight for a national
single payer health care delivery system is to state the obvious. The
struggle for M4ALL has grown due to decades of grassroots organizing
alongside the gradual worsening of Americans' health insurance coverage,
with support now reaching 70% in the general public as reported by FOX News
after the November elections.

Yet now in the middle of a pandemic, where the USA accounts for a quarter of
the world's infections, and a third of the deaths, the USA's for-profit
healthcare system has no national plan or coordinated response. Instead,
since so few Americans are going to the doctor this year, there is
resounding joy in the industry as profits mount simultaneously with the
despair of millions. The NYT reported an "embarrassment of profits" for some
of the largest health insurance companies, a doubling of profits in the
second quarter of 2020 compared to 2019. These obscene profits are coupled
with staggering increases in wealth for billionaires in the healthcare
sector. Their wealth has increased by 36.3% from 402.3 billion to $548
billion between April 7 and July 31, 2020. All this stands in sharp contrast
to failing rural and inner city hospitals, smaller medical practices and the
hundreds of thousands of unnecessary COVID deaths.

For journalists and talking heads in the mainstream media, this
dysfunctional monstrosity is just the acceptable reality of our healthcare
system. Discussing any responsibility or alternatives are disregarded.

With millions losing their job-based health coverage, millions more stuck
with high insurance costs and lower benefits, Medicare for All is once again
deemed off-the-table by all major politicians, including even its biggest
proponents.

This disconnect comes on top of a worsening economic crisis threatening to
push millions out of their homes while half the population is living
paycheck to paycheck, poverty rising and food insecurity is growing. On the
other side of the class divide, trillions of dollars have been showered on
the wealthy and corporations via the misnamed CARES ACT, and the world's
billionaires have increased their wealth 10.2 trillion during the COVID
pandemic. If there's ever a perfect storm of economic, social, and public
health crises, it is now.

The Republican leadership has taken advantage of this crisis and assigned
blame to the largely unpopular ACA and fixated on its destruction. It has
spent its political energy focusing on the high costs and other weaknesses
of the ACA while never offering anything as a credible replacement.

On the other end of the aisle, President Biden has clearly stated his
opposition to M4ALL, promising to veto the bill if passed. Democrat House
leader Nancy Pelosi is equally opposed, making the chances of a vote remote
under the current leadership. The current Democrat platform focuses on
"strengthening" the ACA, an easy attack vector for Republicans who are able
to exploit the real failures of the ACA and continue to disorient the
public.

With these pitiful responses, disillusionment with the system is prevalent,
and Americans are looking for alternatives.

Controlled Opposition or Bottom Up Independent Movement?

Which brings us to the nub of the issue. The M4ALL movement has grown,
support is high and the need greater than ever. Grassroots organizing, the
COVID-19 death spiral, combined with the continued deterioration of
coverages and rising insurance costs has moved public support to a higher
level despite a blizzard of attacks by opponents ranging from the insurance
industry, media talking heads, politicians of both parties, unions, and
liberals.

As it currently stands, the public overwhelmingly favors M4ALL, and the main
legislation, HR 1384, has over 100 cosponsors. Yet there's no clear strategy
or energy emerging to push the bill forward in Congress or mobilize public
support at this crucial time.

Despite an even deeper crisis than the 2008 recession, we are headed for a
repeat of 2009, when the late John Conyers sponsored SP bill had more
co-signers than any other healthcare legislation at the time, but was
ditched by Democrats in favor of the ACA, a bill written by the insurance
industry.

Once again, Democrats are poised to join with Republicans to scuttle the
immensely popular bill in favor of the insurance industry again, all under
the meek disguise of "getting something accomplished".

Clearly, the M4All movement needs to rise to the occasion - or else risk
jeopardizing its own credibility. Not only has public opinion overwhelmingly
shifted in favor of M4All, but large numbers of Americans are ready to fight
for it as well. The Bernie Sanders 2020 campaign drew huge amounts of
activists out week after week for canvassing racked up a record number of
donations.

Now with the Sanders movement gone, and the pandemic exposing the injustices
within the healthcare system, M4All supporters are looking for answers.

The recent proposal by Jimmy Dore, YouTube political comedian, to force a
vote on M4ALL in the House galvanized supporters, drawing tens of thousands
to virtual town halls, but was overwhelmingly refuted by the officaldom of
the Medicare for All movement. This has brought light on all the weaknesses
of the present approach - an insider strategy that gives Congressional
Democrats and the organizations that align with them too much power to
unilaterally determine the direction of the struggle, while stifling voices
in the grassroots. At this crucial moment, the strengthening of a popular
movement is pushed aside for the sake of maintaining favorability within
subsets of the Democratic party. In reality, grassroots energy is the real
source of power. Rather than hitch their horses to insiders, movement
leaders must drive the car, act and work in a non-partisan fashion to
actually build real power.

Where some critics of Dore agree with building a mass organizing force, they
scoff at his proposal and instead say work must be confined within select
electoral races tied to the Democratic party and insist congressional
supporters like Jayapal and Ocasio Cortez are "allies" and should not be
subject to criticism. Besides the "Squad", there are already over 100
co-signers of HB1384. What is their role in strengthening the grassroots
movement? Will they hold town hall meetings and build public coalitions in
their district?

Movement leaders must realize that the members of Congress must be dealt
with from positions of principle and independence. Otherwise, the insider
compromises progressive reps are subject to trickle down to the movement. If
AOC says Medicare for All is off the table, the movement is weakened if
there's not leadership elsewhere standing up and pushing it forward. Public
support is strong but we are up against an industry that is prepared to
spend whatever is necessary to fight us at every turn - leadership is
crucial.

In the period ahead, the peoples expectations will grow and the need for
M4ALL will become clearer but so will the power of corporate Democrats who
now control all branches of government. They will muzzle any grassroots mass
actions and push the insider strategy and demand obedience.

Movement leaders should be wise to exploit a house vote, which would help
many to understand the huge disconnect between Congress and the public.
Actions like this can aid in forming a diverse coalition of labor, racial
justice, and public health organizations to push for large demonstrations,
public hearings, and petition drives. This is what we need to build towards:
a united bloc of grassroots organizations and unions to push legislators to
act.

Labor Needs to Step Up and Fight

However, labor and other organizations that should rise to the occasion and
provide resources and independent leadership at this critical juncture are
simply not capable, largely due to their deep ties to the Democratic party.

Organized labor has been in a steady state of decline for the past few
decades. Rather than use popular struggles such as M4A to try to gain back
some ground, it has largely doubled down on the business union model of
operation, which treats employers as "partners", abandons the role of
membership education, mobilization, and community outreach to increase union
strength and the labor movement at-large.

The lack of an organized independent current inside labor challenging the
dead-end strategy of cooperation holds labor back. Witness labor's silence
over the past months on demanding wages be paid and healthcare for all
workers during the pandemic, something almost all other developed countries
have done. Despite hundreds of resolutions over the past decade supporting
M4ALL at all levels of labor, real support is weak and ultimately folds when
the Democrats give the orders. It has no real life or energy outside of a
small handful of unions, and much of labor officialdom is indifferent or
simply hostile to M4A, seeing brokered insurance plans as one of their last
few selling points of a union to many workers, despite the share of
unionized workers dropping yearly. This puts most of the top labor
leadership at odds with both the growing mass of unorganized workers without
unions and public opinion who are sympathetic to M4ALL and need real
healthcare.

In order to win M4A, other popular programs, and stave off its own decline,
labor needs a mass upsurge against the corporate domination of society and
its political allies. History shows that when labor engages its rank and
file into popular action, it can sweep away major hurdles that seemed
impossible to overcome. The passage of Social Security in the 1930's is one
such example.

It needs an internal revitalization that advocates a fighting alternative
program that mobilizes and puts people first instead of taking cues from
"corporate partners" and Democratic politicians as to what is on and off the
table. Building this necessary independent movement will ultimately clash
with the party, and this is why Dore's proposal has struck such a nerve. The
multiple unfolding crises have put the need for a fundamental change in
plain sight and progressives need to rise to the occasion.

If our only hope for Medicare for All is phone banking for intermediate
legislation deemed "on the table" by the progressive caucus and working to
elect more progressive Democrats to Congress, the movement will never
actually move forward. With an independent movement that doesn't take cues
from "allies" in Congress, but instead uses them to help move the agenda
forward, we can reach a stage where it isn't an isolated YouTube personality
making such a suggestion but membership-led organizations, backed with the
participation of ordinary people, who see themselves playing a real role in
this fight.

Ed Grystar is Chair of the Western Pennsylvania Coalition for Single Payer
Healthcare. He has over thirty years experience in labor and health justice
movements. Served as President of Butler County (PA) United Labor Council,
AFL-CIO from 1987-2002, Western PA Labor coordinator for Jesse Jackson for
President in 1988, PA coordinator for Dennis Kucinich for President in 2004.
He has worked for a number of healthcare unions.

 

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