Thoughts from the national single payer coalition meeting by Dr. Rob Stone
How did the women and men leaving the Seneca Falls Convention for women’s rights in 1848 feel about what they had been a part of? Did they leave with tremendous excitement, with a sense that a movement had been put into motion? With apprehension about what comes next and how much remains still to be overcome? I wonder how they felt because I’m excited by a sense that a small but important step may have been taken this week in Washington, D.C.
The meeting was held Nov. 10-11 in the Samuel Gompers Room at AFL-CIO international headquarters in downtown D.C., a few blocks from the White House. There were about 70 attendees from at least 30 different organizations, meeting in a large room dominated by a two-story-high mosaic glorifying American labor from frontier days onward. It was moderated by Michael Lighty of the CNA and opened by Quentin Young of PNHP.
Quentin noted that England in the immediate aftermath of World War II was physically, emotionally, and financially in shambles, and they elected a Labour government, whose first major move was to institute the National Health Service. There is a strong argument to make that health care reform was the engine of their recovery.
Quentin recalled that when Obama was a state senator, he was lobbying him and Barack told him that before we could ever get to single-payer health care conditions would have to be right: Democrats in control of both houses of Congress, a progressive president, and either a major depression or war to force the issue. OK, all conditions have been met, Quentin said.
Single payer is the way to deal with the housing crisis, unemployment, bankruptcy, Quentin said. It gives us the tools to control costs, to re-emphasize primary care, to improve quality of care. There will be opposition, just as there was to the original Medicare Bill in 1965. The opponents then first got it limited to just the elderly, and after that got preventative care excluded. Medicare has been attacked since its inception, and the moneyed interests have always led the attacks. Corporations are not patriotic, they have no obligation to the common good. As patriots, we must fight for a health care system we can be proud of.
The first panel opened with what has been happening around the country, especially in the labor movement, and Kay Tillow’s great work. Mark Dudzic recalled how labor support for single payer rose from ‘89 onward, only to collapse in the face of the Clinton proposal in ‘93. Quentin had earlier made the point that no country has come to national health insurance without the leadership of the labor movement. I observed that in Indiana we are already seeing important parts of our coalition, like AFSCME (not present at the meeting) and Jobs with Justice (who were present), already appearing to show some fading of support, and asked how best to address those and other groups who are now working for HCAN. I never really got that question answered; I don’t think anything close to a consensus emerged.
John Conyers addressed us over lunch and he remains passionate and energized about H.R. 676. He called single-payer universal health insurance “the most critical, remedial issue on the agenda.” He asserted that the media have been proven wrong on their assessment of the U.S. populace as “center-right” and inherently conservative. Obama was attacked as a socialist, as the most liberal member of Congress, and he still won. The media could be equally wrong about “the political feasibility argument” against single payer. I asked him about the HCAN, Kennedy, and Obama proposals, telling the story of the Memphis garbage collectors who were at the church the night MLK gave his “I have been to the mountain” speech. They came out of the service empowered that “If you walk in a room bent over, then they are going to climb up on your back. Walk in there standing tall and don’t make it easy for anyone to climb on your back.” Conyers hesitated to respond, perhaps because he didn’t want to imply that Obama was bending over.
After Conyers’ inspiring speech we heard from the AFL’s chief health care lobbyist JoAnne Volk and others, and presentations from congressional staffers, all aimed at painting the picture of what the legislative landscape looks like and how to best lobby Congress for support. Volk admitted that at this point the AFL is “not ready to wed itself to a single bill.” The best speech of the day was given by Conyers’ chief health care staffer Joel Segal, who spoke passionately, calling for action on every front we can, mobilization of as broad a coalition as possible, no holding back - now is the time.
Further presentations followed on the theme of “Tearing down the silos” to expand our work, share our experiences, and come together. Donna Smith reminded us of the importance of being “fearless.” At the end of day one there was a sense of excitement tempered by sobriety.
Day 2 started with a fact-filled, persuasive PowerPoint presentation by Len Rodberg taking on the ever-challenging topic of “How do we pay for it?” His remarks were complemented by Mark Dudzic. They were followed by a panel of folks from other organizations that are likely allies: Presbyterians, Universalist-Unitarians, Results, and David Arkush from Public Citizen. Unfortunately, no one from NOW showed up for that, but the point was made that there are lots of other groups we can pull into our coalition.
Arkush asked some cogent questions about how far we are willing to go to oppose HCAN/Kennedy/Obama. “Will we settle for less than single payer? How willing are we to attack it?” And finally, “Are we willing to kill it?” No clear answers emerged to those questions. Regarding building support for H.R. 676, Arkush said it is important get the support of some Blue Dog Democrats and some Republicans for the bill, and that in that context it is important to allay some of the fears people may have about shifting to single payer, fears that will be fanned by the insurance industry.
Should we frame the question as a moral or factual issue? The consensus was “both.” You can only get so far with “escalating experts” but the moral argument won’t work on everyone. Maybe we have been better in the past on the intellectual side, and likely we would benefit from working the moral side more, especially as we broaden the coalition into the faith community.
Over lunch, Rep. Conyers was there again, emphasizing how important he feels this movement is. David Himmelstein gave another illuminating PowerPoint presentation that included compelling evidence that Massachusetts-like reforms or FEHBP-type plans don’t work, and that single payer is the only effective solution; I never grow tired of hearing him speak. More ideas were put out than I can remember. Rose Ann DeMoro gave an inspiring, energizing talk.
Chuck Idelson from CNA and Bill Hamilton from Fenton Communications presented their “Starting from scratch” media campaign. It looked great, but I had to leave while the discussion was still going on. I’m anxiously awaiting more reports of how things came out after I left.
Lots of ideas, lots of energy, now, lots of work to do.