Student activism for single payer

Report Back from the 4th Annual Students for a National Health Program (SNaHP) Summit

The 4th annual SNaHP summit took place on Saturday, February 14, 2015, on the medical campus of the University of Illinois-Chicago. More than 170 medical and health professional students from over 50 schools gathered to discuss single payer, develop their activism and advocacy skills, and create a national strategy for achieving Medicare for All. There were students from states that had never been represented before including, among others, Alabama, Florida, Tennessee, and North Carolina. The fact that so many students, more than double the number that attended the prior year, flocked to Chicago on Valentine’s Day is a testament to the growing commitment of health professional students to achieving equitable and universal access to health care. Click on the link below to view presentations and photos from the conference.


Guest Comment: 

By Scott Goldberg, MS3 

I had the honor of delivering the opening address – entitled “Where We’ve Been and Why We’ll Win – at the 4th annual SNaHP summit. The talk focused on the century-long struggle for national health insurance, what we can learn from these efforts, and why students are well-positioned to spark a broad, social movement for single payer. Here is an excerpt from the speech:

“Now, I’m not disillusioned by the 100-plus year history of failing to achieve national health insurance. In fact, there are important lessons that can inform our efforts and that give me hope that we will be successful where those before us were not.

First, the AMA has opposed single payer since 1917. But while the AMA could honestly say it represented the voice of doctors, it no longer can. Only about 20 percent of physicians are members. This provides an opening, for another physician organization to step into the void that speaks on behalf of what is just and right for patients. You may see where I’m going with this – but this is where Physicians for a National Health Program comes in. PNHP is the only physician organization dedicated to the sole purpose of transforming American health care by passing NHI. And the organization can only grow. If there are 800,000 active doctors in this country, then about 2.5% of them are members of PNHP. This means we, as students and future doctors, have a lot of work to do to get our colleagues to sign up. We should be doing this on a daily basis. Think about all the time you spend with fellow students, residents and even attendings. Think about how many times the issue of insurance comes up and you want to scream out: “If we had single payer, this would not be an issue!” Now, every time that thought comes to mind, do something about it. Mention single payer and encourage those around you to sign up for PNHP. These conversations are not, at the core, political. They are essential to the foundations of our profession, and we must normalize them. I want you to recruit at least one new colleague to PNHP each month. It’s a modest ask, but if everyone here does it we’ll have nearly 2,000 new members in a year. Then, we can start to envision a future where PNHP will usurp the AMA as the organization that speaks on behalf of doctors.

While the AMA might have been a major barrier to NHI in the 20th century, our biggest barriers now are private health insurance companies and Big Pharma. You all know that we are facing one of the most well-financed and formidable opponents in American history. Both have fought tooth and nail against single payer with their army of lobbyists and have contributed heavily to candidates for public office to protect their position and maximize their profits. It is no secret that they spent $173 million to defeat the public option, which amounted to about a million dollars a day during the debate over health reform. So when we talk about single payer, we must talk about the massive profits reaped at the expense of patient care. The neoliberal corporate agenda has infiltrated health care and we must vigilantly fight back against the idea that health care is a commodity and, instead, declare that health care is a public good that all Americans, regardless of race or class, should have access to.

But I am not discouraged by our well-resourced foes for three reasons. One, their arsenal of smear tactics is dwindling. The fear of “socialized medicine” is waning. Communism coming to America is an outdated notion. Two, these companies are universally despised. A recent poll demonstrated that almost all Americans believe that private insurance companies are the biggest problem in our system. So there’s our message right there – we must get rid of private insurance companies to have real health reform. Three, ultimately, the system cannot function without us. If we remain silent, we will only allow these companies to continue to reap massive benefits at the expense of our patients and our professional code of ethics. If we, as health care providers, are united in opposition, we will not be defeated.

You may believe that after 100 years of struggle we will never achieve single payer. But let me tell you why we will win and what we have to do to get there.

I want you to look around you. Our movement is growing exponentially. There are now 35 student PNHP chapters, with 10 new ones in the last year alone. There are 19,602 PNHP members, 731 of whom are students. The second SNaHP summit had 40 students, the third had 80, and the fourth has 160. I emphasize this growth because, historically, students have been the stimulus and source for broader activism. Just recently in Chile, following three years of nationwide student protests, the country will make college tuition-free and are paying for it with a 27% tax on corporations. Look at the civil rights movement in the US. It was the Student Nonviolent Coordinating Committee (SNCC) that spearheaded the civil rights movement. The Freedom Riders, not all, but the majority were young people and students. Over time, it grew and became a mass popular movement and achieved historic things. We don’t know the names of the leaders of SNCC, but that is the point with movements. We know the name of Martin Luther King Jr, but who do you think organized the marches, the talks, the sit-ins? Members of SNCC did. They did the heavy lifting of organizing, going door to door, and putting their lives on the line. Our movement does not need a figurehead. It needs unified direct action.

As Noam Chomsky has said: ‘Direct action carries the message forward in a very dramatic fashion. Direct action means putting yourself on the line. It indicates a depth of commitment and clarification of the issues, which often stirs other people to do something.’ Achieving single payer will require resistance and civil disobedience. All the great movements in history have. Look again at the civil rights movement. Institutional segregation had been going on for hundreds of years, but what sparked the movement? A couple of incidents of direct action. Rosa Parks insisting on sitting in the front of the bus. Black students sitting at a lunch counter in Greensboro. Without these actions, the movement would probably never have happened. You can make as many speeches as you like but they will never have the effect of those actions. And while the movement started with students, it became broad-based and diverse. Just like the movement for single payer, we must reach out to and build ties with labor unions (over 600 have already endorsed HR 676), civic and faith-based movements, and even small businesses. While businesses may seem like natural allies of the private insurance companies, many of them feel the strain of paying to insure their employees and would clearly benefit from government-run health insurance.

In closing, Americans are literally dying for equitable, universal health care access. And so I know that deep down you feel, as I do, that the time has come for direct action. The question is – when do we get started? Here’s one idea – Medicare’s 50th birthday is coming up and a nationwide coordinated action would be a powerful first step.

When I talk to people about single payer, I often hear: “Oh yeah, I support single payer but it will never happen in this country.” I tell them that people once thought the abolition of slavery and women’s suffrage could never be won – that these were “unrealistic” dreams. And yet both of these “unrealistic” dreams were ultimately won. While moderates were advocating for incremental change, the activists pushed for revolutionary change and were successful. What seemed impossible yesterday is something we accept as a given today. So next time someone says single payer will never happen, tell them this: “If you believe it won’t happen, it never will. But if you believe that the only way it will happen is to actually do something about it, then I am sure you will make the only choice that a moral and principled person would, and that is to join me in this struggle.”

Thank you.”

Scott Goldberg is a medical student at the University of Chicago Pritzker School of Medicine and a member of the board of directors of Physicians for a National Health Program.