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There's a small number of Senators and Representatives who support Single-Payer. Rep. John Conyers (D-Mich.) and Sen. Bernie Sanders (Ind.-Vt.) have introduced Single-Payer bills in the House and Senate (HR 676 and S 703). Most are Democrats. Presidential candidates Cynthia McKinney (Green) and Ralph Nader (Independent) promoted it during their campaigns in 2008, as did Dennis Kucinich before he was eliminated in the Democratic primaries. But the White House and most members of Congress have followed Sen. Baucus's lead and don't want it discussed. They don't want its merits compared with the health care reform plans that capitulate to insurance and HMO demands. The health of insurance industry profits takes precedent over the health of the American people.
On March 5, a White House policy summit on health care initially excluded Single-Payer advocates until complaints led to last-minute invitations for Dr. Oliver Fein, president of Physicians for a National Health Program ( http://www.pnhp.org ) and Rep. Conyers. On May 5, a health care hearing sponsored by the Senate Finance Committee featured private insurance industry representatives, the Chamber of Commerce, the right wing Heritage Foundation, the Business Roundtable, and Blue Cross Blue Shield, but no Single-Payer supporters.
The hearing was interrupted by eight protesters who demanded public discussion of Single-Payer. The eight were arrested. Among them were Russell Mokhiber of Single-Payer Action ( http://singlepayeraction.org ) and Kevin Zeese, former Maryland Green candidate for the US Senate and currently Executive Director of the Campaign for Fresh Air and Clean Politics ( http://www.FreshAirCleanPolitics.net ). (Read Mr. Zeese's account of the protest: http://www.opednews.com/articles/Why-I-Was-Among-Eight-Heal-by-Kevin-Zeese-090506-255.html )
Such actions might be the only way to focus public attention on Single-Payer. In past generations, it took strikes, massive and sustained street demonstrations, and political campaigns outside the Democratic and Republican parties to win the eight-hour day and 40-hour week, an end to child labor, civil rights for African Americans, and other reforms. As more and more Americans learn about Single-Payer, how they're getting cheated under the status quo, and how the alternative proposals from Democrats are designed to sustain insurance company profits through mandates and subsidies, the demand for Single-Payer will reach critical mass.
Polls have already demonstrated widespread popular support for a national health care program that guarantees universal coverage ( http://www.wpasinglepayer.org/PollResults.html ). In 2008, the US Conference of Mayors endorsed Single-Payer ( http://www.usmayors.org/resolutions/76th_conference/chhs_03.asp ) as have thousands of physicians.
The recent economic crisis has made Single-Payer even more urgent. Its enactment would provide relief for businesses large and small, since it cancels the high expense and administrative burden of employer-based health care benefits ( http://www.gp.org/press/pr-national.php?ID=158 ). It would relieve municipalities and school boards from having to bear the cost of providing health insurance to employees, reducing budgets and lowering local property taxes.
Many business leaders understand that Single-Payer is the best proposal economically, but they're reluctant to support it. Why?
Dr. David Himmelstein of Physicians for a National Health Program has an answer. Dr. Himmelstein attended "a health care forum a couple of years ago sponsored by the Business Roundtable. And the moderator asked the audience -- made up primarily of representatives of big business -- to indicate their preference of health care reforms. And the majority came out in favor of single payer. Why then is the Business Roundtable opposed? Himmelstein put it this way: 'In private, they support single payer, but they're also thinking -- if you can take away someone else's business -- the insurance companies' business -- you can take away mine. Also, if workers go on strike, I want them to lose their health insurance. And it's also a cultural thing -- we don't do that kind of thing in this country'" ("Top Ten Enemies of Single Payer," by Russell Mokhiber, Common Dreams, April 16, 2009, http://www.commondreams.org/view/2009/04/16-0 ). In short, business leaders don't want to lose leverage over their employees and they fear creeping socialism.
Cheerleaders for Obama or Serious Advocates for Health Care Reform?
Why won't some major unions, like Service Employees International Union (SEIU) and liberal advocacy groups like Families USA, support Single-Payer? (SEIU president Andy Stern and Families USA executive director Ron Pollack participated in the Senate Finance Committee hearing described above.) It could be their long alliance with Democratic Party leaders. The behavior of such groups during the Clinton Administration illustrates my point. Bill Clinton campaigned in 1992 on a promise of universal health care, but after taking office he introduced a reform plan that would have herded Americans into coverage under the top five or six insurance firms. The latter were well represented at the Jackson Hole summit hosted by Hillary Clinton and Ira Magaziner in early 1993, while consumer advocates weren't invited.
The Clinton 'managed care' plan that emerged from the summit was a bureaucratic monstrosity filling over a thousand pages, a gift on a silver platter to those very insurance companies. Medium and small size insurance companies, which were behind those Harry and Louise ads critical of the Clinton plan, would not have been able to compete. President Clinton eventually acknowledged that the plan didn’t even cover all Americans.
Instead of supporting Single-Payer plans offered by Paul Wellstone (D-Minn.) and Jim McDermott (D-Wash.) in 1993, many unions and liberal organizations that had previously favored national health care endorsed the Clinton proposal. They wanted to show support for a new Democratic administration that had replaced twelve years of Republican rule. They didn't want to jeopardize their newly won access to the White House, so they ready to set aside their own agenda.
Rather than winning influence when they invested their support in the Democratic ticket, these unions and liberal groups had purchased their own acquiescence to a president more responsive to major corporate lobbies. (Such acquiescence, combined with an expert public relations strategy, also explains why Hillary Clinton still wins praise as a champion of health care reform, and why the Clinton plan still gets labeled, erroneously, 'universal health care.') Under Bill Clinton, the Democratic pledge of national health insurance, a plank in the party's national platform since 1948, was canceled.
Current enthusiasm for the Obama Administration and the new Democratic majority in Congress poses a similar danger. The Democratic goal is to make health care affordable -- within the context of the market. If publicly financed health care is to be considered at all, it must only be an option in competition with other, private heatlh insurance options, inevitably balanced with public subsidies to ensure continuing profits for the private insurance providers. Thus on April 28, several congressional caucuses (Progressive, Black, Hispanic, and Asian and Pacific American) declared their support for the "public health insurance option" that would be "part of comprehensive health care reform legislation", but shied away from endorsing the Conyers-Sanders Single-Payer bills ( http://www.commondreams.org/newswire/2009/04/28-25 ). MoveOn has created a video ad ( http://www.youtube.com/watch?v=ms2b57MLqZs ) promoting the Obama plan and critical of insurance lobbies, ignoring the participation of insurance companies in the crafting of the plan.
The goal of Single-Payer is to make high-quality health care a right for all Americans, replacing for-profit health coverage and rendering the market as irrelevant as it is to fire departments.
For those of us who understand that health care access, like fire department service, must never be based on corporate profit margins, there are lessons to be learned. We can't rely on the Democratic Party. We can't trust major liberal organizations or unions that have been compromised by politics allegiances. Groups like AMA and AARP that rely on insurance company contributions and ads in their publications will always oppose Single-Payer.
