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Where Does Single-Payer Go From Here? (Part 1)

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Above photo from Code Pink's single-payer action Oct 14, 2009 in Washington, D.C. (See Code Pink's Flickr page for more.)

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In the run-up to the vote on health reform legislation Saturday, the possibility of getting a vote on single-payer in Congress was looking more likely each day. Leaders were admitting privately if not publicly that single-payer grassroots groups were keeping reform legislation from dropping the public option entirely.

But, as Katie Robbins, assistant coordinator of the single-payer advocacy group, Healthcare-Now!, explained, those leading the mobilization for single-payer (Physicians for a National Health Program, Progressive Democrats of America, California Nurses Association, Public Citizen, etc) had a quite jarring experience in the 72 hours before a vote that Democrats now regard as a huge victory for health care reform.

Between Thursday and Saturday, the movement witnessed Pelosi's refusal to allow any amendments on single-payer to come to the floor, Obama's message to Congress to not allow a vote on single-payer so close to a vote on his health insurance bill, Kucinich's and Conyers' decision to not support a vote on single-payer in the House, and a vote on an anti-choice amendment brought to the floor by conservative Democrats and Republicans after Pelosi declared no amendments to the bill would be allowed to come up for a vote.

There was no bloc of representatives in the House willing to stand firm against the White House on the issue of healthcare as a human right or on the issue of establishing a health care system in America that does not let for-profit health insurance companies administer or largely define the solution to the healthcare crisis in America.

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"Some very strong single-payer advocates like John Conyers and Donna Edwards did not vote their conscience. They voted for a bill that's a corporate giveaway, " said Kevin Zeese of the Prosperity Agenda. "They know that single-payer is right but first they're Democrats and they'll allow the Democratic Leadership, which is not a single-payer supportive group, to tell them how to vote."

Margaret Flowers, a physician with Physicians for a National Health Program, identified the problem of progressives unwilling to stand up for single-payer earlier this year.

"The people that are supposed to be our champions of single-payer are bowing to the pressure of the industry and the administration and they're not speaking out or standing up for what's right," said Flowers. "So many of them will admit that a single-payer system is the only way to provide universal cost-effective care, but they don't have the courage to stand up to that."

In an interview conducted almost a month ago, Paul Hochfeld, an emergency physician with the health care reform group Mad as Hell Doctors, described the crisis of political will in Congress. He explained how content physicians advocating for health care reform are with supporting incremental change and not real change like the enacting of a Medicare for All system in America.

"They think that single-payer is politically unfeasible---the enemy of the good. [They say] 'we can't let perfection be the enemy of the good,'" said Hochfeld. "They think I am delusional to think we're gonna get single payer from this Congress but I also recognize that they might be delusional in thinking that incremental change might lead to anything but incremental change."

Such is the issue at the moment. Politicians in Washington haven't the moral fortitude or courage to risk their political careers to save tens of thousands of Americans from dying over the course of the next year. And, at the same time, too many Democrats or progressives regard single-payer advocates as "purists" who are negatively impacting the fight for health care reform. They chide single-payer supporters as they let the politicians set the terms for change and refuse to argue for anything more than this health insurance bill going through Congress.

Zeese explained this bill will "enshrine and deepen the power of the insurance industry." Hundreds of billions of dollars in new revenue, according to Zeese, will now be available for corrupting and influencing Congress, for campaign contributions, for giving leaders' wives positions on health insurance executive boards, for increasing the game of pay-to-play politics in Washington, etc.

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On the public option, Zeese added, "Most Americans cannot buy into it."

"No matter how much you hate your current insurance, no matter how much they've abused you with premiums, co-pays, denials of care, no matter what they've done to you, you can't leave your insurance and go to the public option," said Zeese. "90% of Americans can't even choose it. So much for choices."

Also, the bill allows for a private corporation to run the public option.

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Kevin Gosztola is managing editor of Shadowproof Press. He also produces and co-hosts the weekly podcast, "Unauthorized Disclosure." He was an editor for

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