Single payer popularity poses problems for Democrats

This article was originally published on June 5. Health Over Profit later reposted a ThinkProgress account of the June 28 protest outside the Capitol where some familiar troublemakers set up a ruckus about single-payer health care...

On Sunday, June 4, the same day that Our Revolution, a Democratic Party group that arose from the Bernie Sanders presidential campaign, organized rallies and die-ins to highlight the number of people dying in the United States due to lack of access to health care, the New York Times published an article, "The Single Payer Party? Democrats Shift Left on Health Care," prominently on the front page and above the fold.

The article quotes RoseAnn DeMoro, head of National Nurses United, saying, "There is a cultural shift. Health care is now seen as something everyone deserves. It's like a national light went off." Minnesota Congressman Rick Nolan was also quoted, saying that rank and file Democrats "are energized in a way I have not witnessed in a long, long time." Nolan is correct in stating that following the Democrat's loss in 2016, the party needs "a more boldly 'aspirational' health care platform."

Democratic Party voters have been strong supporters of single payer health care for a long time. Polls have consistently shown that super-majorities of Democratic Party voters want single payer, but Democratic Party candidates keep telling them that they can't have it. The Democratic Party has refused to add Medicare for All to its healthcare platform despite resolutions introduced by single payer advocates. Even the Congressional Progressive Caucus refuses to include single payer health care in its "People's Budget."

In 2009, with a Democratic President and majorities in the House and Senate, single payer health care was off the table. Instead, the "public option" was used to divide the Democratic Party voters and convince them that they were asking for too much. Democrats were told that the public option would be more politically feasible and would create a "back door" to single payer. Many were fooled. And the joke was on them because even the public option, which I call the "Profiteer's Option," was never meant to be in the final legislation.

While the New York Times wrongly blames the liberal and centrist Democrats for not supporting a public option, it was actually the White House and Democratic Party leadership that kept it out of the final bill. In December of 2009, public pressure was working to convince the Senate to include a public option in its healthcare bill. That's when leadership stepped in to stop them. Glenn Greenwald writes:

"I've argued since August that the evidence was clear that the White House had privately negotiated away the public option and didn't want it, even as the President claimed publicly (and repeatedly) that he did. It is the excuse Democrats fraudulently invoke, using what I called the Rotating Villain tactic (it's now Durbin's turn), to refuse to pass what they claim they support but are politically afraid to pass, or which they actually oppose (sorry, we'd so love to do this, but gosh darn it, we just can't get 60 votes). If only 50 votes were required, they'd just find ways to ensure they lacked 50. Both of those are merely theories insusceptible to conclusive proof, but if I had the power to create the most compelling evidence for those theories that I could dream up, it would be hard to surpass what Democrats are doing now with regard to the public option. They're actually whipping against the public option. Could this sham be any more transparent?"

I was present at the Center for American Progress in March of 2009 when Senator Max Baucus stated that the public option was a bargaining chip being used to convince private health insurers to accept more regulations. It was Baucus' staffer, Liz Fowler, a former senior vice president for one of the largest private insurance corporations, WellPoint, who wrote the framework for the Affordable Care Act and shepherded it through Congress. The scam was revealed early and though progressive groups knew it, they were complicit in the scam because they accepted being controlled and silenced by the White House.

Jim Messina, a former Baucus chief of staff, was hired by the White House to be "the enforcer" for President Obama's agenda. Ari Berman described the situation in this enlightening article:

The administration deputized Messina as the top liaison to the Common Purpose Project. The coveted invite-only, off-the-record Tuesday meetings at the Capitol Hilton became the premier forum where the administration briefed leading progressive groups, including organizations like the AFL-CIO, MoveOn, Planned Parenthood and the Center for American Progress, on its legislative and political strategy. Theoretically, the meetings were supposed to provide a candid back-and-forth between outside groups and administration officials, but Messina tightly controlled the discussions and dictated the terms of debate (Jane Hamsher of Firedoglake memorably dubbed this the "veal pen"). "Common Purpose didn't make a move without talking to Jim," says one progressive strategist. During the healthcare fight, Messina used his influence to try to stifle any criticism of Baucus or lobbying by progressive groups that was out of sync with the administration's agenda, according to Common Purpose participants. "Messina wouldn't tolerate us trying to lobby to improve the bill," says Richard Kirsch, former national campaign manager for Health Care for America Now (HCAN), the major coalition of progressive groups backing reform. Kirsch recalled being told by a White House insider that when asked what the administration's "inside/outside strategy" was for passing healthcare reform, Messina replied, "There is no outside strategy."

The inside strategy pursued by Messina, relying on industry lobbyists and senior legislators to advance the bill, was directly counter to the promise of the 2008 Obama campaign, which talked endlessly about mobilizing grassroots support to bring fundamental change to Washington. But that wasn't Messina's style -- instead, he spearheaded the administration's deals with doctors, hospitals and drug companies, particularly the Pharmaceutical Research and Manufacturers of America (PhRMA), one of the most egregious aspects of the bill. "They cared more about their relationship with the healthcare industry than anyone else," says one former HCAN staffer. "It was shocking to see. To me, that was the scariest part of it, because this White House had ridden in on a white horse and said, 'We're not going to do this anymore.' " When they were negotiating special deals with industry, Messina and Baucus chief of staff Jon Selib were also pushing major healthcare companies and trade associations to pour millions of dollars into TV ads defending the bill.

This was the Democratic Party's deal with the devil. They rejected their voter base and went with the donor class to create and market a health law, the so-called Affordable Care Act, that protected the profits of the medical-industrial complex, and it backfired. In the 2010 election, 63 Democratic incumbents lost their seats in Congress and the party has been in decline ever since with a record low number of elected officials nationally. On issue after issue, the Democratic Party betrayed its base and voters finally gave up, choosing either to vote for other parties or not vote at all.

The question now is whether the Democrats will change.

So far, despite the title of the New York Times article, the answer is no. Although there is widespread voter support for single payer, Nancy Pelosi says the party is not going there and is funneling advocates' energy to the state level, even though state single payer systems are not possible without federal legislation. At the national level, Democrats are paying lip service to Medicare for All: "We need to get there eventually but right now our task is to fix the ACA" is the current talking point.

The reality is that the political currents have shifted. The public is not going along with the con. People want solutions to the healthcare crisis, not more tinkering with the current failed healthcare system. Across the country, the message is clear that the public supports National Improved Medicare for All. And whichever political party in power embraces this will see a surge in popularity.

Our task as advocates for National Improved Medicare for All is to stay fired up -- continue to speak out about Medicare for All, write about it in local papers, meet with members of Congress, organize in our communities and run for office. We must be clear and uncompromising in our demand for National Improved Medicare for All to create a visible tsunami of support that will wake our legislators up.

When the people lead, the legislators will follow.

Margaret Flowers, MD is a Maryland pediatrician, co-founder of Health Over Profit for Everyone and on the steering committee of the Maryland Health Care is a Human Right campaign. This article was reposted June 7 on the Progressive Maryland BlogSpace.

 

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