I Am Why Single-Payer Hasn't Passed

by: Chris Bowers

Wed Sep 02, 2009 at 10:37

In case you were wondering why single-payer hasn't passed into law, I wanted to let you know that I am the reason. Even though I support single-payer health care, I have not spent much time on Open Left advocating for it. As such, single-payer has not passed because of me.

Here is what could have happened:

  1. Progressive blogs and email organizations advocate for single payer all the time every day;

  2. This advocacy leads to millions of progressive activists attending rallies and contacting members of Congress on behalf of single-payer;

  3. Members of Congress are so scared of these activists, they pass single-payer into law.
The path was pretty straightforward.  It is common knowledge that there is an unstoppable corps of left-wing activists who can force Congress into passing left-wing legislation.  However, in order to mobilize that corps, bloggers need to advocate for positions that corps likes.  Once they do, the left-wing activist corps will spring into gear and get the job done.  But they won't do it until bloggers advocate for it.

I first noticed this when I appeared on Hardball criticizing President-elect Obama for loading his cabinet with moderates.  The marches on Washington, D.C. that resulted my appearance left him no option but to appoint real progressives from there on out.  I could have done the same thing for single-payer, but I didn't. Here is what I did instead:

  1. I convinced the tens of millions of progressive activists who are familiar with the work of Jacob Hacker that, while Congress was not going to pass single-payer, Democrats could pass a public option that would cover 130 million Americans.  Like most public option advocates, I wrote about that all the time during 2007 and 2008, just around the same time that Hacker was becoming a household name.

  2. While I was unable to voice my opposition to Hacker's proposal at the time due to his overwhelming popularity among progressive activists, I was engaged in behind the scenes maneuvering with the chairs of the relevant House and Senate committees to introduce legislation with a much weaker public option.  Since I can't stomach 130 million people being covered by the public option, I instead successfully persuaded the committee chairs to introduce legislation that would only cover around 10 million Americans.  It was necessary for me to do this behind the scenes, because otherwise the Hacker legions would know that I was using them.

  3. By lying to the Hacker legions like this, I was able to harness some of their activism on behalf of the weaker public option. Unfortunately, most of these activists saw through the lie and as a result we were out organized in town halls in August anyway.  Foiled again!
Snark tags off in the extended entry.
Chris Bowers :: I Am Why Single-Payer Hasn't Passed
Actually, that isn't what happened at all.  It does seem to be what some single-payer advocates think happened, but it isn't.

If you are upset at me because I am a single-payer supporter who didn't do much single-payer advocacy, well I'm sorry about that.  I wish I knew how to pass single-payer into law--or a carbon tax, or to end the war in Afghanistan, or an expansion of Social Security--but I don't.  That isn't bullshit--I really wish I knew, but I don't.

I have spent the last few months trying to increase progressive power in Congress.  This effort is centered around a new strategy I call "The Progressive Block," and yes the k is intentional.  Basically, the strategy is for House Progressives--reinforced by the netroots--joining with Republicans to block must-pass Democratic legislation unless we get some real concessions in return for passage.  I didn't develop this strategy--it bubbled up from discussions online about drawing a line on health care early in 2009, and from earlier online discussions about building progressive power.  In March, the new House Progressive co-chair, Raul Grijalva, brought the idea to the single-payer advocates of the Congressional Progressive Caucus, who then voted to draw that line on a Medicare-like public option.  At around the same time, Darcy Burner was brought in to help organize the effort both short-term and long-term.  A test run of sorts took place in May and June on Afghanistan war supplemental funding.  At that time, House Progressives, aided by Fire Dog Lake and other bloggers, worked to remove IMF funding from the supplemental bill.  It didn't quite work, but in delaying the Democratic leadership by a couple weeks it did at least show potential.

In addition to selling the strategy, my part of that effort has been working with Democracy for America, HCAN and state bloggers to try and show that 50 Senators support a public option.  Combined with the Progressive Block in the House--which Blue America, MoveOn and many blogs are working to reinforce--and combined with primary challenges to key Senators like Michael Bennet and Arlen Specter, our goal is to make it easier to pass a public option into law than to not pass a public option into law.  As of two weeks ago, 34,827 activists have taken action in our part of that effort.  I am humbled, excited, and honored by everyone who did so.  Thank you!

This is the best idea and the broadest effort I encountered to try and make the federal government more responsive to progressives in the long-term, and to try and improve the health care bill in the short-term.  It certainly struck me as more attractive and workable than just writing blog posts explaining why single-payer is so great.  Feel free to disagree with that assessment.  In fact, feel free to disagree with strategy discussions altogether.  If you think what I did was somehow wrong, I can live with that.  I honestly believe I am involved in the best effort progressives have going right now, and I also believe I did the best I could to help make it happen.  If you think I somehow hurt the cause, then I am sorry.  If it turns out not to be successful, then I am really, really sorry about that.  Maybe we should have gone in a different direction, but we can't turn around at this point in this particular fight.  There will be time for re-evaluation afterward, but for now we can only keep pushing ahead.

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Gee, I guess we hit a nerve (4.00 / 2)
Defensive, much?

I am in earnest -- I will not equivocate -- I will not excuse -- I will not retreat a single inch -- AND I WILL BE HEARD.  

Thanks for being productive (4.00 / 2)
Its been a big help.

[ Parent ]
I've been ecstatic (4.00 / 5)
about your work to put together the Progressive Block. Please: Keep On, Keepin' On!

Thanks Chris

I wonder if you hold your breath, turn blue and insult your allies we can have a general strike and then get everything we want? (4.00 / 1)
You have to try everything Chris. Come on! I want a general strike of workers committees!

Or something.

Thanks for working for real change CB.


The government has a defect: it's potentially democratic. Corporations have no defect: they're pure tyrannies. -Chomsky

The Rubber Band Man speaks (4.00 / 10)
Lest no one be offended, let me state at the outset, the "Rubber Band Man" is me.

As a grizzled veteran of these battles may I say that both kinds of activity are required.

Chris is in all likelihood right that if everyone adopted Lambert's m.o. of channelling his inner William Lloyd Garrison:

I am in earnest -- I will not equivocate -- I will not excuse -- I will not retreat a single inch -- AND I WILL BE HEARD.    

we would not be too much closer to passing single-payer than we are now.

On the other hand, without the Garrisons, annoying though they may sometimes be to people who are working their asses off trying to win something in the here and now by getting down to the nitty-gritty of ugly real politics, the ugly real politics can come to dominate and thus the Lamberts and Garrisons perform a real canary-in-the-mine reality check function.

Without Lincoln, all the Garrisons in the world wouldn't have succeeded in abolishing slavery.  Without Garrison, all the Lincolns in the world probably wouldn't have even tried.

OK, the "Rubber Band Man" has spoken again.  

Now play nicely.

sTiVo's rule: Just because YOU "wouldn't put it past 'em" doesn't prove that THEY did it.

Garrison? (0.00 / 0)
I thought that was Glenn Close....

[ Parent ]
Thanks! (4.00 / 1)
This diary really clarifies the situation. I always suspected you were the lynchpin in the national issues swirling around healthcare reform. Nice to know I was not wrong. Best part is that, now, I know who is to blame for all the problems in the country. I'm so relieved. Thanks again.

How do you feel about shouldering the blame for the quagmire in Afghanistan? I seem to remember you pushing some ideas on that front, too?

So much blame, so little time.

"It sounds wrong...
     ...but its right."

Its tough to swallow (4.00 / 1)
Feels pretty bad. I've become everything I ever hated!

[ Parent ]
remember this? (2.00 / 2)

What happened to this guy? Oh yeah, he won the primary. Also there's Rahm Emanuel whispering sweet nothings in his ear everyday.

I'm with you (0.00 / 0)
and have been blogging accordingly. My main concern is that the activism centered around the public option has unwittingly overpromised what the real public option will do for people (if we get a public option passed). HR 3200 is a lot weaker than Hacker's proposal, and the Senate HELP version is even worse.

Join the Iowa progressive community at Bleeding Heartland.

Wave a wand! It's Sweden!!! (0.00 / 0)
If this was easy FDR would have done it.

HR3200 if enforced correctly is a very strong bill. Everything depends on Sec 116 which in my view is the keystone. Done right Sec 116 makes the public option almost unnecessary. That is if your goal is insurance reform. As Howard Dean and others have pointed out insurance reform doesn't mean health care reform and the public option is critical if we are going to get to the latter. But too many people are confusing the two goals and so concluding that HR3200 will inevitably deliver us like sheep into the slavering jaws of the insurance companies.

I want Single Payer. Yesterday. Absent that I want a strong Public Option because I believe it will ultimately lead to Single Payer. But if I can't get that I would accept a weak Public Option because I believe any such plan will ultimately shake loose of its shackles. If I can't have even a weak Public Option I am going to conclude that we really, really missed a generational opportunity to put another brick in the New Deal wall. Which will be sad indeed.

But that doesn't mean that HR3200 without a public option would not be a huge step forward. Once again if done right. That is "a lot weaker" is by definition relative. Sec 116 of HR3200 transforms the entire business plan of the entire health insurance industry. And with Sec 113 is almost certainly the key target of opponents.

[ Parent ]
Don't forget... (4.00 / 4)
The Kucinich Amendment is part of HR 3200, and that would allow state-based single-payer experimentation.

National Nurses United (AFL-CIO) is America's RN union, representing 150,000+ nurses from all 50 states.

[ Parent ]
Can you please provide a link to these two sections? (0.00 / 0)

sTiVo's rule: Just because YOU "wouldn't put it past 'em" doesn't prove that THEY did it.

[ Parent ]
I'm with you until the weak public option choice (0.00 / 0)
I concern is that is a poor bill gets signed into law any more reform agendas in the near future (10 yrs?) will be summarily put-down by saying, "Been there. Done that. Move on."

Not sure what "shake loose of its shackles" means. Can this happen without further legislation?

"It sounds wrong...
     ...but its right."

[ Parent ]
but if not enforced correctly (4.00 / 5)
than don't we run the risk of HR 3200 being as useless as Kennedy-Kassebaum 1996, which was supposed to ban rescission?

And why should I believe that state regulators will be tough with insurance companies in the future if they haven't in the past?

Join the Iowa progressive community at Bleeding Heartland.

[ Parent ]
Snark is awesome!! (0.00 / 0)
Well not so awesome as wit, actual humor, biting satire, or deep irony. But kind of, sorta, a little, hmm. Well I guess not that awesome at all.

For the record I agree with Chris on the substance, I think most of the Single Payer Now! folk need to get that sanctimonious better than thou stick out of their asses and start thinking about political reality. But as the responses here showed snarkish self-deprecation doesn't work well when critics basically agree with the stated conclusion.

Now I know how to respond to those emails... (4.00 / 1)
... I've been getting. Thanks Chris!

Working Families Party online street team was here

Plausible compromises? (0.00 / 0)
Is there a way to get more Dem support for the public option by limiting the scope of what could be offered, at least in the first year or two?  I don't know all the various options in play, but my thought is why can't the public options be somewhat limited to relatively basic insurance policy choices to begin with, letting private insurers compete for the so-called "cadillac" or higher end policies.  The trigger moving forward would be the reduction in the premiums on these policies compared to some scored standards in order to get a deficit neutral result.  Failure to meet the premium reductions would allow the public options to expand into this realm also over time.

I would think this would allay fears amongst some Dems about a public option immediately distorting the market and leave open the possibility of market forces actually working in the health exchange to lower the cost of these policies.  Is what I am suggesting a possibility to expand the likelihood of public health plans surviving in these bills?

You do great work Chris, Keep it up (4.00 / 7)
You are a master at tactics and are a big reason we left-liberals have moved any legislation against the corporate block prevalent in both parties.

We may not say it much, but I'm saying it here.  

I greatly appreciate your work.  

You are doing a great job Chris (4.00 / 3)
I really appreciate your efforts. You have done a great job fighting against the entrenched insurance companies, the corporate media, and the corporatist Republicans and sell-out Democrats. In this hostile environment, it is very difficult for progressives to win anything. You have figured out specific measures we could take to force positive change and you've explained those strategies well so that we could implement them. You've done a great job.

Perhaps you should have included a few more posts about the advantages of single-payer Medicare-for-All and provided some more support for groups like Physicians for a National Health Program  and the California Nurses Association in their efforts to explain single-payer Medicare-for-All and HR676. But what you have done has been great.

shorter Chris Bowers... (0.00 / 0)
Rather than work directly for progressive change, i decided to work for greater visibility and insider influence for Chris Bowers as a means of achieving progressive change.  I've achieved my personal goal, but people noticed that the progressive change that my greater visibility and insider influence was supposed to bring about didn't happen.

So now I'm going to try and change the subject to how stupid the advocates of genuine progressive change are.

Hostile environment is right (0.00 / 0)
Glenn Greenwald said it at one point, we may have elected Obama but the Democrats of 2006 haven't gone anywhere.  And, those were the same Democrats who rolled over every time Bush told them to.  And, then we got to watch Obama's appointments.  Boo-ya!

The response to the economic crisis foreshadowed every element of this health care reform.  Stimulus vs TARP.  Everyone remember that?  Any number of people wondered why Obama's stimulus was so small in the beginning.  Well, he had to get it passed, you know.  So, we wound up bargaining down from a down position.

And, it has happened again with health insurance reform.  What could have been single payer never made it to the table (kind of like impeachment didn't).  Congress made it pretty plain where this quasi-negotiation was going to begin.  I don't recall there ever being a point where there was any real leverage that could be exerted.

At this point, I honestly believe the best outcome is for the progressives in the House to kill this baby dead.  I don't trust these ongoing secret negotiations, a White House that continually leaks that a public option was only there to be bargained away, from the beginning, or some damned reconciliation process that also happens behind closed doors.

In this environment, Chris, I think you ran with what was available.  Blaming you for somehow failing to do a better job of pushing for single payer ....? WTF?  

Nope.  We're watching a slow motion, freeway, eight lane, chain reaction car wreck.  Legislatively, I no longer believe the steering wheel is connected to the front tires.  If we really think we can steer this mother, we're deluded.  By throwing our weight from one side of the car to the other we might be able to put enough body-english on it to keep it from going over a cliff, but that doesn't mean we won't land wheels up in a ditch.

It's past time for us to stare squarely at what's before us and recognize it, for what it is.  

Single Payer is Righteous (0.00 / 0)
But as a very intelligent activist recently wrote...

We've gotta keep our wits, recognize realities, and acknowledge the limitations of the situations we find ourselves fighting in (while not accepting those limitations as permanent).

I think the work detailed above accounts for all three.

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