there should be several bills not a single denouement (0.00 / 0)

i nominate Harkin’s Healthy Lifestyles and Prevention America Act to be in the mix

http://www.cspinet.org/new/200…
http://www.apa.org/ppo/issues/…
http://www.commercialexploitat…

a lot of different silos love this bill.  

the wife’s graduate work in food systems, nutrition and public policy studied this bill.  

John McCain is dishonest

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by: Fred Gooltz @ Tue Jul 22, 2008 at 16:51:12 PM CDT

 

Connect Kentucky (0.00 / 0)

I read with interest that you have “killed Connect Kentucky.”  With all due respect, Mr. Stoller, I think you, along with Art Brodsky, have certainly helped expose CK for what they are, but I don’t think you have “killed” it.  Here is their link and they seem to be alive and well:  

http://www.connectkentucky.org/

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by: Concerned Taxpayer @ Tue Jul 22, 2008 at 17:13:10 PM CDT

 

their budget was vetoed (0.00 / 0)

The program is dead.

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by: Matt Stoller @ Tue Jul 22, 2008 at 17:17:56 PM CDT

[ Parent ]  

I haven't followed the details (0.00 / 0)

but I think some other states have taken steps to adopt the ConnectKY model, maybe including ties to the original ConnectKY group (according to a post by Drew Clark these include Ohio, Tennessee, West Virginia and South Carolina).  

These steps may be small and insignificant and these movements may actually be toward more progressive and productive models (I don’t know), but it suggests that while the rejection of the ConnectKY budget was a positive step, the pursuit of this model by its backers isn’t over.  They certainly have deep pockets and are used to targeting states where they’ve got the most leverage and see the most opportunity.  

This doesn’t detract from Matt’s main point, but only underscores the need for ongoing efforts and vigilence, including at the state level.

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by: mitchipd @ Tue Jul 22, 2008 at 17:44:05 PM CDT

[ Parent ]  

There is already a coalition around food (0.00 / 0)

One coalition that lobbied on the farm Bill this year included a whole lot of people into nutirition and the way the subsidies particularly for corn and wheat and the lobbies behind them skew people’s diets toward products with whiote flour and high fructose corn syrup.  The organic farmers, fruits-and-veggies nutritionists and opponents of industrial farming got together in a large coalition that, while not successful in reducing subsidies due to Pelosi’s and the leadership’s desire to protect farm state legislators, dod get a great deal of money included for nutrition programs, marketing programs for fruits and veggies, research on and help for organic farming, and at least some continuation of wetlands programs.  Not enough, but a step in the right direction.

Agreed that a giant coalition on healthy lifestyles and solid health care is needed.  We also need a coalition to attack greed and excessive consumerism and predatory business practices.  It’s alll of a piece–too amny of us have been persuaded by advertising to adopt unhealthy, corrupting, unsustainable and soul-destroying lifestyles.  But that’s another story.

And one little suggestion–7/11 isn’t a food store; it is a snack store, and they aren’t the same thing.  

John McCain–He’s not who you think he is.

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by: Mimikatz @ Tue Jul 22, 2008 at 17:42:47 PM CDT

 

unfortunately (4.00 / 2)

in too many inner-city areas, residents mainly have access to only 7/11 equivalents.  I remember reading a NYT series on diabetes in inner cities a few years ago and then later watching a PBS segment on pioneering inner-city neighborhood-level organic gardens.  Together they drove home the serious extent of the problem and the fact that it was a function of multiple reinforcing “problems” which required systemic, multi-faceted solutions.

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by: mitchipd @ Tue Jul 22, 2008 at 17:51:27 PM CDT

[ Parent ]  

In CA Farmers' Markets are an alternative (0.00 / 0)

At least in some areas.  There is a real effort to locate them in areas where pooer people can shop here in the East Bay.  The local Kaiser Permanente medical center even holds one once a week.  Availability of good food is a serious problem.  Supermarkets that cater to lower end customers have much more junk food than my local yuppie market.

John McCain–He’s not who you think he is.

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by: Mimikatz @ Tue Jul 22, 2008 at 19:07:02 PM CDT

[ Parent ]  

A truly broad health reform coalition not possible without single payer (4.00 / 4)

Where’s single payer? Where are the major single payer groups and leaders within this broad coalition?  Single payer healthcare is the broadest and most inclusive way to reform this broken system but its major advocates are noticeably absent from HCAN’s inner sanctum.

Replacing one set of complexities for another won’t solve this problem. I heard Al Gore say at Netroots Nation that fixing a broken system with more of what broke that system will not work. His example was that drilling more oil and selling to the Chinese will not alter the path of climate change at all.  In fact, it will make it worse. Makes sense.

That logic is as true in healthcare reform as it is in our efforts to address climate change.  Hoping to create conditions under which more people can and likely will become customers of the flawed for-profit private health insurance industry is not the way to reform healthcare.

I like Gore.  And he’s a single-payer advocate, so I know he gets the bigger picture.

And any coalition for health reform that does not place the leaders of the single payer community prominently and proudly within its ranks is not nearly broad enough to solve this crisis.

Attractive as a $40 million dollar war chest may be, it won’t buy a better, cleaner, more fiscally or socially responsible plan than single payer.  

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by: SiCKOdonna @ Tue Jul 22, 2008 at 17:51:15 PM CDT

 

Amen, Donna (4.00 / 4)

It’s all kind of unclear where this is going, but what is clear is that the first thing HCAN–this new coalition–did was tell the Universal Medicare/”single-payer” movement to take a hike.

Which means…they’re narrowing the coalition by excluding over 430 labor organizations, including many of the most activist international unions, almost every one of the nation’s leading Registered Nurse organizations, leading health reformers like Health Care Now, and a bunch of different activist doctor organizations such as Physicians for a National Health Program.  Oh, and that’s not counting all the state-based groups, bloggers, activists, and the hundreds of legislators around the country who are supporting Universal Medicare.  Many of these folks have written about being excluded at various sites.

This is broadening the coalition how exactly?

If things remain this way, you will see a fundamental split in the healthcare reform movement…the grasstops vs the grassroots.  

The upshot will be it will be more difficult to pass any real healthcare reform, and the insurance industry will keep laughing all the way to the bank.  

Why again is this being singled out as smart organizing?  Smart organizing does not start by alienating the base.  

I know from firsthand experience, as do others, that the new coalition has some great folks working there…but whoever is setting policy over there is making a fundamental error that will set us back significantly.  I hope something can be worked out to avoid this.

Join the California Nurses Association and National Nurses Organizing Committee in the fight for guaranteed healthcare on the single-payer model at www.GuaranteedHealthcare.org/blog

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by: California Nurses Shum @ Tue Jul 22, 2008 at 18:20:28 PM CDT

[ Parent ]  

Amen California Nurses Shum! (0.00 / 0)

If things remain this way, you will see a fundamental split in the healthcare reform movement…the grasstops vs the grassroots.  

to me, HCAN looks primarily like a pre-emptive strike against single-payer.

I’m quite curious as to how many of these labor unions control their own insurance funds…. i.e. is health insurance for its members being administered by the employers, or do the employers provide funds to the union, which then contracts for insurance coverage.

“Single payer” doesn’t just minimize/eliminate the role of insurance companies, it eliminates control of billions of dollars in funds provided to unions by employers for health insurance — and “money is power” as they say.  

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by: plukasiak @ Wed Jul 23, 2008 at 14:40:42 PM CDT

[ Parent ]  

you are speaking to something important (4.00 / 1)

you are speaking to something important here about the save the internet campaign.  by not standing behind one bill as an all-eggs-in-one-basket moment, they were able to do two things:

1)  focus on the growth of their coalition as a powerful instrument for policy change around people’s access to speech and communication online

2)  put their coalition forward as an ‘open source’ one — a group whose principles might now focus on net neutrality, but, as they gain diversity and power, might engage with community internet, computer access and literacy, and telecommunications franchise agreements that make true set-asides for neighborhoods and for training.  

it’s the tricky balance between creating a coalition to win a particular victory, and investing organizing strength in building a group of people with a changing to-do list that might not get done in one year, five, or ten.

because technologies are changing rapidly, i think that coalitions like savetheinternet should focus on growth and building their political leverage so they can execute the major changes communities need in the future, not just today.  as the cost of devices that get us online and get us connected goes down, and the policy opportunities to control how those devices are made and distributed approach, we need a big, flexible coalition to put us in the drivers’ seat of our digital future.  i hope we can get it together in order to win something around the white spaces fight, for example.

so what can HCAN do to make sure that it is flexible and powerful at the same time?  what organizations need to join?  i think donna from sicko is right about the single payer folks, and i’d add the fair food folks.

but we also need to remember that a growing membership on digital inclusion, or on health, needs to be able to make compromises and set priorities.  how big can coalitions like this get without collapsing of infighting before winning a series of important changes?

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by: Hannah_Sassaman @ Tue Jul 22, 2008 at 18:12:50 PM CDT

 

Good points Hannah (4.00 / 1)

(including one of my pet issues, the broadcast white space)

My sense is that the more fundamental and systemic is the proposed “solution/policy,” the broader the coalition can be. At the same time, a systemic view of problems and solutions might also alienate some groups that are heavily focused on specific parts of the problem or specific solutions.  In my view, such groups are less valuable allies in key respects, since their preferred solution may in fact conflict with a systemic solution.

I liked Reed Hundt’s take on Gore’s recent “renewable electricity generation and grid upgrade” proposal.  In my reading of his comments, Hundt described Gore’s initial focus on the electric grid as very ambitious on one hand, but also very strategic in terms of its value in providing a necessary enabling platform for a transition to plug-in-hybrids and electric cars, while postponing some of the political fights that the latter agenda would entail if it was put first on the political-battle agenda.
http://tpmcafe.talkingpointsme…

I think this strategic political understanding of Gore’s comes from his deep understanding of all the related “system-change” issues, as well as the complex and challenging politics that each one involves.

I think this kind of thinking is where we need to go.  From it, natural, strong and and expansive coalitions seem likely to form.  Yes, compromises and priorities will need to be set, but I think these will be clearer and easier to agree on if we’re working from a systemic diagnosis and solution strategy.  Without this, coalitions tend to be heavily dependent on horse-trading.  Some of this is necessary but if, as in today’s Washington, its the primary mode of legislating, the result smells a lot like horseshit.

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by: mitchipd @ Tue Jul 22, 2008 at 18:41:43 PM CDT

[ Parent ]  

I strongly agree with your main point, Matt (0.00 / 0)

Now, if HCAN took on what it means to be healthy, the playing field broadens dramatically.

I firmly believes that the best way (perhaps the only way) to address our country’s key problems is to develop a broad and systemic diagnosis and strategy.

I think Gore’s recent speeches have spoken to this type of system-transforming approach in the energy/ecology arena, tying together national security, jobs, economic growth, global warming, pollution, etc.  As Matt notes, “health” is also tied to all these issues, as is our agricultural system and related public policies.

For the most part, the entrenched mass media is not capable of (and/or willing to) communicate a systemic perspective.  They mainly promote fragmented and fleeting thinking about “this and that,” “trends and crises” along with gossip, stereotypes and glib, cynical “analysis.”

In part because the MSM is largely counterproductive to the goal of promoting broad systemic change (cultural hegemony, anyone?), the netroots can and should play a key role in facilitating the kind of “broad coming together” that Matt seems to be pointing to (in terms of issues and strategies) and which Mike Lux may also have been referring to (at least in part) in his earlier post.  I also pointed in that same general direction in my recent “American Blogger” proposal.
http://www.openleft.com/showCo…

Matt cites the work of Lessig and McChesney as providing “intellectual roots” and “bedrock” platform for the various forms and forums of the “open Internet” movement.  This level of foundational and integrating analysis is key to building system-level strategies and enabling a process of relatively massive education and mobilization around issues tied to these “bedrock” issues and understandings.  And it has arguably been achieved with regard to basic Internet issues.

This “building from strong intellectual roots” approach is consistent with the initial step proposed in my AB proposal, which was to build discussion threads, communities, principles, policies and even specific legislation based on the writings of authors/experts who have laid out foundational analyses in key areas like economics, health, energy, etc.

I’m glad to see someone with Matt’s political savvy laying out this kind of strategic direction at a time when the political environment and media/tech landscape may be ready for it.

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by: mitchipd @ Tue Jul 22, 2008 at 18:26:24 PM CDT

 

Focusing the coalition (0.00 / 0)

By broadening a coalition and the issues involved, you bring in new allies, but you can also bring in new opponents. I think your point would be stronger if you focused on how the health care coalition could be about pushing for a universal health insurance bill that had as its goals not only access to health care but at improving the health care of Americans.

Access to health care would be the beginning point, while better health would be the end goal, in a sense. Analogously, more and better Democrats, or public schooling and then better quality and outcomes to education.

The focus on better health could involve “nonpartisan” groups such as doctors, parents, the PTA, and others.

One way to do this is to incoporate incentives into the legislation to states to improve the health care of their populations, for example, by providing more funding to states that did so. Another is to set up community health boards that would identify health care issues and set goals to improve health care.

I think there is a controversy here as to whether HCANN includes single pater advocates or not. A little reporting and a post to clarify this issues would be helpful.        

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by: johnraymond @ Tue Jul 22, 2008 at 18:30:59 PM CDT

 

We don't need a universal Health Insurance bill (4.00 / 5)

We need a universal health care bill.  The most introguing thing that happened in the Congress this past few weeks was the Dems standing firm on the Medicare reimbursement cuts, eventually overriding Bush’s veto.  The Dems (in the House especially) built a coalition including Doctors that stood against the health insurers, paying for not cutting the reimbursement by cutting out the subsidies for insurers to enter the Medicare field.  The doctors (at least a substantial part of them) have figured out that the insurers are not their friends, and that they can be even more arbitrary and intruisive than government.  This is a far cry from 1993 when a coalition led by insurers killed Hillarycare, and bodes well for real progress in the coming 4 years.

Getting the doctors on the side of universal health care is essential.  Single payer or multiple, it has to at the very least have a government-run component plus community rating to remove the ability to cherry pick pateints and,e ventually, cause for-profit companies to exit the field

John McCain–He’s not who you think he is.

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by: Mimikatz @ Tue Jul 22, 2008 at 19:57:47 PM CDT

[ Parent ]  

of course, we all should do the best we can to take responsibility for… (4.00 / 1)

our actions. Collectively, as progressives for universal health care, we recognize that it’s not “every man for himself.”  We’re all in this together. People make choices as individuals, but those choices are constrained by their circumstances. Re incentivizing thinness…Be careful not to pass judgement and blame the victim for his/her injuries or bad health. That thinking totally ignores all of the broad socio-economic determinants of health and eating patterns, not to mention genetics.
   Most people understand it is unfair and inequitable for people to have differential exposure to carcinogens, pathogens, and toxins based on the racial or class make-up, or the zip code of their neighborhood.  Inequitable opportunity to shop for/or afford “fresh/organic” fruit, meat/fish/poultry, fruits and vegetables.
   Asthma and chronic lung diseases are more prevalent near the ports, highways, industrial and manufacturing plants, and in large cities in climate/geographical zones given to atmospheric inversion layers. Bus drivers, train operators, and computer operators, have sedentary occupations and are probably more prone to obesity. Schools have replaced music, art and p.e. programs with computers.  Is it any wonder stress and obesity is on the rise among school children?  Each life is precious and has valuable potential. Each person deserves healthcare.
    If we’re going to hold people accountable for their personal health behaviors, don’t they also need to have equal access to health-promoting resources; wellness check-ups, early treatment for illness or injury when it’s more timely and cost-effective.
    Insurers exclude or jack up the price of coverage discriminately, citing factors such as age, sex, zip code, and  pre-existing conditions that are no fault of the individual. However, as a moral and just society, we need to extend the benefits of a single-payer national health system to all.

     

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by: RN4MERCY @ Wed Jul 23, 2008 at 02:24:04 AM CDT

[ Parent ]  

Why should coalition building be so exclusionary? (4.00 / 4)

I have a lots of concerns with HCAN.  One of my biggest is that there already exists a huge grassroots movement around single payer healthcare.  Just for example, check this list: (courtesy of Dr. Steve B on Kos):

AL Health Care for Everyone: http://alabamahealthcareforeve…

CA Nurses Association: http://www.calnurses.org/
CA Physicians’ Alliance: http://capa.pnhp.org/
CA Health Care for All: http://www.healthcareforall.org/
CA One-Care-Now: http://www.onecarenow.org/…

CO Health Care for All:  http://www.healthcareforallcol…

CT Coalition for Universal Health Care: http://cthealth.server101.com/

DE Informed Civic/Political Coalition: http://deinformedvoters.org/

FL PNHP: http://www.tbpnhp.org/
FL for Health Security: http://www.ffhs.org/

GA for a Common Sense Health Plan: http://www.commonsensehealthpl…

IL Health Care for All: http://www.healthcareil.org/
IL Singel Payer Coalition: http://www.ilsinglepayercoalit…

IN Hoosiers for Commonsense Health Plan: http://www.hchp.info/

KS Heartland Health Care for All http://healthcareforall.kumc.edu/

KY PNHP: http://www.kyhealthcare.org/

ME People’s Alliance: http://www.mainepeoplesallianc…

MD Health Care for All Coaltion: http://www.mdsinglepayer.org

MA Campaign for Single Payer: http://www.masscare.org/
MA Affordable Health Insurance for Everyone: http://healthcareformass.org/
MA Alliance to Defend Health Care: http://www.massdefendhealthcar…

MI Universal Health Care Access Network: http://www.michuhcan.com/

MN Universal Health Care Coalition: http://www.muhcc.org/
MN Citizens Organized Acting Together: http://www.coact.org/

MO for Single Payer Healthcare: http://www.mosp.us/…

MS PNHP: http://www.pnhp-mo.org/

NH PNHP: http://www.granitestate-pnhp.org/

NY Metro Chapter of PNHP: http://www.pnhpnyc.org/
NY State Capital District PNHP: http://capitaldistrictpnhp.blo…

NC Committee to Defend Health Care: http://www.ncdefendhealthcare….
NC Healht Care for All North Carolina: http://www.HealthCareforAllNC….

OH Single-Payer Action Network: http://www.spanohio.org/
OH PNHP Ohio http://www.pnhpohio.org/
OH Health Care for All Ohio http://healthcareforallohio.org/

OR Health Care for All: http://www.healthcareforallore…

PA Philly Area Committee to Defend Health Care: http://www.phillyhealth.org/
PA  http://phillyhealth.blogspot.com/

RI Everybody In-Nobody Out: http://www.everybodyinnobodyou…

TX Health Care for All:  http://www.healthcareforalltex…

UT Health Alliance:  http://www.utahhealthalliance….

VT Health Care for All:  http://www.vthca.org/

WA Health Care for All: http://www.healthcareforallwa….
WA PNHP: http://www.pnhpwesternwashingt…

WV Mountain State PNHP: http://mountainstatepnhp.com/

WI Coalition for Health: http://www.wisconsinhealth.org/

WY Voices Foundation: http://www.wyoming-voices.org/

For Single-Payer Actions in Your State:
http://www.pnhp.org/…
&
http://www.pnhp.org/…

More State Contacts:
http://www.healthcare-now.org/…

State-by-State Legislation in Process:
http://www.ncsl.org/…

Health and Health Care Facts in Your State:
http://www.statehealthfacts.org/

All of those are real grassroots organizations devoted to the fight for single payer healthcare.  Most of them have been in the fight for a long time – some of them for 20 years or more.  To the best of my knowledge, none of them are part of this “grassroots coalition”  and as far as I know none of them were approached for their input or to be part of it.
The other disturbing thing about HCAN is the pre-emptive surrender part.
In the fight for net neutrality, no one went into that fight saying “well, we’d like to give the telecoms the right to skew the internet a little less than they want to.”
No one started by saying “The telecoms are too big to fight, so we should concede half the battle right at the beginning.”
But that’s exactly what HCAN is doing in regard to the insurance companies.  Single payer activists are not unrealistic.  We get it that there may be compromises to be made.  We get it that the whole pie may not be eaten at one sitting.  But we don’t see any reason to totally take off the table the one solution that we all know is best, which is exactly what HCAN has done.  

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by: Chico David RN @ Tue Jul 22, 2008 at 21:40:48 PM CDT

 

I can speak to one coalition (0.00 / 0)

One Care Now is the umbrella coalition in California for supporters of single-payer health care.  If you go to their website you’ll see that there are a number of member organizations that are either now part of HCAN or groups that CNA has in the past suggested were not “single-payer advocates” because they were willing to consider something less than single-payer.  

In California, one of the principle anchor organizations for HCAN in California will be Health Access California (which I used to work for).  If you go to their website, you’ll see that their Board of Directors include people from both the CNA and California Health Care for All (also listed above).

So this whole idea that advocates of single-payer were kept out of HCAN is just a big not-so.

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by: Matt Lockshin @ Wed Jul 23, 2008 at 04:15:52 AM CDT

[ Parent ]  

Oh Matt (4.00 / 1)

First of all, one of the first posts on HCAN’s Web site, and HuffPo, by their executive director is called “Why Not Single-Payer.”

I mean that’s pretty clear, right?

Now, on to your points about Cali.  First of all, go to the OneCareNow Web site, you will see nothing about HCAN.  

The real California anchor is Health Access, which was a driving force behind Arnold’s bill last year…which was a similar attempt to build a center-right coalition to pass legislation that is not Medicare for All.  Health Access, it has been reported but I cannot verify, was the group that banned all signs advocating for SB 840 last week at the launch.

May I ask where you’re getting the info about the inner workings of HCAN and what they have and have not said?  All of the leading single-payer groups…PNHP, CNA/NNOC, HealthCareNow, etc….have reported being stiffed by HCAN.  What evidence do you have to questino that?

Join the California Nurses Association and National Nurses Organizing Committee in the fight for guaranteed healthcare on the single-payer model at www.GuaranteedHealthcare.org/blog

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by: California Nurses Shum @ Wed Jul 23, 2008 at 11:49:57 AM CDT

[ Parent ]  

Center-right, are you effing kidding me !?! (0.00 / 0)

Just for the record, the folks Shum is calling “center-right” include:

One of three sponsors of One Care Now:
California Teachers Association

Three other groups that are part of the One Care Now State Strategy Group:

California Council of Churches/California Churches Impact California Alliance for Retired Americans
Consumer Federation of California

This “center-right” coalition also included such rightwinger organizations as:

California Labor Federation
SEIU (with the full support of both the international and UHW)
AFSCME
California ACORN
ACLU of Southern Californian
Planned Parenthood Affiliates of California
CalPIRG
Alameda Health Consortium
American Federation of Television and Radio Artists
California Pan-Ethnic Health Network
Congress of California Seniors
California National Organization for Women (NOW)
Consumers Union
Health Access California
Latino Coalition for a Healthy California
Latino Issues Forum
LifeLong Medical Care
Lutheran Office of Public Policy – California

Interestly enough, all of these groups are listed as part of the One Care Now coalition on its website.  

In other words, these groups are progressive when you’re talking about them being part of Shum’s coalition but when you’re talking about them being part another coalition (at the same time as they’re part of Shum’s coalition) they suddendly ipso facto become center-right.  All of their advocacy on behalf of single-payer magically disappears.      

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by: Matt Lockshin @ Wed Jul 23, 2008 at 19:37:56 PM CDT

[ Parent ]  

Oh come on (0.00 / 0)

That coalition totally collapsed, which is why Arnold’s plan only got ONE vote in the Democratic-controlled State Senate.  You know that the collapse of labor support was a significant reason for this, including some of the very groups listed here.  People looked at the financing of the plan, and the numbers simply could not work out, because you can’t both increase insurance industry profits and improve healthcare coverage.

Any healthcare coalition that is built around the active, eager, enthusiastic support of 9 of the 10 largest insurers in the state is center-right.  Any healthcare plan that would have guaranteed billions in public subsidies to the for-profit insurers is a center-right plan that would have clearly hurt patient care in the state.  

This obviously does not change the progressive nature of some of the groups, but the coalition itself was center-right, and dominated by Arnold supporters.  

Join the California Nurses Association and National Nurses Organizing Committee in the fight for guaranteed healthcare on the single-payer model at www.GuaranteedHealthcare.org/blog

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by: California Nurses Shum @ Thu Jul 24, 2008 at 11:37:21 AM CDT

[ Parent ]  

And for those that DO see insurance as the primary obstacle? (4.00 / 2)

It seems there is a growing agreement among some elements of the center-left that we cannot or should not pick a fight on the basic economic and financial issues that have plagued health care. Insurance is indeed the problem because it demonstrates the risk shifting, predatory nature of modern capitalism. So-called progressives that believe we should shrink from that bold fight to use a massive coalition to engage in vague and undefined policy fights that avoid the issue that virtually everyone agrees is at the core of our health care crisis are risking the abandonment of an invaluable opportunity to produce serious change.

The marginalization of single-payer activism is broad and persistent. It is as if social democracy is again being written out of the movement to fix health care as it had been after the failure of Truman’s proposal in the late 1940s.

One clear thing that came out of Netroots Nation was the need for social democrats to hustle to not just complain about insurance companies, to not just demand single-payer, but to organize to make it happen. We must no longer make it easy for liberals to demonize us as mere purists. It’s time to start planning and organizing, otherwise we’re going to be shut out of the conversation permanently.

In that sense it’s worth noting the persistent failure of mandated insurance plans to mobilize a mass base. There simply is no grassroots constituency for these plans. The political force necessary to remake the US Senate can only be mobilized through support for guaranteed healthcare that one receives as a right of being alive. HCAN, by refusing to acknowledge the existence of that policy, is dooming itself to being a movement without a base. No wonder they have to use such a huge wallet…

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by: Robert in Monterey @ Tue Jul 22, 2008 at 23:10:46 PM CDT

 

"So-called progressives" (0.00 / 0)

This is a phrase I see a lot and hear a lot these days when it comes to health care.  Even at Netroots Nation the phrase was used by a man in the audience to refer to the membership of HCAN.  And in your comments it seems to me that you are using it in the same way (although your characterization of the group in question is so unsuited to HCAN that I only assume you’re referring to them based upon our lengthy prior exchanges on this topic).

If the folks who fought to elect Donna Edwards aren’t progressive, who is?  If Elizabeth Edwards isn’t progressive when it comes to health care, who is?  And I suppose that Planned Parenthood, whose employees are harassed and threatened with physical violence on a daily basis, needs you to tell them a thing or two about what it’s like to stand up and fight for something you believe in.  Then maybe they’d be real progressives, right?

If you want people to stop telling you that you’re being a purist, then stop acting as though the only legitimate way to be a progressive and/or a supporter of single-payer is to agree with you.  

And let’s be very, very clear.  HCAN did not leave out single-payer advocates.  Many of the groups involved have a record of supporting single-payer and the principles they are organizing around are fully consistent with a single-payer system. HCAN left out the folks who fundamentally disagree with their program and strategy to the extent that these people (e.g. CNA) actually question the very values motivating a group like HCAN?

There is a very jagged fracture within the progressive movement around health care.  We need to recognize how difficult it is to mediate this fracture and not let it turn us against ourselves more than it already has.  These types of internecine fights are toxic and they kill movements.  

The use of the phrase “so-called progressives” when referring to people who have earned the right to have their values and motives taken at face value is nothing more than a poke in their eye.

More substantively, the use of the phrase betrays an inability to grant the possibility that there is a space for legitimate disagreement among progressives around this issue.  So even when it’s not inflammatory, it still marginalizes you.  If you are the rightmost edge of true progressivism in this country, if HCAN represents not only a strategic error but also a betrayal of progressive values, then where do you find the people and institutions you need to win?    

By way of disclaimer, I used to work for a health care reform coalition in California that included many of the groups that make up HCAN.  However, I am no longer affiliated with them in any way and these remarks are simply my personal opinions at the time of posting.
   

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by: Matt Lockshin @ Wed Jul 23, 2008 at 03:30:44 AM CDT

[ Parent ]  

Are we going to define "progressive" out of existence? (4.00 / 2)

My objection is on the grounds of political economy and having “progressive” be a coherent set of policies organized around the core theme that markets need to be taken back out of the delivery of core services.

Single-payer’s value is that it’s the only kind of reform that reverses the shifting of risk to and the plundering of wealth from working people. Progressivism to me is about undoing the neoliberal policies of the last 30 years. HCAN seems interested in moving away from that fight in pursuit of something they deem to be more winnable. That argument has merit. It has value. And it’s not progressive. It doesn’t need to be, of course.

But it does cause us to ask where we’re going. Is our movement one that is interested in taking out neoliberalism by root and branch? Or do we believe, for various reasons, that we have to try and moderate the sharpest edges of that system first?

I reject the notion that single-payer advocates are self-marginalizing. HCAN has clearly done the marginalizing themselves. We seek coalitions on this and as was explained at Netroots Nation most of us are willing to support intermediate steps, such as expanding S-CHIP, shoring up Medicare, greater regulation of insurers, etc. We seek pragmatic solutions. We have our work to do.

But we rightly reject the redefinition of a fundamentally neoliberal solution – mandated insurance – as a progressive solution. It’s just not. We would reject mandated fire insurance instead of the current universal fire care, for example. We rejected privatizing social security. So why on earth would we do the same thing with health care?

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by: Robert in Monterey @ Wed Jul 23, 2008 at 10:53:00 AM CDT

[ Parent ]  

mandates are not the problem… (0.00 / 0)

and depending upon the nature of the mandate, can provide a path to single payer.

Indeed, any plan that doesn’t include mandates is basically a subsizied version of what we’ve got now.  “Community rating” simply doesn’t work without mandates, and “community rating” is key to keeping insurance costs down.

If we don’t go with single payer now, the only way we get there is if there is a “Medicare for All” – like option… and individuals can opt out of employer/union administered private insurance plans, and see the savings in their paycheck.  

 

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by: plukasiak @ Wed Jul 23, 2008 at 14:58:26 PM CDT

[ Parent ]  

well mandates might be the problem… (0.00 / 0)

I mean it’s kind of an imprecise word, but if mandates just end up allowing insurers more customers, revenues, public subsidien, medical influence, and political leverage…than they are the problem.  Because patients would definitely suffer as a result.

Join the California Nurses Association and National Nurses Organizing Committee in the fight for guaranteed healthcare on the single-payer model at www.GuaranteedHealthcare.org/blog

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by: California Nurses Shum @ Wed Jul 23, 2008 at 19:00:50 PM CDT

[ Parent ]  

Robert, you and I don't disagree about single-payer… (0.00 / 0)

…we disagree about how to get to single-payer.

Again, you simply leave no room for progressives to disagree with you.  And in doing so you ascribe thoughts and values to me that I don’t have while ignoring the values I say I have and the thoughts I have expressed to you on countless occasions.

The bottom line is that even if I’m wrong in my assessment about how to get to single-payer, even if I am as wrong as wrong can be, it still does not change the fact that I am motivated by the very values you claim for yourself but deny me.

Robert, you’re not a bigger supporter of single-payer than I am.  I’m sorry, you’re not.  You don’t get to claim that mantle and deprive me of it.

         

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by: Matt Lockshin @ Wed Jul 23, 2008 at 19:06:13 PM CDT

[ Parent ]  

Progressive (0.00 / 0)

You can be progressive on many issues, Matt…Iraq, education, whatever…and not on others, and still be a progressive.  I don’t know, Ron Wyden comes to mind.

The point is, it’s not progressive to give up on the dream of FDR, HST, JFK, LBJ, let alone Ted Kennedy, John Conyers, and Sheila Kuehl, by giving up on Medicare for All.  The problem in the American healthcare system is this wasteful, non-productive private insurance industry…the progressive stance on health care is to try to fix this with, dare I say it, European or Canadian style improvements.  

Join the California Nurses Association and National Nurses Organizing Committee in the fight for guaranteed healthcare on the single-payer model at www.GuaranteedHealthcare.org/blog

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by: California Nurses Shum @ Wed Jul 23, 2008 at 11:57:20 AM CDT

[ Parent ]  

define "first", define "serious" (4.00 / 1)

It’s the first serious attempt from progressives on the health care side to govern

Earlier this month, Health Care Now held demonstrations against health insurance companies in cities across the US. Just because you didn’t pay attention does not mean it didn’t happen.

The US Conference of Mayors just endorsed HR 676. I would suggest that the US Conference of Mayors, and the 91 cosponsors of HR 676 is some serious political muscle.

And I think it is best to keep focused on passing legislation instead of being pulled in 20 directions at once. But hey, you would know so much more about winning legislative battles than John Conyers.

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by: AliceDem @ Wed Jul 23, 2008 at 09:33:05 AM CDT

 

HCAN Different from Net Neutrality (0.00 / 0)

We can debate the philosophical origins of Net Neutrality another day.  Certainly there were lots of people who believe in open networks and the free Internet.

The big difference I see is that HCAN has $40 million.  What those of us fighting to preserve the Internet wouldn’t give for, say, 1/10th of that — not to be greedy or anything.

Art Brodsky
Public Knowledge

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by: artbrodsky @ Wed Jul 23, 2008 at 12:29:33 PM CDT

 

single payer (0.00 / 0)

the single payer movement feels the same way

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by: AliceDem @ Wed Jul 23, 2008 at 12:33:54 PM CDT

[ Parent ]  

Why is our health care system broken? (0.00 / 0)

This is the underlying question all need to be asking.  As a new member of the blogging community, I must say this has been an interesting and valuable discussion.  Comments and opinions are as varied as our society.  However, we all agree health care is broken.  I cannot but wonder how many contributors to this discussion are commenting from a philosophical base, and how many know first hand the cruelty of the health care system in the USA.  Words come cheaply.  To say incremental health care reform is a viable solution, is to deny the elephant in the room exists.  Working as a direct patient care registered nurse, in acute care hospitals, for the past 30 years, gives me credibility concerning this subject.  I see every day I work the consquences of our profit driven health care industry.  Make no mistake, it is an “industry”, not a health care system.  I do not understand the dance that is being done around this issue.  There are only two options.  Continue to subsidize the for profit insurance industry ,ie mandates to purchase insurance, or provide the citizens of this country medicare for all. The mandated plan in Massachusetts is a big mess, and is not working.  Folks are being criminalized for refusal to partake in purchasing insurance they cannot afford, and do not want. Why would anyone want to support this venue?  Just because you have health insurance does not mean your insurance will pay your health care costs.  I have a friend who has “good” health insurance.  She developed a cancer in which the primary site cannot be identified.  Therefore, her to date four coarses of different chemotherapeutic drugs, hoping to find the right one, are being denied by her health insurance as “experimental”.  What kind of industry is one in which profits are made at the expense of peoples’ lives.  How many more deaths will it take before we stop this insane dance, in support of a health insurance industry without a conscience?  HCAN needs to come out strongly in support of a single payer system.  That is the progressive, grassroots stance that will provide what the citizens of this country need for better health outcomes.
Kathryn D. RN      

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by: katnurseadvocate @ Thu Jul 24, 2008 at 14:36:58 PM CDT

[ Parent ]