You won't get something if you don't ask for it.
That is why we should not be surprised that Medicare-for-All is not on the political table right now: it's not just that big money is opposing it, it's that many progressive organizations refuse to fight for it despite its solid public support.
The most immediate obstacle to its passage is hence the stagnancy and elitism of many organizations that ought to be taking up the charge.
Organizing for America has 13 million e-mail addresses in its database but obviously will not favor Medicare-for-All. This is naturally not a democratic organization: it seeks to mobilize millions of Obama supporters but hardly represents their views on policy. It may have made sense to work for OFA during the Obama campaign but it sure doesn't now.
The main "progressive" health reform coalition, Health Care for America Now, has goals that are similarly stunted: it pushes the "Obama plan."
HCAN believes that everyone in this country should have accessible, quality health care they can afford. We are fighting for a uniquely American solution that gives you a guarantee of coverage and real choice: keep your private insurance plan or join a new public health insurance plan so you are no longer at the mercy of the private insurance industry.
But the public plan now in Congress is a "mouse" public option and bears no resemblance whatever to the original idea championed by Jacob Hacker that could enroll huge numbers of people. The CBO projected only 10 million joining it by 2019 and even that was before the Blue Dogs removed any Medicare based payment rates.
In reality much of the House bill is based on mandates, with smaller parts being the "mouse" option and an expansion of Medicaid. Most importantly, the employer based system that is so dreadfully inefficient will remain intact and thus America's incredibly high health spending likely will also. The leadership of HCAN glosses over all this.
The national leadership of the AFL-CIO has also caved in to intense pressure at the top to grant a rubber stamp to Democrats despite it being against the wishes of their own rank and file. | |
Thirty nine of the state AFL-CIO organizations have endorsed Medicare-for-All but the national leadership stubbornly refuses. Endorsers include the SEIU that may be advertising over on the right.
AFL-CIO's sadly inadequate position is much trumpeted by this website lately as if it were some wonderful stand. In reality it is a sign of a devastated labor movement that has shrunk from representing 30% of the workforce in 1970 to a mere 13% today, not much higher than the number before the New Deal. If the AFL-CIO wants to be much more than irrelevant in the health care debate then it must endorse national health insurance. Instead of mindlessly praising the national leadership, friends of AFL-CIO should encourage it to do so at its next convention.
The pushing of only a public option has disastrous consequences for building a movement. One problem is that nobody knows what a public option is and in the words of this writer:
This is mostly a debate being had among policy elites and the relatively small fraction of the public that is highly knowledgeable and engaged about health care reform; for most others, the details are lost on them.
Those few who are highly knowledgeable then wonder why the public is not enthusiastic about reform. For example one poster here said:
A majority of Americans are stupid, shallow, and are unable to think beyond the most immediate thing that is placed in front of them.
Such people are blind to the fact that it is the failure of their own movement to offer help that causes public indifference.
Ezra Klein, not exactly a rabid supporter of fundamental reform, made a similar point talking about the shortcomings of the current House bill. His favored plan here was Wyden-Bennett, but the same argument actually works even better in favor of national health care.
[The current House bill] does not offer obvious benefits to an insured worker. You can argue that it changes the system around them: There are subsidies if they lose their job and regulations to protect them from the excesses of private insurers. But though the health-care system might be different, it will not, for most people, feel different. And that has made it hard to explain to people why this is something they should pay for. You can tell the insured worker what he gets if his circumstances change. You cannot tell him what he gets if his circumstances do not change.
Summarized simply, he says that current proposals just don't do enough.
All of this leads me to my last would-be progressive organization on health care: this very website, Daily Kos. As I noted a while ago, this website is probably to the right of public opinion on health reform, as astonishing as that may be. This flies in the face of its claim to be a liberal website on this issue. Perhaps the definition of "liberal" is not meant to be with respect to the public: liberal means whatever we want it to mean, and if ignoring public opinion is part of that, then who cares? But in any case the current stance of Daily Kos on health reform is either dishonest or merely elitist. The fact that this is one of the more left wing of the major internet blogs should only make us pause at how distorted the whole health care debate really is.
In the end, we cannot blame organized business for beating us if we don't even dare to try in the first place. Accepting legislative compromises like the public option may sometimes be necessary, but that is completely different from making them the actual goal. From a public relations viewpoint that is probably a complete disaster. Organizations like Healthcare-NOW! offer the best chance at building a successful movement, with their clear message that offers large and easy to understand benefits for the public. Prospects for change will be hobbled until we rise from the current state of elitism and defeat.