We in the progressive community, or at least those of us concerned with the issue of health care financing - which I hope is all of us - have an enormous disconnect at the moment. As smart people with great ideas, we would like to think that we can provide a unified message regarding the issue of health care financing with maybe a little quibble here and there. In reality there are essentially two divergent messages. Everyone is in agreement that private insurance as we know it is a failure in providing access to health care in any way that anyone might consider to be efficient, equitable, comprehensive, or universal (or palatable, for that matter). The disagreement centers around one key issue: WTF do you do with the private insurers?
One camp says: get rid of them, they serve no useful purpose.
The other camp says: keep them in play, we can't get rid of them (except maybe death by 1000 cuts through regulation) because they are too powerful
Full disclosure: I'm solidly in the first camp - and I've subversively paraphrased the message of the second camp.
This is my first diary. It's rather simple, but addresses what I believe is a fundamental issue in our community. Kos admonishes us against sticking to our guns in the little battles lest we lose the big war (I'm paraphrasing). I really don't think this is the case here, although the "incrementalists" would have us believe otherwise.
Unless you've been asleep, you have no doubt by now been assailed with a least one appeal for joining/contributing to the Health Care for America Now! campaign. The first one I got was from MoveOn, followed quickly by TrueMajority and a few others that slip my mind at the moment.
Being curious, I immediately went to their website to check it out. WOW! This is nice! Universal health insurance, very well designed site, loads of participating organizations (Planned Parenthood for crying out loud), even a Blog for the younger set!
Being an avid and deeply involved supporter for single-payer health care financing (I am the vice-chair of the Santa Barbara chapter of Health Care for All - California) I needed to know what this was really all about. Universal health care, of course! Insurance companies bad for the system, of course! Loads of stuff I could agree with here and fully support - they might even get some of my hard-earned green. Christ, even Robert Greenwald was producing a video for them.
Drilling down a little, I finally came across the "statement of principles" (I'm almost certain it was called that at the time, now it is called the "statement of common purpose" - which to me seems rather vague).
Looming largely in my critical eye was the following:
"A choice of a private insurance plan, including keeping the insurance you have if you like it, or ..."
Huh? Wait just a minute, you mean you are actually going to "reform" the financing of health care and allow this too? I don't get it. How the f**k do you do that (if you have any questions as to why this is impossible, just spend ten minutes at any single-payer advocacy site such as onecarenow.org)? After thinking about this for a bit I came to the conclusion that either they were completely delusional or this was a purposeful pander to get people to join the campaign.
Virtually everything else in their "statement of whatever" was clearly geared around keeping private insurers in the game but worded so as to remove the sting from how they currently play the game, and there were many things that I think everyone, even McCain Republicans, could gleefully support. Look, insurers aren't the villains here. I know a lot of insurance brokers who are the most wonderful people you would ever hope to meet; caring, compassionate, and doing their best to enroll people in a broken system in a way that they feel serves everybody's interests. I don't want to remove insurers from the game because they are assholes, I want them out because they provide no value added.
So how do we reconcile Health Care for America Now!? How do we, single-payer advocates, and progressives in general, make them our allies? How do we resolve this glaring departure from the single-payer model, and their insistence on including the private insurers which every knowledgeable person knows will eventually kill viable reform?
A few thoughts. Let's acknowledge that, just like in the insurance industry, there are some people already caught up in the HCAN campaign who are well-intentioned, caring, feeling, compassionate, true-believers - just like me. Also, let's acknowledge that the lead spokesperson for HCAN is Richard Kirsch (hey, he just posted over at Huffpost), who actually used to be a total single-payer advocate. Let's know that Andy Stern is a prime mover in this campaign, and that he might actually have a little stake in the matter as private insurance is one of the draws for union membership - not to mention the fact that he seems to be trying desperately to break his own union for crying out loud.
We all have a stake here. This country will eventually adopt single-payer, unless we truly are a nation of idiots, which I sincerely doubt. It is only a matter of when. I applaud the "little people" of the HCAN campaign, those who perhaps are just entering this movement for the first time, who have our best interests at heart. They can all be easily moved to the single-payer camp.
At the same time, I have to question the bigger players. MoveOn, for example. How many of you are MoveOn members? I am. And I was sickened when I realized what they had done (literally sick to my stomach). On July 11, I received an email from MoveOn in which they elicited my support for HCAN. After doing due diligence (being a bit skeptical of the pitch), I questioned the "upper echelons" of MoveOn to ascertain how they had possibly come to the conclusion that their membership was less supportive of single-payer than the population at large - an extremely remarkable result for a putative progressive subset of the population. Turns out that they had jumped on the HCAN approach before consulting their membership. Then they tried to cover their tracks by polling the membership with a clearly biased questionnaire that skewed the results towards what was consistent with their decision - the inclusion of the private insurers. He'p me Jaysus! This is absolutely sickening! And to boot at least 500 grand of their hard-earned money. Eli Pariser is an absolutely amazing guy, by all accounts (he is mentioned glowingly in Taking On the System by Kos). And yet, this top down bullshit... a true affront to you and me.
It was at once comical and painful to read the post and the responses to Eli's post in the Huffingtonpost entitled something like "What do MoveOn Members Really Think About Health Care". Nearly everyone commenting was a single-payer supporter, proof positive that their "poll" was a total sham. Miles Mogulescu posted a beautiful takedown of this pitiful attempt to exonerate MoveOn. Even HCAN had to take down a post because the responses were so single-payer biased.
So who amongst us progressives is willing to reconcile with HCAN? They are doing a shitload of work, they have a shitload of moolah, is it in the right direction? I'm ambivalent. I hate the top down stench. I love the money. Take the poll: