Single Payer: Californians, It's Time to Have Hope

I couldn’t help but notice that, historically, the compromises are forged by the exact same powerful interests every time, working like scavengers randomly picking through the ideas of national health insurance, with little consideration given to whether any “reform” was actually going to improve the health care system for the average American.

In fact, a century of such “health care reform” has brought our health care system to the point where it is deeply fragmented, unimaginably costly and the least effective system in the entire developed world at delivering either health or care. I can’t help but wonder where we might have been in terms of universal health care had proponents not forfeited their goal quite so fast.

Most striking? The grassroots role that physicians repeatedly played in defeating national health insurance. The American Medical Association functioned as an exceptionally effective grassroots movement that was embedded in every community across the nation. They organized education and lobbying campaigns against universal health care, labeling their efforts as “protecting the public health”. They hired PR consultants who admitted that they were attempting to label national health insurance as “socialized medicine” for the simple reason that Americans were opposed to socialism.

The litmus test for “politically feasible” has historically been largely defined by where doctors, insurers, business and labor stood on the issue. Throughout the last century, there was no grassroots group as singularly focused on the passage of single payer health care as the physicians and insurers were opposed to it. That’s changed considerably, especially in California, as the 500 or so organizations that support SB 840 continue their evolution into an effective coalition that works tirelessly (and largely under the radar of many in Sacramento) to educate and organize Californians on universal health care.

More importantly, groups that traditionally oppose single payer, like physicians, are no longer unified against it. The American College of Physicians made history last year in their endorsement of single payer and the California Medical Association includes a large and growing minority of members that strongly support single payer. The American Medical Students Association has quickly risen to become one of the most passionate and inspired groups advocating for passage of SB 840. Another powerful provider group, the California Nurses Association has gone “all in” for single payer and is working in much the same way for single payer as the American Medical Association once worked to oppose it. Their dedication unites with that of organizations like Health Care for All – California, school employees, the League of Women Voters, retired teachers, and others who are deeply embedded in communities across the state.

The lesson that advocates of single payer should take from history is to observe how the AMA was able to defeat national health insurance through steady community education and organizing. This is why single payer has the best shot, politically, as well as on a policy basis, for winning passage. Only single-payer boasts the kind of unified and dedicated grassroots movement for something that makes large reform possible.

In the midst of an unprecedented and inspiring presidential primary, the theme for 2008 is unmistakable - it’s time to have hope.