As Toxic Health Care Debate Peters Out, Labor's Medicare-for-All Activists Dig In

Whether Congress passes a weak health care bill this month or puts the debate out of its misery altogether, labor’s single-payer activists are showing no signs of slinking out of sight.

Witness a remarkably upbeat Labor Campaign for Single Payer conference in Washington March 5-7. As lobbyists and politicians wrangled a few miles away over what campaign coordinator Mark Dudzic called a “bound-to-fail, toxic” bill, the advocates of Medicare for All could point to big strides in popularizing their vision over the last year.

Although everyone from President Obama to high-priced senators to most union leaders tried to ignore the single-payer option, the health care reform debate created the space to educate and agitate for a real solution.

“There’s no sense that a rerun of the ’90s is in store, with a decade or more of waiting for another go,” said Jon Flanders of the Troy Area Labor Council in New York.

Over the past year, single-payer advocates could point to:

• Hundreds of presentations to union and community groups, thousands of one-on-one conversations, and scores of demonstrations, produced by sturdy local coalitions like the Jobs with Justice health care committee in Portland and the Healthcare Is a Human Right campaign in Vermont.

• An opposing force to Tea Party-ers at town hall meetings last summer.

• Dozens of arrests at insurance companies and other venues.

• 74 resolutions sent to the AFL-CIO convention last September (a record number), resulting in a pro-single-payer resolution there.

The 124 delegates wasted little time bemoaning the fact that most union leaders had backed a “public option” they presumed more viable than single payer. Dudzic couldn’t resist pointing out: “Labor took a stand from the beginning—for a robust public option, an employer contribution, and no tax on benefits. How’d that work out?”

And Michael Lighty, policy director for the California Nurses Association, said the public option was never real: “The public option was just a stalking horse to get labor to support whatever President Obama wanted. Then it was removed and labor is still supporting whatever Obama wants.”

Delegates mostly focused on the future, though, talking about how to pass state-level bills in California, Vermont, and Pennsylvania and sharing specific tactics to educate members and the public for the long term.

Many unions and the AFL-CIO had passed resolutions supporting both single payer and “building on what presently works.” As Alice Brody, a retired Teachers union staffer in Albany, said, this created “SPINO—single-payer in name only.”

In practice, almost all leaders tried to use what clout unions have to shape the existing bills, with single payer on a burner so far back it was off the stovetop. Only a few unions, such as the California Nurses, did both: wading into the Beltway fray while continuing to pound home the single-payer message at every opportunity.

Once the dust settles and wounds are licked, the Medicare for All supporters hope some unions will learn from their humiliation this year and start taking their pro-single-payer stances seriously.

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The Maine AFL-CIO is already on board. It’s adopted an internal education program for its locals, using a costing chart to illustrate the huge savings of single payer (tinyurl.com/costingchart).

The California School Employees Association likewise has carried out a member-to-member education program that’s already reached 20,000 members, one at a time. The Labor Task Force for Universal Healthcare, in Los Angeles, planned a day-long workshop March 20 to train activists how to talk about Medicare for All (“human right,” yes; “entitlement,” no.)

Bob Sisler of Retirees for Single Payer, in Michigan, reminded delegates that the all-inclusiveness of single payer entails a “shock factor.” “When you don’t have good insurance,” he said, “people have been trained to think it’s your fault—you didn’t get the right job, or didn’t bargain the right coverage.”

The Maine AFL-CIO has asked the national federation to call a single-payer summit and to take up the crusade with a commitment of resources no less than those devoted to this year’s frustrated effort. Conference delegates will also be calling on their home locals and CLCs to press the AFL-CIO.

The Maine federation noted, “Had we collectively pursued such a strategy after the last healthcare policy failure in Congress in the mid 1990s…we would be in a much stronger position today.”

ON THE STATE LEVEL

The California legislature passed single-payer bills in 2006 and 2008 and will do so again this year. The trick for unions and other advocates is to elect a governor this fall who will not veto the bill, as Arnold Schwarzenegger has. That is by no means guaranteed.

If that hurdle is crossed, the insurance industry will force a ballot initiative to block the bill. The question then could go before California voters in 2012. Lighty said single-payer advocates relished the chance to tell voters their choice is between single payer and Congress’s “individual mandate.”

Or, if the movement grows enough in the next few years, it could bypass the legislature and the governor and put a measure directly on the ballot. In either case, deep base-building is required.

California’s bill would set up commissions to determine how funding would work.

PENNSYLVANIA PROMISE

In Pennsylvania, a grassroots movement has been building since 2004 and appears poised to pass a bill this year, which Governor Ed Rendell has promised to sign. The movement—HealthCare4AllPA—has little official labor backing, though many rank-and-file members are involved. Only PASNAP, a nurses union, has enthusiastically joined in the organizing.

Pennsylvanians have pressed petitions, letter writing, radio call-in shows, lobbying, rallies, and town hall meetings, carried out by 10,000 (non-dues-paying) members in 27 chapters around the state. Chapter reps make a weekly conference call to plan strategy. In October the group got close to 1,300 people to a Tuesday rally in the state capital, hours from population centers in Philadelphia and Pittsburgh.

Taking a “fiercely nonpartisan” stand, according to Executive Director Chuck Pennacchio, an AAUP member, the organizing has led to 33 out of 50 members of the state senate (including 13 Republicans) calling for an economic feasibility study of single payer in the state. Pennacchio said that “selling Republicans on the fiscal conservatism of single payer was key. Republicans will come back to power at some point and we don’t want them to dismantle the good work we’ve done.”

Pennacchio believes the group can and must get their bill through the legislature this year, as Rendell will leave office in January. It includes a “fair share” funding mechanism: a 3 percent payroll tax on earned income for employees and 10 percent for employers.

A looming problem for all three states is that the Obama bill wouldn’t permit states to set up their own single-payer plans. Successful laws are likely to be mired in the courts for some time.