The final vote on health care reform is going to be close. And Dennis Kucinich may be the one vote between victory and defeat.
Kucinich says he won’t vote for the bill because it is a bail out of insurance companies and is not his preferred way of reforming health care, single payer.
So far, only a very few advocates for single payer, who could have substantial influence over Kucinich, has asked him to vote for the bill. As far as I know, no one from Pennsylvania, which has one of the most active and impressive movements for single payer, has asked him to support the bill. As far as I know, Pennsylvania single payer advocates like Walter Tsou and Chuck Pennachio have said that the legislation should be defeated.
This is very hard for me to understand for a few reasons.
For one thing, the bill will save lives and reduce suffering. No one, including those who have raised serious questions about the bill, has raised any doubt about that. Some single payer advocates, such as Walter Tsou, are doctors. One would think that the hippocratic oath comes into play here. All single payer advocates claim that they care about the plight of the uninsured and undersinsured. They have a funny way of showing it.
Now I’m not asking them to say that the bill is the best or even a good solution to the health care mess. I don’t think it’s the best solution. I know it is not perfect. And I’m sure that, from the point of view of someone who supports single payer, it is a terrible bill.
So let the single payer advocates say it is terrible. But they need to tell Dennis Kucinich to support it because it will save lives and reduce human suffering.
To say vote against this bill in the hopes that we will soon get something much better at the national level is foolish and immoral. It is foolish because it is clear that if we lose we won’t get anything better soon. And it is immoral because without any guarantee that we will get something better, then risking tens of thousands of lives a year is deeply wrong.
I find it hard to understand for a second reason. I’ve debated Walter and Chuck many times over the past two years. I’ve heard them say, time and again, that there is no incompatibility between working for the Obama approach in Washington and working for single payer in Pennsylvania. (I’ve said the same thing.) They have implied a number of times that, while they don’t think much of the Obama approach, they would not oppose it.
So now, when the chips are on the table, where are they?
Third, as I pointed out in a blog post yesterday, while the legislation in Washington may theoretically delay adoption of single payer in Pennsylvania, it also creates an enormous opportunity for single payer supporters because it will require the State Senate to bring health care bill to the floor in order to create the Exchange. This will give single payer supporters their best opportunity to move single payer in Pennsylvania forward.
And, fourth, single payer supporters are progressives generally. Surely they understand the consequences for legislation on jobs, climate and energy, immigration, and net neutrality if President Obama and the Democratic leadership are defeated. Another single payer supporter, Charlie Chrystle, with whom I have had many disagreements, has said that this is a reason to support the bill.
So what is the trouble?
I wish I knew. It strikes me, however, that part of the problem is the self-image of the single payer supporters. Time and again, I’ve heard Walter Tsou call me a pragmatist while he calls himself an idealist. It seems to me that some of the single payer supporter won’t sacrifice this self-image in order to support the legislation before Congress now.
Another part of the problem may be strategic. It may seem to the leaders of the single payer movement that the will undermine their support in their movement if they say to Kucinich “vote for this terrible bill.” It is as if supporting something that is far from their ideal will tarnish the whole movement and undermine the support of the members of the single payer movement.
I’ve seen Chuck do this before. When Neighborhood Networks, the progressive organization I helped found, endorsed Chuck for Senate a few years ago, we did it with the understanding that he would endorse Bob Casey against Rick Santorum if, as most of us expected, he lost the primary. Neighborhood Networks made that endorsement of Casey. I don’t think Chuck ever did.
The leaders of the single payer movement may be right about their followers. Perhaps the followers will leave if the leaders show just a little pragmatism. If so, then that’s too bad.
It’s too bad for health care reform if we lose.
And, frankly, it’s too bad for progressive politics.
Because I think it is time we came to a new understanding of what idealism in politics means.
To say no to the immediate reforms we can make now, and the path it leads toward further reform, in the name of policies that are not attainable today, such as single payer, is not, in my view, idealism. It is moral self-indulgence. It is the political stance of people who care more about showing how politically pure then they care about actually accomplishing real political change.
It is the political stance of people who don’t really have anything to lose if we don’t enact any reforms this year. In twenty months of working for health care reform, I’ve met exactly one person without health insurance who said we should wait for something better than we can get.
This is not, I repeat, idealism. And, frankly, I don’t think it characterizes many people on the left, including many of the people who show up at single payer rallies or would like to enact single payer at some time in the future. Many of those people are working with me in HCAN right now. Almost none of them have turned their back on our efforts, even as we have lost ome things we very much want in the bill in Washington.
So if the leaders of the single payer movement think they have to stand apart from the struggle in Washington, I think they are misreading their supporters. There are a few who practice the kind of moral self-indulgence I am criticizing. But they are very few.
I think most people understand the difference between moral self-indulgence and idealism.
They understand that the real idealists are not the people who are always ready to say no to anything possible and insist that we could get something better if we only would try for it.
The real idealists are the people who know just how hard it is to move this country; who have been organizing in all the tough Congressional districts around the country; who have fought for each of the small victories we have won so far in this campaign; and who know how important it is to have a real victory this week, not just because we care about saving lives and reducing human suffering, but also because we know that political movement are built on victories, however small, not on noble defeats.
I’ve heard Chuck Pennachio make promises that single payer is right around the corner in Pennsylvania. (Last September at Philly for Change he said that the bill would be on the Governor’s by November 19, I believe.) Chuck is a persuasive speaker. And when I hear him, I always hope for a minute that he is right, because, whatever my doubts about it as an ideal, single payer would be better than what we have today. But I know how difficult it is to get legislation through the Pennsylvania General Assembly and I see no path to victory any time soon.
Perhaps failure will keep the true blue single payer activists motivated. But I really doubt that. I don’ think you can build a movement that goes from defeat to defeat. I don’t think you can build a movement just appealing to middle class people who want to see themselves as standing above the political looking down on it. There just aren’t enough of such people. And eventually failure wears us all down, even those who live by their anger at everyone who is not as pure as they are.
There is another way forward for the single payer movement: not to compromise on their principles or to say that the bill before Congress is great or even good but, rather, to say, especially to Dennis Kucinich, the bill is better than nothing. The better way forward is to be part of a victory, however small, and then to encourage all of us idealists who have been working for this compromise legislation to join together in working for the next step forward in Pennsylvania and beyond.
I know that I’m not going to be satisfied with what I hope we achieve this week. I know that the HCAN activists will not be satisfied, either. I hear from many of them who ask me what’s next? What is the next issue? What is the next step forward on health care reform? And many of them say, what can we do in Pennsylvania to improve on what we do in Washington? Is single payer something you want to fight for?
I always tell them that as the state director of an organization that promised members of Congress that we would not demand single payer, I couldn’t support it in Pennsylvania. But once the HCAN campaign is over, that changes. And then what we do next depends on many things: on what issues are on the table here in Pennsylvania, on what our chances are for victories, and on what the leaders of the single payer movement intend to do.
In the future we can work together to build a movement for further health care reform, that could include single payer, in Pennsylvania.
But if we are going to work together, it has to start this week.
The final vote on health care reform is going to be close. And Dennis Kucinich may be the one vote between victory and defeat.
Kucinich says he won’t vote for the bill because it is a bail out of insurance companies and is not his preferred way of reforming health care, single payer.
So far, only a very few advocates for single payer, who could have substantial influence over Kucinich, has asked him to vote for the bill. As far as I know, no one from Pennsylvania, which has one of the most active and impressive movements for single payer, has asked him to support the bill. As far as I know, Pennsylvania single payer advocates like Walter Tsou and Chuck Pennachio have said that the legislation should be defeated.
This is very hard for me to understand for a few reasons.
For one thing, the bill will save lives and reduce suffering. No one, including those who have raised serious questions about the bill, has raised any doubt about that. Some single payer advocates, such as Walter Tsou, are doctors. One would think that the hippocratic oath comes into play here. All single payer advocates claim that they care about the plight of the uninsured and undersinsured. They have a funny way of showing it.
Now I’m not asking them to say that the bill is the best or even a good solution to the health care mess. I don’t think it’s the best solution. I know it is not perfect. And I’m sure that, from the point of view of someone who supports single payer, it is a terrible bill.
So let the single payer advocates say it is terrible. But they need to tell Dennis Kucinich to support it because it will save lives and reduce human suffering.
To say vote against this bill in the hopes that we will soon get something much better at the national level is foolish and immoral. It is foolish because it is clear that if we lose we won’t get anything better soon. And it is immoral because without any guarantee that we will get something better, then risking tens of thousands of lives a year is deeply wrong.
I find it hard to understand for a second reason. I’ve debated Walter and Chuck many times over the past two years. I’ve heard them say, time and again, that there is no incompatibility between working for the Obama approach in Washington and working for single payer in Pennsylvania. (I’ve said the same thing.) They have implied a number of times that, while they don’t think much of the Obama approach, they would not oppose it.
So now, when the chips are on the table, where are they?
Third, as I pointed out in a blog post yesterday, while the legislation in Washington may theoretically delay adoption of single payer in Pennsylvania, it also creates an enormous opportunity for single payer supporters because it will require the State Senate to bring health care bill to the floor in order to create the Exchange. This will give single payer supporters their best opportunity to move single payer in Pennsylvania forward.
And, fourth, single payer supporters are progressives generally. Surely they understand the consequences for legislation on jobs, climate and energy, immigration, and net neutrality if President Obama and the Democratic leadership are defeated. Another single payer supporter, Charlie Chrystle, with whom I have had many disagreements, has said that this is a reason to support the bill.
So what is the trouble?
I wish I knew. It strikes me, however, that part of the problem is the self-image of the single payer supporters. Time and again, I’ve heard Walter Tsou call me a pragmatist while he calls himself an idealist. It seems to me that some of the single payer supporter won’t sacrifice this self-image in order to support the legislation before Congress now.
Another part of the problem may be strategic. It may seem to the leaders of the single payer movement that the will undermine their support in their movement if they say to Kucinich “vote for this terrible bill.” It is as if supporting something that is far from their ideal will tarnish the whole movement and undermine the support of the members of the single payer movement.
I’ve seen Chuck do this before. When Neighborhood Networks, the progressive organization I helped found, endorsed Chuck for Senate a few years ago, we did it with the understanding that he would endorse Bob Casey against Rick Santorum if, as most of us expected, he lost the primary. Neighborhood Networks made that endorsement of Casey. I don’t think Chuck ever did.
The leaders of the single payer movement may be right about their followers. Perhaps the followers will leave if the leaders show just a little pragmatism. If so, then that’s too bad.
It’s too bad for health care reform if we lose.
And, frankly, it’s too bad for progressive politics.
Because I think it is time we came to a new understanding of what idealism in politics means.
To say no to the immediate reforms we can make now, and the path it leads toward further reform, in the name of policies that are not attainable today, such as single payer, is not, in my view, idealism. It is moral self-indulgence. It is the political stance of people who care more about showing how politically pure then they care about actually accomplishing real political change.
It is the political stance of people who don’t really have anything to lose if we don’t enact any reforms this year. In twenty months of working for health care reform, I’ve met exactly one person without health insurance who said we should wait for something better than we can get.
This is not, I repeat, idealism. And, frankly, I don’t think it characterizes many people on the left, including many of the people who show up at single payer rallies or would like to enact single payer at some time in the future. Many of those people are working with me in HCAN right now. Almost none of them have turned their back on our efforts, even as we have lost ome things we very much want in the bill in Washington.
So if the leaders of the single payer movement think they have to stand apart from the struggle in Washington, I think they are misreading their supporters. There are a few who practice the kind of moral self-indulgence I am criticizing. But they are very few.
I think most people understand the difference between moral self-indulgence and idealism.
They understand that the real idealists are not the people who are always ready to say no to anything possible and insist that we could get something better if we only would try for it.
The real idealists are the people who know just how hard it is to move this country; who have been organizing in all the tough Congressional districts around the country; who have fought for each of the small victories we have won so far in this campaign; and who know how important it is to have a real victory this week, not just because we care about saving lives and reducing human suffering, but also because we know that political movement are built on victories, however small, not on noble defeats.
I’ve heard Chuck Pennachio make promises that single payer is right around the corner in Pennsylvania. (Last September at Philly for Change he said that the bill would be on the Governor’s by November 19, I believe.) Chuck is a persuasive speaker. And when I hear him, I always hope for a minute that he is right, because, whatever my doubts about it as an ideal, single payer would be better than what we have today. But I know how difficult it is to get legislation through the Pennsylvania General Assembly and I see no path to victory any time soon.
Perhaps failure will keep the true blue single payer activists motivated. But I really doubt that. I don’ think you can build a movement that goes from defeat to defeat. I don’t think you can build a movement just appealing to middle class people who want to see themselves as standing above the political looking down on it. There just aren’t enough of such people. And eventually failure wears us all down, even those who live by their anger at everyone who is not as pure as they are.
There is another way forward for the single payer movement: not to compromise on their principles or to say that the bill before Congress is great or even good but, rather, to say, especially to Dennis Kucinich, the bill is better than nothing. The better way forward is to be part of a victory, however small, and then to encourage all of us idealists who have been working for this compromise legislation to join together in working for the next step forward in Pennsylvania and beyond.
I know that I’m not going to be satisfied with what I hope we achieve this week. I know that the HCAN activists will not be satisfied, either. I hear from many of them who ask me what’s next? What is the next issue? What is the next step forward on health care reform? And many of them say, what can we do in Pennsylvania to improve on what we do in Washington? Is single payer something you want to fight for?
I always tell them that as the state director of an organization that promised members of Congress that we would not demand single payer, I couldn’t support it in Pennsylvania. But once the HCAN campaign is over, that changes. And then what we do next depends on many things: on what issues are on the table here in Pennsylvania, on what our chances are for victories, and on what the leaders of the single payer movement intend to do.
In the future we can work together to build a movement for further health care reform, that could include single payer, in Pennsylvania.
But if we are going to work together, it has to start this week.