[ Fight for What You Want. Not What You Think You Can Get.]
[https://portside.org/] 

 ONCE AGAIN: IT’S TIME TO START BARGAINING AGAINST OURSELVES  
[https://portside.org/2018-05-07/once-again-its-time-start-bargaining-against-ourselves]


 

 Mark Dudzic 
 April 27, 2018
Labor Campaign for Single Payer [https://www.LaborForSinglePayer.org] 

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 _ Fight for What You Want. Not What You Think You Can Get. _ 

 , Labor for Single Payer 

 

On April 18, Senator Jeff Merkley (D-OR) and Senator Chris Murphy
(D-CT) introduced the Choose Medicare Act
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h0/Cgli4CBrE3m-2BUxO1EJ7f1XgVPELRvypyH98oecseXTF-2BpFFHfzeFr0JJd1e7YJh5u-2FrpXHwUMRYkEsliDV73lXmhJiLI0Lyasd6o1ab7p-2BlEouSerVy8lxyrjyQydbPbW1vPUzOM0tB5Q4BsJ78DYwuq5Dv9TEqLlj3jd7Todv8KzH04jS-2FtG3G3Tr5fqsP-2FmDFgQCBwunFaimEUNlr-2F9nUALEGzsjXoukm9Em9y-2FZ088znTPFEar4xJcODObLKu6hHoXjdwl5RjGPin5Ydi5kGoudL6GKDoapakspHfOOB-2FBSI3sec763oshmLY2tBuJM7LS54ckgGB96ppeJk6DYorzvM74OlqZxHVkU-2BI0-2BBJj20PbiRjc-2BCL696A5UI2X6EdWKco8xhdoi8I6kJMv-2F3sbW8JakRfvOfKDoDdZl3mF7fAIouTTedAgDqMRBu1W9CZp9KRVxtRSJ49KU5iEQ-3D-3D]
into the U.S. Senate. The bill closely tracks the recommendations made
in a January Article by Jacob Hacker
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h1/KRjI6sTRmFzeZar5VOFd6gBcpbwWyCleBuaA6S8FIWO8o-2Bn6lMLSZ4b4oVFfbXskLO9YSoXn4dXc7rcWlguWEAXGAF1ShE2dYz8RoLng2LKqykFXj4awHX-2FK8yvpa7dDha-2BfVowwb62-2B-2BXOanntLl-2B1W2sT3Pk50hSUp60cKf73WHiQVVChTzoG8xwqN7CZszYwGKekOnX4G-2FBdnuJ0uohP-2F2K4DKC3MLykvinrKm9Nqt-2BrRroiVR0nb-2FtzOoexf1MlrP0F-2F9d7MPK8-2F6DjyCIEqU-2FvJYzsg0n-2Bm12ZwA395ZFyrdXNpKmiHxWw-2FKW-2FoQbbJxzydRpcVJajBXBhDSTathQ7ADyTyu387WztDTbk-3D]
and a February proposal by the Center for American Progress (CAP)
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h2/I0eiVf-2BNhlTEYm4seFNDiVB9WPs1teLjqcRgOANY0lREzj-2BBi9F3Yp1pdpSiKBbO4Gelux5KnFPY5ia5gMgO2WheM9zMr7IoOKw47mABQZUx7-2FAqVYUJEiJa-2Biu1f6g7z7y7qGTJ-2BHql2TKQo6lYQUWENt5EsAFK-2FYlAPEoNOTUvk4J8q3KPhMEhnjyX-2F4tYQY4cxvPykLnjtqTsZE3Ax85xDGWGJgWpRXiejIF0B4-2BGxF5wJ1EAftHHi8TjJYdikoAgu7YHoV7oKzVwAQNlhgNVNRYLpk7SYypGd-2FiCHOatPDAGOUfR7xugm2hjoS9id55cm1DnFhmEMtvnwe-2BbAkKx8bpgPvJV0Qx2ereiaYez8CYjXQXnWsLaFj9Mr1UZpCYYqwVT2mJfqcmhaxbV6-2BQmSkGB4p2vQAKHASRddycOyrFrKmXOh00tanHUnv-2FL].
Both Hacker and the CAP were leading advocates of the public option
during the debates that led to the passage of the Affordable Care Act
in 2010.

Choose Medicare would improve Medicare with benefits comparable to a
current gold plan under the ACA. It would allow people the option of
purchasing a Medicare plan on a healthcare exchange and allow
employers the option of purchasing a Medicare plan for their employees
in lieu of private insurance. It would give Medicare the authority to
negotiate prescription prices.

SO WHAT’S NOT TO LIKE?

Like Medicare and Social Security, the proposals in the House (HR 676
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h3/a8Z5LRyAEBMqydP-2FL-2F5LEsP3LhNdl-2FfaX-2FPrlCdNvzLCFiQF5vsgu1iiDPaYulZT3iuXkNyGqJ2mXyDmaTHaMM-2FM-2BGeaj-2FaJBbelR-2B2bX657hF2lokYm5Qt-2FmmdSaI0Zyl5SjnrpCRWXYYZLEVUbtwrbJwj-2Fnstr3ZIatWKIJOMV1dqCPzpDWJbdYrbwRpdzGUe4dQcyvbowrBaSD2XznrYwgS-2B7Xeh8oO-2BRuh1rZ3a6KSyr0K0GNBUYYKyaolXC5xiQ6jr2fTcpV68tdgykOQfsyjnFvHXLOQ31A-2B7-2BFHPrOQp-2BKBmrhJGKnLOtviCS9qWk7qN-2Fe9-2BXvdxSN8EMFkDzQwe0Wg6H-2B79sRNI-2BWFjTytvqKJBbnJmXuRgwT-2Bhh])
and Senate (S 1804
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h4/a8Z5LRyAEBMqydP-2FL-2F5LEsP3LhNdl-2FfaX-2FPrlCdNvzKHtZ1ZAGEFjQtbz-2BXwhMFOR34mTYDn-2FXlAk5b7jwl4Ex2F5whW3SEkehwVwg0GN-2BIcE-2F6PFPNph6pA-2FJ6so9GCsajt-2FUCrBprQcSdSYhVmXTZEyTjSRBvwbHepeSd6Ir-2B5dSRrEZBSFCjJGUe-2F-2BJ73Rt-2B8ZRX-2FXNlTPvmStoH06pSXxw8nh03mN447f5W-2BpmXk1bcUQZhshhl-2Bw7PStCSx1sfy5i5AXHDt8PKN0XJtX1aYSqfJQaPXHZGqbPwMjx48-2FWgTByCeNucbcyTJOYYnFrJtX-2B6DVCiaz7sZcxTRW0HGYG9w-2BwQmnirqxKHb9oFDuBkvB3931kA3QVJiO3A3])
for Expanded and Improved Medicare for All are _social insurance_
programs. All Americans would receive comprehensive cradle to grave
coverage. Healthcare would be equitably financed through taxes with no
significant financial barriers to care.

Choose Medicare, on the other hand, would create a “Medicare Part
E” plan that would effectively be a _private insurance_ product
purchased in the marketplace. Access would be limited to those who
choose to buy it (and can afford to do so) or whose employer deigns to
offer it as a benefit.  Except for those currently eligible for
Medicaid under the ACA, its costs would be fully paid for by
premiums--with, as in the ACA, some income-based subsidies-- not
public financing. Coverage would be available only so long as you, or
your employer, paid for it and beneficiaries would still be
responsible for approximately 20% of their total healthcare costs.

There are intrinsic problems when public goods, like healthcare, are
treated like commodities. A system designed to accommodate profit
seeking and multiple payers can never achieve the efficiencies and
cost savings of a social insurance model. Competing health plans with
different costs, co-pays and deductibles reinforce inequality and
disparity and make a single standard of care unachievable.

Commodified health insurance products generate all kinds of
unanticipated consequences including the dreaded “adverse
selection” in which decent coverage is undermined by shoddy
insurance plans. Continued linkage of health insurance to employment
deprives working class Americans of the healthcare security that they
want and deserve

DÉJÀ VU ALL OVER AGAIN

There are many good things about the Choose Medicare proposal. If this
were the only possible option to improve on our current dysfunctional
healthcare system, it might be worth consideration. However this
proposal comes at a time when support for Medicare for All has never
been stronger. Some states are coming close to enacting
Medicare-for-All-style legislation and a powerful grassroots movement
is gaining momentum. More and more politicians are jumping on the
bandwagon. A pathway to victory is emerging.

Groups close to the Democratic establishment are promoting the Choose
Medicare plan. As Bernie Sanders remarked
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h5/kilmq4yahfKGsjdDvZO5dmnaUN09NZtyhKJJt4MwGKTX0LKdLu-2FY5xzn3fV1kqByQQ-2F1nEtc516FNlsP4h2zMHyGLdlVVPWYqwC5wP5uFFx8Qx3VgBgtoMaxweN0C0pHeizqpmaIadr4SFvSOv9W5x7Sln8YFK7TiBuBIwxIXq-2FGnufey3m6Z5DN93EmanB6lnzoTDGuLJ4OfyliGvH0mYiUGHgpaFgpm93GWUMv9-2BmA-2BTdKbqv7Z-2BXXvZVG1SHQLGSqZj9cFVpxKEg4-2F38tAyeuutsKoyyW4ew3dLKe0s-2BYM2R4SpJ6pxS-2B4Q-2BKT8RMSrN0Y88ILMVnHRdn5ftbI6hFLv6mLZDLkQ527MLInftcu1VS4q2WslNkx-2Fl2Pnlrc-2F7At-2FGgG-2FRpbRczusMGtVYkBgGoRdlzy4KspvINuQLQYDAprcQuZP5NHX3ZIp2IxII-2F8vZnPSRBg3ThBGAMRQ-3D-3D],
it “shows that the Democratic Party is moving our way.” However,
we’ve gone this way before.

In 2007, as the country faced a massive economic crisis and the
American people were demanding a solution to the healthcare crisis,
Jacob Hacker released his "Public Option Plan"
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h6/e4E9U5TsreWOLomGt-2B16nkimeiZT8SAYdYIRUhtefUIHmQQFeEFj-2FaErRbaOkNqbZncqqqGk-2FuOflR8loUwhshz-2FXEQXVhEKmiasvusvp8yd9VvZWVo8a9IphQUXegkxt4aTfKuTcGA90Lp-2B2IkFZsp2ix3zfyDEB-2FjqYzW5whVEWWoS5o5hrDcGPrNWrIbTA4aADs1RAUigtkLfNVFpegjGLJytRrzq1wc0WDplytJM1Z9pA4RIM8-2BaNCAWDucSdNYXuJJvTk5A8e8YJc466mFSWXUWAe4TC-2FL7TaSHbWiqgq5nRixrMH5YNfjtor3R3WdRKQAXe5SZGaR6BEr0hgst9JzgQ0Lx4Em-2FFbgGEukmVjS60S10TlqZ5KoV68oQ3zECggqhtdapCS6neT9iFdfcWf32mtt5CyykFDU6O1k-2Ffk8aPkAA4wb6MPImKf5D].
Declaring that a Medicare for All plan was politically unfeasible, he
called for a robust public option using a Medicare-like plan that
would effectively compete with private insurance and enroll over 100
million Americans. Political candidates latched on to the concept as
an alternative to calling for Medicare for All. Barack Obama
incorporated it into his campaign platform and, once elected,
repeatedly stated
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h7/bqdygTI1vIsnazaB26bAUFbDLCH0doRmw-2FS8eD1DC4JCQ4sXyxlCJYJ25xv0lNAi3YVFItMmPIyVgOgSbN-2BEAQ-2FHZCKiGSn2yFiA0vfAxbYq2FJhU4OETj9lZaVFsxfj-2BU2I-2FQO1ZCJbPTTh1I3LGr0vUN4vWrP6pin8E-2BEamtbng6JhfsBvwg8MVfw8ZT6Ntf1NmvO33H1VuvpQyx564SYygNv2wyrUdjvr6xTaQ69T-2FlaE0Cs-2FX7TduVRkVCqRt5mVORhUZ9ntS7lB5TSqhRbJdYlThpgIvgjA598SOMoCFuZWqz-2B71rBQOZnQ0hsL4Hu4nbQkoyrwfg6idZZqCs-2BG2fvUx9HIv8lh0XpBo-2FXNocgsaUnVXYWnDEFU5v5tU8jGgwunmkKYOm1K-2BNCIPn4sOaYO-2BL9xWJGATqjrkPfOLbDH2-2FpBRsq2cZfrlLYu8mnzVAzaSNaSuajX3nyruJTRL9fxykVM8o2O31oIUbw-3D]
that he would not sign a bill that did not include a public option.

The House ended up passing a version of the Affordable Care Act that
included a deeply compromised version of a public option that would
have, at best, covered no more than 10 million Americans. Even this
modest provision was stripped out of the bill in the Senate and we
were left with an Affordable Care Act that gave Americans the right to
buy health insurance but fell far short of establishing a right to
healthcare.

Nonetheless, nearly all of the original advocates of the public option
—even those who argued that it could be a circuitous route to
Medicare for All—went along with each compromise and concession
until, as Grover Norquist famously declared about other government
programs, _“…it is so reduced in size that I can drag it into the
bathroom and drown it in the bathtub.”_

FIGHT FOR WHAT YOU WANT. NOT WHAT YOU THINK YOU CAN GET.

Nearly all supporters of Choose Medicare (and of the public option
before it) would agree that a single payer Medicare for All system
would cost less, cover more and deliver better healthcare. But they
maintain that Medicare for All is not politically feasible. Their
mantra is, “Don’t let the perfect be the enemy of the good.” In
effect, they are saying that the power of the Medical Industrial
Complex is so great that it can forever stifle the clearly articulated
political will of the majority of the American people.

The problem with this, as any shop steward who ever sat across the
table from a boss knows, is that when you start negotiating by
conceding your opponent’s points, you have nowhere to go but
downhill. Frederick Douglass had it right: _“Power concedes nothing
without a demand. It never did and it never will. Find out just what
any people will quietly submit to and you will find out the exact
measure of injustice and wrong which will be imposed upon them.”_

Proponents of this approach believe that clever policy proposals will
somehow get us to healthcare for all without the necessity of an all
out fight. They are like Douglass’ sunshine soldiers who “want the
ocean without the awful roar of its many waters.” But, as economist
Gerald Friedman
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h8/kilmq4yahfKGsjdDvZO5dhljxeqZzOonqmekTF0PWHyX7F8HpA-2FNPp1etDygZdEADxXnfV8ZbUIv06-2BAVYdv6mGrpsvrPkHtjryAhYzYC9Yw8vVlOtFiIBHqm9SJgpbr-2BaNZrHkZFvQCrFLzt2BmU0f1D-2BAnzbFC30xdvT6pQAy9WPTBdaV6s6uuFWnM0UyDu4b0gtg-2FYEyhSZywZ-2FpL9pjmFqbumxH1qEDyyU9r9mS2u8rG-2BUgHsp0xKylCVJmaWNf4h9BA-2FoXB-2FEVWMOSn2qD0hmEkjgKR2e9A6Y3udL18TYQvP5WpctPJ2kTvSW6hagRFbHfYvqm2lNPBhGP5nF93aH7zhEKivqU2eTSfa0W-2BNG3zRqVnx-2BDPAQxf1K5HkO6AWsqpJP84bMbP7RvnGHGvWjcxctmFnGn6TA3DhuQcLgcG-2Fq1WW07X0Ld-2BZwN0]
has pointed out, “There is little reason to believe that insurance
and pharmaceutical lobbies won’t fight just as hard against the
[Medicare Choice] plan, which would undeniably be a disaster for their
bottom lines.”

THE PATHWAY TO VICTORY

Medicare for All has won the battle of ideas. Now we have to win the
battle against entrenched economic and political power. This fight
won’t be made any easier by harboring illusions that we can somehow
compromise our way to victory. Every country in the world that
recognizes healthcare as a right for all of its citizens did so in
response to a powerful working class movement backed by unions and
grassroots organizations. The time has come to construct such a
movement in the U.S.

“A defensive posture and incremental demands have not worked.
Let’s play offense instead,” says Michael Lighty of the National
Nurses United
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h9/cFoZqz6SQtbQcdm-2F4-2FQtITOb3lEO-2FtvdAtnQfL7dQHxyYYy5RsUR6yKn-2BWOpWRtusfZ2o8Ro8H81KkuZIAWOTYpLMSuYkqdvWiDP4ka4IoB-2B2FtoFcCMO7kCTXPiPbrJOLjjWFDFxGdA1VGX2bW-2BVYxo5DeDM-2BDaKsc-2BYuoSCh75teYDX7xQfPDzE-2F-2Fq-2FEaSoYifYzvj7VRvkIYXMIDTEq-2BujufWAMSvWh78HjQUb1CcnmFEgEPBnnasaWAAVYQEWpJthVKUcSgYr9KcVgokxeHiX4RjqTCyRlfNgLgk2-2BXo04AxhBFu1eP89kjum3I11waXwyz-2Fi6PZBndpS5gs33n7eoHOR1XwjSTqbazN3hdawHSINWLVfqRY6ccRzgGyaZImjTCDJlLTJWFLgp6rmw-3D-3D].
“We don’t need insurance, we need healthcare. This is the strategy
that can turn the tide: building a broad movement of workers to demand
economic and health justice.”

This June 22-24 at the NATIONAL SINGLE PAYER STRATEGY CONFERENCE in
Minneapolis, we will be part of the launch of a new national campaign
to win Medicare for All. We won’t be talking about clever policy
proposals. We’ll be planning how to build the kind of power
necessary to transform American politics and win healthcare for all.

Be part of this historic event. Register today!
[http://click.actionnetwork.org/mpss/c/DQE/ni0YAA/t.2gy/-GQdjk5kR0qT_HBr3t8Txg/h10/e4E9U5TsreWOLomGt-2B16no-2BPxBpXmCSYg1EI-2B5YH8NeXN1oYvl-2BpVrDhThcprtda9daa2HQm-2BKdNBruN6AZ1f5Hykp7zf2p6WP1usll1rISxSsr-2FKqqpFCpAZNKI02sWnNOWclC7Cm99mVfjaG5e9ljqxofVrKKTSVwbzyTonCT-2BSJxnyMZej8MeNwbq-2BLEan4792KE5iS6ZXQe4J6nZuDnWSg9vsC-2BzrZdiaGKkjQG-2FqdA5CVXR-2BCEm1f-2BrU2txESb-2FaruFRWbbyltAuR4QXxNjg16-2FoDZbuaRkJJb2xU5BAe3bK367Ozm9ok5EGWaD8mPKzf6Bv7RUSLq4JUJ5hqZ88HNLgmUQf47tt-2BDNDS5fsE3aF1e1lnOl8cBMJBxUV6vA-2B3ZvHdB33r8ezEu4i2kfjM3ePMmoIcQiXjMs9Qg-3D]

In Solidarity,

Mark Dudzic
National Coordinator

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