viernes, 3 de julio de 2009

Terrific Piece on Healthcare

Jane Slaughter over at Labor Notes just wrote a great piece about Labor's role in the health care reform debate. I highly suggest you read it. In the article, Ms. Slaughter points out that, while the union rank-and-file largely supports universal medicare (hundreds of union locals, as well as several state federations and labor councils have endorsed it), the leadership of Change to Win and the AFL-CIO do not, and have instead come out in favor of public-private competition. At the closing of the article, Ms. Slaughter expressed, in the clearest and most concise language I have ever read, why this position is so truly puzzling (and maddening):
Say you’re a union bargainer who thinks her members deserve a dollar-an-hour raise, but believes that realistically the company won’t give more than 50 cents. Would you start out by asking for 50 cents? Yet that’s what union lobbyists are doing, in effect, around health care reform in D.C. this year. It’s how labor has been doing its politics for a while now: behaving as supplicants rather than as actors trying to define the game, consenting to the accepted wisdom.
Jane Slaughter, I could not agree with you more! I tried to make the same point back in March, though in a far more stumbling and far less persuasive manner.

Everyone who is following the health care debate knows that passing single payer in the current Congress is basically impossible. According to Ms. Slaughter, the sponsor of single payer legislation in the house, John Conyers, was asked “What would it take this Congress to pass single payer?” back in May. His response: "Nuclear weaponry”. Unfortunately, I don't think Mr. Conyers is too far off. The health care industry just has too much power. Our legislators are too dependent on health care campaign contributions and simply too corrupt to challenge the interests of the industry. It truly is a sad reflection on the health of our democracy when arguably the most popular health care reform proposal, supported by two thirds of the public and 60% of Physicians, is "off the table" and politically impossible. That's the reality we're living in. Nevertheless, if a strong public option which competes with private insurers is the best we could possibly get, as unfortunately I think is the case, then why come out for a public option right out of the box? Even if the labor movement does not universally agree that single payer is the best option (Andy Stern, for one, I'm sure is against it), it would nonetheless be a strong negotiating tactic for them all to come out in favor of single payer. Sure, labor is not what it once was. But unions still represent tens of millions of Americans. The unions also ought to have at least a little leverage over Obama, after they were central to his election victories in places like Pennsylvania and Ohio last year.

Imagine if the entire labor movement joined the movement for single payer, which is already growing and making waves without the support of the national union leadership. Imagine if the rally held last week, which drew 7,000 people, called for Medicare for all. In such circumstances, wouldn't the Congress have no choice but to at least have a public option included in the bill, rather than just subsidies and mandates for private insurance? Wouldn't it be harder for spineless, corporate hacks like my Senator, Joe Lieberman, to oppose a public option? Joe, incidentally, was backed by nearly the entire Connecticut labor movement in his 2006 primary race with Ned Lamont. The same criticism could also be levied at numerous liberal commentators, by the way, such as the entire staff of Open Left, who never say a single word about single payer. I honestly cannot see any circumstance in which aggressively advocating for single payer could hurt the progressive movement in terms of the final outcome of the legislation. And even within the confines of the broad framework adopted by labor in this debate, there's still more room for pressure. Instead of asking for a generic public option, for instance, why not specifically demand a public option with the power to negotiate rates, or demand that Medicare be opened up to all, instead of separating people into multiple, and therefore weaker plans?

Alas, Ms. Slaughter's call to push for the whole dollar, even though we know we'll probably just get 50 cents, is largely theoretical at this point. Labor, as well as much of the progressive movement, have already made their first move and that move is rather week. If we end up with a poor health plan with either a weak or nonexistent public option, Jane Slaughter will have diagnosed one of the main reasons why.

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