Laying the Groundwork for Single-Payer Health Care

Frank Russo has a very interesting post up about a poll commissioned by the Public Policy Institute in California, which appears to show that people very much want a major change in how we distribute and finance health care - and are willing to pay for it.

• The message is loud and clear that Californians, both those who vote and those who do not, want action and a change from how health insurance is provided.

• There is overwhelming support for "universal coverage", and a split of opinion on including all children in the state, regardless of their parent's immigration status.

• There also is strong support for the shorthand description of the plans being advanced by Governor Schwarzenegger and the competing plans of the Democratic leadership of an approach with "costs shared by employers, health care providers, and individuals."

• However, by a two-to-one margin, most prefer "a universal health insurance program, in which everyone is covered under a program like Medicare that is run by the government and financed by the taxpayers" nationally to "the current health insurance system in the United States, in which most people get their health insurance from private employers, but some people have no insurance." The preference here is a descriptor of what is known as "single payer."

(I should remind everyone that right before the election, the head of the PPIC had the gall to say that health care wasn't an issue in the gubernatorial race because most voters have insurance and are "generally satisfied with the kind of healthcare coverage that they're getting personally." Except, not. But of course, nobody wanted to talk about issues back then, when there was a horse race to be dissected.)

There is incredibly strong support for change on health care. Like many polls, this shows support in the abstract, but traditionally, when it comes down to details and the entrenched interests like the insurance cos. and HMOs beat on any proposal for a while, they get clobbered at the polls. But the support in the abstract is a road map to success for a genuine progressive solution to the growing health care crisis.

Right now the Democratic legislative leaders are giving up the game before it has been played. They claim that Arnold will not sign a single-payer bill, and so they're being "pragmatic." That's true, in the way that surrendering from a fight you can win is pragmatic. Perata and Nunez don't seem to care about the overwhelming public support that single-payer has the ability to have. The way this will turn around is by a massive education and lobbying campaign to show the legislature exactly what people want. This is similar to what Randy Bayne is saying about the poll:

Medicare is a single-payer system. So, whether they know it or not, or want to admit it or not, most people really do want a single-payer health care system [...]

The message seems to be, "we really don't care how you do it, just reform the damn thing." Unfortunately, reform for reform sake may worsen the situation by escalating the cost of health care and further limiting access. The only reform proposal that guarantees access to comprehensive, affordable health care is single-payer.

And just for the anti-tax for any reason crowd, most people polled, "63 percent of all adults and 59 percent of likely voters say they favor the U.S. government guaranteeing health insurance for all citizens even if it means raising taxes.".

What all this tells me is that a better job needs to be done educating people about what single-payer is, is not, and how the simplicity with which it works. Reform is wanted. Universal – true universal health care – is wanted. And the topper – we're actually willing to chip in a little to get it.

An education campaign, that Medicare for All or Kuehl's plan won't cause long lines or prevent you from seeing certain doctors, is crucial. Otherwise, progressives (and apparently, the vast majority of Californians) won't have a say in this debate. And that education campaign is not just saying "I believe in universal health care." That debate, IMO, is largely over. If this is the best that the other side's got, arguing that the problem is too much regulation and that people have too much insurance, then the debate is truly over. Digby doesn't seem to think so, and he praised Barack Obama's rhetorical effort yesterday to move the debate forward.

This is important. Universal Health Care, the concept, is far from settled, but Obama is just seizing the issue and saying that it is. And he's doing it with inspirational rhetoric that makes you feel as if it's an inexorable tide of progress, daring those who would try to stop it.

We are a long way from any plans and frankly I don't particularly want to hear about them yet in detail. I just want to know if the Democrats are prepared to say that they believe in universal health care. If they don't believe that then I want to hear why. That's the bright line that Obama is drawing and I think it's pretty smart.

That's simply not true, and as a Californian I'm shocked to hear Digby say otherwise. Right here in this state, we have a "universal" plan on the table, which is an individual mandate to buy "crappy health care for all." It has no floor for basic coverage, it perpetuates the employer-based system by forcing them to provide health care or pay a tax (employer-based health care is a mistake that must be corrected), and is a windfall for the private insurance industry. Oh, and Schwarzy wants to cut the public health budget to do it. The competing plans by our idiot leaders in the legislature aren't much better. The PPIC released a poll yesterday showing that Californians want something far more progressive, but they aren't aware that there is another option. It's SB 840, authored by Sheila Kuehl, Digby's own state senator, and it's in dire need of some amplification and support to push the debate in a more progressive direction.

If we simply stop at "I'm for universal health care," we enable these inadequate plans by people like Schwarzenegger, and the public will accept it because it LOOKS LIKE he's doing something to deal with health care, and change is what people want, at any cost. This will be decided in this legislative session, without a doubt, and it will then serve as a model for the nation. I don't want the whole country getting stuck with the crappy plan currently being shoved down our throats in the Golden State.

A bill was introduced in the US House today providing for single-payer. Corporate America is trying to determine how to fix health care. Here in California the leader of the State Senate went up on the air with ads promoting his Schwarzenegger-lite plan. The signal-to-noise ratio is very high right now, with everyone offering these competing plans. But that doesn't mean that we should keep the argument in the abstract.

Do I think that you could ever get Arnold to sign a single-payer bill? Probably not, but you can make it hard for him not to, and make the potential veto pay with a yearlong campaign for a single-payer solution on the 2008 ballot, starting with ads the day he vetoes it. Actually, starting with ads TODAY.

They're not playing a political game in Sacramento right now. Whether or not the Governor is willing to sign a bill today isn't important. He won't have to sign anything until October. That's nine months to rally the public, an eternity in politics. AND, all of the pressure is on him to deliver on his post-partisan promises.

Senate Health Committee Chair Sheila Kuehl has been somewhat visible with her single-payer plan (SB 840), and I'm told that SEIU will be stepping in shortly. This can be a defining moment for the grassroots and netroots, a 2-year effort to work together and get a real health care system in this state. But it has to get started, so people don't fear the boogeyman of "government-run health care."