I had some face time with Rahm Emmanuel two weeks ago at my friend Owen's. (Owen's brother-in-law is the former chair of the Democratic National Committee.) Rahm said nothing surprising but made his points. He had just finished David Kennedy's 1999 book Freedom from Fear, about WW II, the Depression and, germane to this conversation, the tremendous compromises involved in forging the New Deal.
Politically, he asserted, if you want to make big changes, you have to choose your battles and win the big ones. If health reform goes down, then energy, global warming, financial reform and labor's legislative agenda are all at risk. He stayed right on message.
I posed this to him: "Many Democratic politicians, including our Blue Dog Rep. Baron Hill, tell us in private conversations that they believe we have to get to single payer eventually. What advice would you give on how to get there?" Without a blink, he replied it's "going to be a long haul," and if we don't pass this bill it's going to be even longer. He asserted that this bill begins building the required infrastructure for any future progress.
Since then, the loss of the Democrats' super-majority in the Senate has left everything up in the air. Which brings us back to the recurring question -- Should we kill the bill?
"The loss of the Democrats' super-majority in the Senate has left everything up in the air. Which brings us back to the recurring question -- Should we kill the bill?"
There has been an incredible amount written in the progressive community about this. At one end is Helen Redmond's Beware the Progressive Democrat, published in CounterPunch on Dec. 23, arguing that we can't trust Sanders, Weiner or Conyers and that we've got to build our movement without any of that unreliable crew (kind of a rough "logical conclusion," if you ask me).
At the other end is Nate Silver's Health Care: The Elevator Pitch, published on FiveThirtyEight.com in the Dec. 16 issue (and a number of other posts), where this bright political analyst makes the case for incrementalism. Silver also notes, "I've gotten as many nasty comments and e-mails from Democrats on this issue [over the last two weeks] as I have in the past six months from conservatives on all issues. That emotion is a factor in this debate seems self-evident to me."
All that emotion is evident as the blame is ladled out for Republican Scott Brown's Senate victory in Massachusetts last week. Is the message that the country is turning against the progressives' urge to legislate change or that Obama has compromised the hope for change he promised by reverting to Washington business-as-usual and disappointing his base?
The health-care bill will be at the center of this cyclone, and it's too soon to say what gyrations the Dems will attempt to push it through. Our response as single-payer advocates should remain unchanged -- we have strong, informed positions on the poor policy provisions in the bill. I think we are best to remain silent on the political strategy (tragedy?) to be pursued. I see an important distinction between being a pointed, persistent, insistent, carping, kvetching, nagging critic of this bill for policy reasons on the one hand and joining in the political discussion about the merits of killing the bill on the other.
"If no bill passes, then we have a different set of problems/opportunities."
Let's not be drawn into the classic Progressive Circular Firing Squad. Our message is clear. If the Democrats still manage to pass some form of health reform, they can celebrate, but WE'RE STILL FOR HEALTH REFORM, AND THIS AIN'T IT!
If no bill passes, then we have a different set of problems/opportunities. If those who predict Republican ascendancy in the 2010 elections are right, then our work is really cut out for us. Meanwhile, all those who forsook single payer for the allure of the public option are ripe to be brought back into our fold. Movement building will continue. Opportunities to form coalitions will appear. As the business community becomes even more frustrated, they will open to our message.
Here are the real lessons learned as we look back to the Iowa caucuses last January from our vantage point looking out on the chaos this January:
- As much as we had hoped that this was a historic opportunity to make drastic, needed changes in our health-care system, there really wasn't the support to go all the way to single payer. We can second guess Obama and Rahm forever, but I don't believe there ever was a chance in hell that Evan Bayh, much less Joe Lieberman or Ben Nelson, would have ever voted for single payer.
- We should look again at a strategy of incremental reforms, a strategy that has been fruitful for many movements. That is a longer story to explore later.
- No matter how hard we try to predict the future, we will always be surprised. Remember that even if single payer had passed in the full glory of HR 676 without amendment, we would have to defend it, improve it and deal with its unintended consequences. This work will never end.
How can we ever hope to win? As Bill Moyers asked David Corn on his Bill Moyers Journal on Jan. 8, "Have people been so politically abused that the will to fight for democracy, the political will has been dissipated? "
"There is no better issue to organize around than universal health care."
Will it first take campaign finance reform to break the grip of the big money? Where will that movement come from? What other options do we have?
There is no better issue to organize around than universal health care. In the environmental movement we learned the word NIMBY - Not In My Back Yard. Sometimes people distain NIMBYs, but many a NIMBY activist has started locally before coming around to a global perspective. Health care is everyone's back yard, front yard and right inside the house. Our issue's not going away, even if some politicians do.
We will stay in this fight for the long haul. There is no real alternative except to quit. When I get discouraged, I turn to one of the original crusading journalists and a real hero, I. F. Stone (no relation):
"The only kinds of fights worth fighting are those you are going to lose, because somebody has to fight them and lose and lose and lose until someday, somebody who believes as you do wins. In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose. You mustn't feel like a martyr. You've got to enjoy it."
The great joy of working for change has been the people I have met and hearing the stories they have told me. I'm in this for the long haul and look forward to seeing you all many more times in the years to come. And I can't wait to see what's going to happen next.
Rob Stone, M.D., is the director of Hoosiers for a Commonsense Health Plan. He can be reached at .