How to Revive the Fight for Single-Payer

[Redfairen]

From an opinion piece on single-payer legislation as proposed by Rep. Jim McDermott of Washington.


McDermott’s new legislation would break from the longstanding liberal assumption that the government must enact universal social programs that apply rules and benefits uniformly to all states at once. He figures that would allow the resistance to block single-payer for many years. So he wants to create a special deal for the limited number of states willing to uphold higher standards. State legislatures and governors can win approval to design and operate their own single-payer system, deciding how and where to spend the healthcare money the federal government already pumps into their state. (The Vermont Legislature has already approved, with the governor’s support, a move toward single-payer but can’t implement it until 2017, when it will need a federal waiver to do so.) 

The congressman offered his hometown example, known as WWAMI—a five-state cooperative arrangement that includes Washington, Wyoming, Alaska, Montana and Idaho. The University of Washington has the only medical school in the Northwest border region, so the other states send their med students to Seattle and finance their education, in return for the students’ commitment to come home to serve rural communities. This mutual support has functioned for forty years, despite red-blue differences. McDermott believes those five states could do a better job than distant DC of deploying and operating a first-class healthcare system. 

To liberals who cry heresy, McDermott invokes Robert La Follette’s famous dictum that the states should be our “laboratory for democracy,” the best place to experiment and develop new solutions to public problems. Conservatives ought to like McDermott’s proposal because it disperses power closer to local decision-making. Liberals can embrace his approach as a practical way to break the stalemate on healthcare and open the way for basic solutions. The congressman from Seattle thinks it may take a few more years of chaotic conflict before people understand the opportunity. But state governments—even in the neo-Confederate Republican Party—may start clamoring for this new approach once they begin to see the results. 

“There are places where this could work,” McDermott said, “and once people see it work in Oregon or Washington, or maybe Kentucky, the people in Tennessee are going to say, ‘Why the hell don’t we have that? Are we not as good as the people in Oregon?’ Then you’re going to get the governor of Tennessee to do an about-face.”


http://www.thenation.com/article/177465/how-revive-fight-single-payer

[Cleita]

1. He's not wrong. Single payer does not have to be done by a government.

Even the PNHP single payer advocates say that. It's just the government is probably the most efficient way to do it, but it doesn't mean you can't do second best.

[Wounded Bear]

3. I disagree....

I think that these state and regional solutions can be very valuable to the move to true UHC. Vermont is a great example of moving in a progressive direction. WA already had one of the best public HC systems in the country before the Repubs started whittling away at it. We are one of the states that embraced the ACA rollout and it has gone well here. A lot of Americans are unfamiliar with how the Canadians actually did it. It's actually run by the provinces up in the Great White North. I think we could definitely follow a similar model. State by state, it is coming here, too.

I think that we strike while the iron is hot. To wait on alternative UHC/single payer systems would allow the insurance companies to entrench the subsidized corporate system that ACA has propped up. Many of the Medicaid expansion dollars start to roll back in a couple of years.

Now is the time IMHO.

[Wounded Bear]

5. False dichotomy...

I have it on good report that Pres Obama can multi-task.

Besides, this is happening at the state/regional level. The national dialogue should not be affected much. In fact, the next 'big issue' is the budget. You'd think that the Repubs had learned a lesson about holding the economy hostage from the last debacle, but I've grown leary of expecting rational reactions from ideologues.

Besides, the last thing we need to do is allow the Repubs/conserves to control the dialogue.

[CTyankee]

6. They have to keep harping on it as a bad thing because they KNOW that even in the deepest red

states once people have health care universally they won't give it up, no matter how much propaganda is thrown at it. Medicare and SS are just as popular in MS as in MA and repubs know this. They've only got empty, false rhetoric, not actual facts. Once the people have health care, that game is over.

[William769]

8. This President can walk & chew gum at the same time.

Just because most of the public can't well...

And when it comes to the republicans yes they are one issue only to make America fail and as hard as they have tried these past couple of years to do that, once again they are failed.

[Brigid]

9. I disagree because . . .

There are still pig-headed states like this one that still won't set up an exchange or expand Medicaid. I am considering moving once I finish school because of this.