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Single-Payer Straw Man

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Thursday, June 25th, my friend Robby Stern invited me to sign and deliver two letters to the Federal Building in Seattle. There were twelve of us who signed, urging Senator Maria Cantwell to declare her support for a public health care option. Robby was polite and forceful. He urged the Cantwell staff to come out with a clear statement of support. Recently, Robby said Cantwell is on board. The other letter thanked Senator Patty Murray for her support. There is some speculation for what health care reform might look like (PDF). A "strong public health insurance option" seems to be the consensus wording.

Robby chairs a large health care reform group called the Healthy Washington Coalition. In a planning meeting for the May 30th "Health Care For All" march, an older Latino man stood up and asked Robby, "What should I tell folks that ask about documented or undocumented status?" Robby said, "The theme is health care for all." President Obama said something similar after his health care speech on Wednesday July 22nd. Chuck Todd of NBC asked Obama how many people would be covered. Obama said he wants to cover as many people as possible, but clarified it would not be single-payer.

Even though Obama's old doctor supports a Medicare type program, single payer has become the Ralph Nader of health care reform. Single-payer supporters, much like fans of Nader, have good reason to be mad. In my opinion single-payer makes sense and so does Nader. But for whatever reason they are both on the outside looking in. Advocates are pissed that it (single-payer) is not an option. Opponents are scared that health care reform secretly means single-payer.

On bbjohn 83 commented on a David Sirota article about why single payer is not in the debate:

Everybody so far is commenting that it is not possible to pass single payer legislation. Of course it won't be possible if it is completely out of the debate and receives zero media coverage. The point isn't what is likely or "possible", the point is that the Democrats seem to be scared of even letting single payer be mentioned at all. What are they scared of? Maybe if single payer was mentioned in an all-inclusive debate, then some of its features may be adopted into the final product, which emerges from congress. It would only do good.

As Senator Murray spoke at the May 30th march, a portion of the crowd pumped their fists and chanted, "Single-payer, single-payer." The next day, the single-payer straw man was wheeled out in the comments section of It represented a microcosm of the erroneous public perception about health care reform. One side feared the rally was for socializing health care and implementing a single-payer system. The other side was mad that the P-I didn't mention single-payer as a viable part of the health care debate.

Senator Nancy Pelosi said that single payer is "off the table." But a strong public option could be closer to single-payer than I first thought. In my opinion Obama knows single-payer is kryptonite terminology. The vetted words and talking points consistently exclude single-payer, and thus Obama may have a chance to push for more coverage. I hope he is going for something similar to a single-payer system, but with a more palatable classification.

In front of the Federal Building on Tuesday July 28th, Robby led a good-sized crowd of us in singing happy birthday to Medicare, which turned 44 three days later on Friday July 31st. Ironically, one argument eroding public support is health care reform's false threat to Medicare (public health care insurance for Americans over 65). Medicare is popular for good reason -- it covers a lot of people. So, this is the catch: people are saying, "Don't touch my Medicare," and simultaneously fearing more coverage. People love a good public health care option. We should expand it.

Robby has a running debate going with his barber. They have different political views. But as Robby says, "My barber understands about this." On this issue they agree and their differences melt away. Robby brought in two posters for the May 30th "Health Care For All" march -- one in Spanish, one in English and his barber was happy to display them both on the shop mirror. Robby closed the meeting with this sentiment: "75 years ago first legislation for universal health care was introduced by President Roosevelt, but there was too much on his plate. History could be made this year." This reform would be a first step toward a more humane approach to medical care.

I hope we don't stumble.