Why Liberal Reformers for Single-Payer Health Care Always Lose

MASS-CARE is a Massachusetts organization that would have its members and supporters believe that it is fighting for a single-payer universal health care plan. But it is not. It is typical of liberal organizations that send out fund-raising letters like one I received recently. I was so angered by what I read in the fund-raising letter that I wrote to the organization. Here's what I wrote and how the MASS-CARE's Co-Chair responded.

Joseph Curtatone, Mayor of Somerville, is an ardent defender of Israeli ethnic cleansing and an opponent of the ballot question #5 in his City last year that supported a basic human right (Article 13 of the Universal Declaration of Human Rights), the right of return of all refugees, including Palestinians. Israel denies this right to Palestinians, which is the root of the conflict in that region. Israel is based on ethnic cleansing, which is the most anti-democratic practice imaginable. A member of your board is on the wrong side of this fundamental question--on the side of inequality, and on the side of anti-democracy (since people who are ethnically cleansed certainly cannot vote in their country to which they cannot even return.)

Grace Ross is an ardent opponent of allowing the public to vote on whether same-sex marriage will be illegal. She opposes the basic democratic principle that ordinary people are fit to rule society. She uses the specious argument that it is wrong to vote on rights. What right? The right of any pair of consenting adults to marry each other? Nobody believes in such a right, which is why the law against adult siblings marrying each other is uncontroversial. Same-sex marriages will mean more children brought into the world by anonymous sperm (or egg) donation and many people think this is bad, emotionally, for children because it breaks the bond between the child and one of its biological parents, and it does this DELIBERATELY. People in a democracy would be able to have a say in this question. But Ross doesn't want them too; she is a foe of democracy and she is on your board.

What these people have in common is that they are opposed to true grass roots efforts to make a more equal and democratic society. So when your fundraising letter talks about "building an active grassroots coalition" I just don't believe it. "Grassroots" means democracy, and your board includes enemies of democracy. Dump these overt enemies of democracy, and I'll re-consider donating.

MassCare has tried to extend its influence throughout MA by expanding our Advisory Board. We picked people who have been active in Single Payer and are potentially able to help effect true health care reform in MA. It would be unreasonable to insist that every member of our Board adhere to a set of beliefs on issues that are outside of the universal health care reform that we are trying to achieve. In truth, there are most likely people on the Board who don't reflect my views on outside issues. MassCare is a single issue organization. Our coalition of 90+ organizations is working on this one issue and welcome support from anyone who shares our goal of achieving universal health care that is comprehensive, equitable, patient-centered, and sustainable for society.

Here's the problem. A true grass roots movement for single payer, if it intends to win, needs to mobilize the public (who wants single payer) against the corporate elite who do not want it, and this means organizing in a very different manner from what your organization is presently doing.

Instead of yielding to the "reality" of the legislature being in favor of the current "multi-payer" scam by, as your fundraising letter explains it, focusing on a "cost-control agenda," a genuine grass roots movement (which your organization purports to be organizing) would be doing something along the lines of what I spelled out in my open letter (We Need A Whole New Approach: An Open Letter to Advocates for Universal Health Care). It would expose the fundamental conflict (in general and with respect specifically to health care) between the values of most people versus the values of the people with real power in our society (whom the legislators serve.) It would organize a popular movement that understood WHO was preventing universal affordable single payer health care (it isn't just the insurance companies, as I show in Market-Driven Health Care And Social Control.) It would help the public understand WHY the corporate elite were preventing it. And most importantly it would focus on ensuring that the public understood why the corporate elite were WRONG to prevent it. It would inspire people by making it clear that it intended to DEFEAT the power of those who were preventing it, and whose values of inequality, top-down control and pitting people against one another are the opposite of most people's values of equality, concern for one another and democracy. It would not play by the rules of the legislature, which are designed to prevent anything from happening that the corporate elite oppose.

It would, in other words, inspire people and give them confidence to take the kinds of mass direct actions that are necessary to win.

The problem is, you have people on your board who would never stand for such a genuine popular grass roots movement, because such a movement would threaten the power of the anti-democratic corporate elites whom these members of your board are tied to. And the remaining members of your board, fearing to lose the "support" of these overtly anti-democratic members (and the larger strata of society they represent), will not dream of organizing a genuinely pro-democracy movement.

A genuinely pro-democracy movement is, of course, given the reality of our one-dollar-one-vote capitalist society, revolutionary. And your board is afraid of being revolutionary. Please correct me if I am wrong about this point--I would love to hear that I am wrong, believe me.

And so, your agenda is the totally uninspiring retreat that you call "focusing on a cost-control agenda." It will accomplish nothing towards winning single payer. And this is a shame. But it will please the likes of Somerville Mayor and staunch supporter of Israeli ethnic cleansing, Joe Curtatone, I have no doubt.

You say these anti-democratic board members (interestingly, you don't deny they are anti-democratic on the "other" issues I raised) are "potentially able to help effect true health care reform in MA." It is the other way around. Despite their claims to want single payer, they are the reason you are not building the kind of movement that it will take to win it. This is typical of how the corporate elite stay in power. They use their influence to control the opposition, and thereby guarantee that the opposition remains ineffective, giving the illusion of making a real fight but not actually doing it, and thus doing more do demoralize people and discourage them than anything else the elite could do.

The Co-Chair replied that she didn't think our ideas were that different, but added that she didn't view Israel the way I did.

Unfortunately, the ideas guiding the organization are not at all what I was proposing; they are the liberal ideas that always fail:

1) Make alliances with foes of genuine democracy while pretending to build a "grassroots" movement;

2) Avoid framing the issue as an aspect of the class war between the great majority with positive values of equality and democracy and concern for one another versus the tiny elite minority with disgusting values of inequality and top-down control and pitting people against each other, since this may upset "important" people on the organization's board of directors;

3) Isolate one issue from all others so that those not focused on that specific issue will not understand the larger significance of the struggle and its connection to other issues they may be more concerned about;

4) Pretend that the goal will be won by persuading politicians in the State House, who are controlled by big money;

5) Avoid like the plague talking about the need for mass direct action--the only way that anything substantial has been won for We the People in the history of the United States. These victories were only partial and often short-lived (which shows the need for a revolution), but all of them were won by mass action, not by hob-nobbing with and catering to the elite: the abolition of slavery and Jim Crow, the institution of the 8 hour day (it was nice while it lasted), the legalization of the right to strike (although the big unions have always been controlled by the big corporations), and the withdrawal of troops from Viet Nam (only to be followed by invasions of Panama and Iraq and Afghanistan).

The failure of liberal organizations like MASS-CARE demonstrate that we need a revolutionary outlook to win.