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Massachusetts health care — wonky, with a healthy dose of reality

Man Bites Dog Dept: CA Single Payer Advocate Endorses CA Health Reform

Man Bites Dog Dept: CA Single Payer Advocate Endorses CA Health Reform

January 14, 2008

Check out this blog for an analysis by Stephen D. Schear, self-described longtime California activist for a Canadian-style single payer health care system. He’s come to the conclusion the Schwarzenegger/Assembly health plan now being considered by the California Senate deserves support – from a pro-single payer perspective. One of many money quotes:

“In 1980, when I was a young lawyer working in a law collective in East Oakland, we had a discussion about the presidential campaign. One of the collective members argued that we should support Ronald Reagan rather than Jimmy Carter because Reagan’s election would result in the Revolution coming sooner, because he would expose the flaws in capitalism. Reagan won, but the Revolution did not come any sooner. We did end up with massive tax cuts for the rich, cutbacks in Medicaid and Legal Aid, and generally disastrous consequences for the poorest Americans. The idea that making things worse or leaving conditions bad generates support for monumental changes has generally proven to be an illusion.

“Defeating ABX1 1 will not result in single payer arriving any sooner. Support for single payer will not increase because the health care system stays terrible or gets worse. Our health care system has been inefficient, expensive and unfair for the last 20 years and those conditions have not generated the support necessary to make single payer a reality in a single state in the union. …

“Most importantly, if we defeat ABX1 1, we will not have single payer. We will have what we have now: no effective cost controls, 7 million uninsured, private insurance companies that are free to decline coverage to those who are ill or who have preexisting conditions and no required employer contributions for health care. The question that is before us is whether California residents would have better and healthier lives if ABX1 1 passes. ABX1 1 would improve the health access of millions of Californians and begin the formation of a more rational and equitable system. ABX1 1 looks great in comparison with the status quo.”

Steve’s writings remind me of my own path. Between 1990 and 1994, I was the lead single payer advocate in the MA House of Reps. In October 1991, I forced the only single payer roll call vote in the history of the MA legislature – got 29 out of 160 votes. In 1994, after the Clinton health plan fiasco, and a disastrous single payer ballot initiative in California that lost 27 to 73%, I asked myself how many folks had been helped by the hundreds and hundreds of hours I had spent. I came up with a number – zero.

In 1995, I switched to an incremental strategy, and in 1996 we passed the first of a series of laws triggering a massive expansion in MassHealth. In 2000, I asked myself the same question – how many folks had been helped by the incremental strategy. I came up with a new number – 350,000.

I don’t know if what we accomplished had any impact on the prospects for single payer in Massachusetts. I sincerely doubt it. Here’s my favorite quote from Stephen:

“The millions of Californians who lack health insurance need help now, not just the hope of someday reaching the promised land of single payer. One of my daughters is a Buddhist and teaches me that we should be guided in our activities by love and compassion for all sentient beings. Compassion for the millions of people who would gain access to health insurance through ABX1 1 requires its support.”

Just my Buddhist colors showing through, I guess.
John McDonough