The Greatest Obstacle to Single-Payer Health Care: The Democratic Party

California Single Payer Activists
Single-payer advocates march in downtown Los Angeles, March 26, 2017, in support of a bill that would create a national health care system in the state of California.

Regardless of the fate of the Senate’s barbaric health care bill — which, according to the Congressional Budget Office would throw 22 million Americans off of their insurance —the left should seize on the renewed health care debate to push for a universal, single-payer program.

The United States stands alone among wealthy democracies in not treating health care as a basic human right, guaranteed to all citizens. Instead, we have a for-profit, pay-or-die system.

Can’t afford health insurance…? Well, as Democratic Rep. Alan Grayson sardonically put it: “Die quickly.”

But, then, that is capitalism for you. It is a perverse economic system that treats everything — including human lives and the ecosystem that supports all life on the planet — as a commodity.

As famed consumer-advocate and three-time independent presidential candidate, Ralph Nader wrote in an open letter to House Minority Leader Nancy Pelosi, earlier this year:

“Obamacare, without a public option, has been a complex patchwork in so many ways —including forcing individuals to purchase inadequate insurance from private insurance companies — insurance that carries with it high premiums, deductibles, co-pays and forces narrow networks.”

“For many,” Nader adds, “Obamacare is quasi-catastrophic insurance with limited choice of doctor and hospital.”

Nader goes on to urge Pelosi and the Democrats to push for “single payer Medicare for All — everyone in, nobody out, free choice of doctor and hospital, no medical bankruptcies, no coercive co-pays or deductibles … and no more deaths due to lack of health insurance.”

Sadly, I fear Nader’s exhortation will fall on deaf ears — assuming, that is, Pelosi even reads his letter in the first place.

For one thing, the Democratic Party has regarded Nader as a pariah ever since he “spoiled” the 2000 presidential election for Al Gore — a baseless accusation completely undermined by the fact that Gore won the popular vote and would have won the Electoral College if the Florida re-count had been allowed to take place. It was the right-wing Supreme Court that stole the election from Gore — not Nader.

But, beyond the Democrats’ abject hatred for Nader (as well as more recent Green Party standard-bearer, Jill Stein), the biggest reason the Democrats are unlikely to push for a single-payer bill, now or anytime in the near future, is because they are adamantly opposed to it.

Sure, the prospect of a universal health care program has long been a staple of the Democrats’ campaign rhetoric dating back to President Johnson’s administration. But when push comes to shove, and the Dems are actually in a position to implement single-payer, party leaders suddenly come up with all sorts of excuses why such a national health care program could “never work” here in America, or is “politically impossible” because they simply “don’t have the votes.”

During the Democratic Congress’s crafting of the Affordable Care Act, single-payer was “off the table” from the get-go. In fact, when single-payer activists peacefully interrupted an early White House public hearing on health care, Democratic Sen. Max Baucus (MT) promptly called security and had them arrested. Baucus and his colleagues glibly laughed as the protesters were, one by one, removed from the room.

And the Democrats have only become more forthright in their opposition to single-payer in recent years.

Last year, Pelosi publicly rebuked Sen. Bernie Sanders’ single-payer campaign platform — specifically, his intent to raise taxes on the wealthy in order to fund the program. “We’re not running on any platform of raising taxes,” Pelosi said during a Jan 27, 2016 press conference.

Regarding single-payer, Pelosi added, “It’s no use having a conversation about something that is not going to happen.”

Speaking of Sanders, now would be a prime moment for him to submit his long-promised Medicare-for-all bill in the U.S. Senate. Yet, according to an article by single-payer activist, Dr. Margaret Flowers, Sanders has instead opted to join his Democratic colleagues in fighting to save — and later improve upon — the ACA. Flowers criticizes Sanders for having his “priorities backwards,” accusing him of having “greater allegiance to the Democratic Party than he has to the supporters of Medicare for All, his base.”

But then, the nominally “independent” Vermont senator has always been a de facto member of the Democratic Party, as evidenced by his role as “sheepdog” for Hillary Clinton in the 2016 presidential campaign.

And Democratic legislators in California recently killed a bill that would have implemented a single-payer system in the state. California Assembly Speaker Anthony Rendon announced June 23 he was putting the bill, SB 562, on “hold,” effectively leaving it stranded in legislative limbo. The bill passed the State Senate, 23-14, earlier this month.

All of this is further evidence that the Democratic Party is perhaps the greatest obstacle to achieving universal health care, nationally or even at the state level. As the Bay Area chapter of Socialist Alternative writes of the Dems’ betrayal on SB 562, on their website:

California Senator Diane Feinstein, House Minority Leader Nancy Pelosi and Governor Jerry Brown are united. They want to kill off the whole idea of single-payer. … Once again they [the Democrats] aim for a corporate-friendly “centrist” policy when the left is the popular place to be. Despite the progress that Obamacare represents, it and Trumpcare are both market-based plans that do not challenge the big health insurance companies’ parasitic role in health care.

Little wonder then, that Kevin Phillips, a former strategist for Richard Nixon, once referred to the Democrats as “history’s second most enthusiastic capitalist party.”

Pelosi seemed to concede as much during a CNN town hall-style debate, earlier this year. When a young man in the audience asked Pelosi about the Democrats’ failure to move further to the left on economic issues in accordance with a growing majority of young people, Pelosi responded, “Well, I thank you for your question. But I have to say, we’re capitalist and that’s just the way it is.”

Well, there you have it. Straight from the donkey’s mouth.

But despite the Democrats’ professed anxieties about the “difficulty” of funding a single-payer system (*cough* Tax the rich! *cough*), it is really not complicated at all. Currently, our pay-or-die health care system wastes $375 billion a year on health insurance paperwork alone — most of which is billing-related. This accounts for roughly 15 percent of overall national health care spending.

And while single-payer has always had broad popular support among Americans, that support is currently at its highest level in decades. A recent Pew Research Center survey finds 60 percent of Americans support “a single-payer approach to health insurance.” Likewise, a majority of respondents believe it is the “federal government’s responsibility to make sure all Americans have health care coverage.”

The Republicans’ stalled efforts to “repeal and replace” Obamacare have, understandably, put leftists in a difficult position. They are scrambling to defend a health care reform that, while certainly better than any barbaric, “free-market” alternative the GOP has in mind, is still significantly flawed.

Thus, there has never been a better time to push for single-payer. The left’s job should not be to defend the “lesser evil” of an untenable status quo. Rather, we should be unafraid to offer bold, radical alternatives to our racist, sexist, xenophobic capitalist society. This includes an unapologetic recognition that abortion is a form of health care which all women should have free and unhindered access to without shame or stigma.

Sadly, Planned Parenthood and the Democratic Party will not make these demands for us. Only the working class can bring about its own emancipation. This is yet another reason why the working class needs its own revolutionary political party.

As Democracy Now! host, Amy Goodman, and Dennis Moynihan observe in a recent column titled, “Medicare for All: A Prescription for What Ails Us”:

“Single-payer is already in practice in the U.S. and is immensely popular. It’s called Medicare, the tax-payer funded program that guarantees health care for seniors and people with permanent disabilities.”

They continue:

… Currently, 57 million seniors and people with disabilities are on Medicare, out of a U.S. population of 320 million. There is no rational reason why Medicare couldn’t be expanded to cover all Americans, regardless of age, from birth to death. … The savings [from a Medicare for All system] would be extraordinary, and the system would most likely be as popular as Medicare is today.

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Ignore the GOP’s Lies: The Pentagon is Not Broke

Fighter Jet

During a recent interview on NBC’s Meet the Press,  Maine Republican Senator Susan Collins reiterated one of the biggest lies about Barack Obama’s presidency.

When host, Chuck Todd asked Collins if there is “any part of [President Donald Trump’s] budget you support?” she responded:

“Yes. I do think that we need an increase [in spending] for our veterans and an increase in military spending because readiness has really suffered.”

For context, the majority of Collins’ six-and-a-half minute interview was devoted to the president’s proposed health care bill which, as of this writing, is DOA. These remarks were her sole reference to military-spending.

Yet, the statement, minor though it may be, is extremely significant.

The notion that military readiness has “really suffered” due to Obama’s budgetary policies has been widely repeated by congressional Republicans, Trump, and the corporate media. The GOP maintain Obama “depleted” military funding, leaving the U.S. woefully under-prepared—if not, in fact, completely unprepared—to adequately respond to a foreign attack.

Trump alluded to this notion of a “weakened” military during his March 1 address to Congress.

“I am sending Congress a budget that rebuilds the military, eliminates the defense sequester and calls for one of the largest increases in national defense spending in American history,” Trump said of his proposed $54 billion military-spending budget.

This oft-repeated talking point that the military suffers from a lack of “readiness,” corresponds with the equally false narrative that Obama was “weak” on matters of foreign policy—too eager to engage in “wimpy diplomacy,” and “negotiations,” rather than military force.

But this baseless narrative ignores the fact that both military spending and the use of military force increased under Obama. Indeed, Obama—who received the Nobel Peace Prize less than a year into his presidency—proved to be more of a warmonger than George “I’m a War president!” Bush.

Under Obama, the U.S. escalated the war in Afghanistan, down-scaled—but did not end, entirely—the U.S. military occupation of Iraq, and engaged in covert drone bombing campaigns in Yemen, Pakistan, Somalia, Libya, and Syria. Perhaps most unnerving was the Obama administration’s penchant for relying on unmanned predator drones which can be controlled from thousands of miles away, and its codification into law of extrajudicial targeted assassinations.

The latter tactic claimed the lives of at least two U.S. citizens: Anwar al-Awlaki and his 16-year-old son, Abulrahman al-Awlaki.

Obama even maintained a not-so-secret “kill list” of suspected terrorists targeted for death, for Christ’s sake! Perhaps Republicans are just jealous a black man got to engage in all the really deranged, ultra-violent stuff, while Cheney and Rumsfeld had to settle for merely waterboarding people.

The fact is Obama was hardly the peacenik Republicans—along with their subservient echo-chamber in the corporate media–constantly portray him as. Likewise, the claim that Obama “depleted” the military of funding, leaving it in a “weakened” state, is downright laughable.

Contrary to the GOP’s rhetoric, the United States still maintains the largest, strongest, most expensive military force in the world.

As Branko Marcetic writes in a March 6 piece for Jacobin titled, “The Lie of ‘Rebuilding’ the Military”:

The US military has a vastly larger airforce, navy, and number of aircraft carriers than any of its closest rivals. While it commands less manpower than China and India, its nuclear stockpile—a mind-boggling 6,970 warheads—is second only to Russia. The massive three hundred held by France in third place looks piddling by comparison. According to a 2015 Credit Suisse report, all of this and more means the United States far outmatches any other country in terms of military strength.

As Marcetic notes, maintaining an absurdly massive military of this size does not come cheap. The Pentagon ate up $622 billion of the federal budget in 2016, alone. Fifty-four percent of our federal tax dollars go to military spending. And much of this money is wasted on outdated, Cold War-era weapons and fighter jets the Pentagon has no need for—a fact that, curiously, goes unnoticed by “fiscally conservative” Republicans who constantly harp about the need for the government to “get its fiscal house in order.”

(And while we are on the topic, can we mention the hypocrisy of claiming to want to “shrink the size of government,” while lavishing the military–which, last time I checked, is part of the executive branch of the federal government–with billions of dollars?)

Contrary to what the talking heads on “liberal” NPR insist, the largest portion of the federal budget is devoted to the misleadingly-titled category, “Defense”—not so-called “entitlement” programs like Social Security, Medicare, and Medicaid.

But military-spending is so sacrosanct among both political parties it is almost never brought up in budgetary debates. Instead, we are told immigrants, refugees, public school teachers and their “cadillac-style” retirement benefits, and the earned-income programs won through hard-fought working-class struggle are to blame for our nation’s budgetary woes.

This is the perverse genius of the so-called “austerity” policies the global capitalist elites have pushed in Europe and the U.S. since the Great Recession: Socialize the costs and privatize the profits. And during Obama’s presidency those profits continued to soar for weapons manufacturers like Lockheed-Martin, Raytheon, and General Dynamics, which owns Bath Iron Works, one of the largest employers in Maine.

The Trump administration, meanwhile, is eyeing deep cuts to the Environmental Protection Agency (EPA), which is now headed by climate change denier, Scott Pruitt. Also on the chopping block is funding for the National Endowment for the Arts, the State Department, the Corporation for Public Broadcasting, and most federal regulatory industries.

Turns out Americans should have heeded President Dwight Eisenhower’s outgoing warning about the dangers of the “military-industrial complex,” after all.

“As millions of Americans struggle with inadequate health care, low wages, deteriorating public services and uncertainty about their futures as the wage gap between the wealthy elite and the working poor widens,” famed consumer advocate and ertswhile independent presidential candidate, Ralph Nader wrote back in 2013, “billions upon billions of taxpayer dollars are pouring into the coffers of the Department of Defense ever year.”

All of this makes clear the left’s urgent need to revive the beleaguered anti-war movement, which largely remained dormant during Obama’s presidency. As Maine anti-war activist, blogger, and professional organizer, Bruce Gagnon told me in a 2015 interview, “Liberal Democrats are reluctant to challenge the president when he’s ‘their guy.'”

“It’s a real hypocrisy,” Gagnon added. “And it’s a real problem for maintaining an active anti-war movement.”

Perhaps the fact that it is now a Republican carrying out these disastrous wars will reinvigorate the anti-war left. The mass opposition to Trump’s racist campaigns against Muslims and immigrants is certainly an encouraging sign. Socialists must tap into this growing movement, while also making the broader connections between the global refugee crisis and U.S. imperialism.

But our first task must be to offer a forceful rebuke to the bourgeois falsehood that the military needs “rebuilding.” Quite the reverse, we should be investing less money in killing people, and more on infrastructure, good-paying jobs, renewable energy programs, health care, and our public schools.

“Monopolies, oligarchy, the striving for domination and not for freedom, the exploitation of an increasing number of small or weak nations by a handful of the richest or most powerful nations,” Vladimir Lenin wrote in his 1917 essay, Imperialism: The Highest Stage of Capitalism, “… all these have given birth to those distinctive characteristics of imperialism which compel us to define it as parasitic or decaying capitalism.”

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