Incrementalism is a Road Block Not a Road Map

In words that might sound familiar—whether or not Gandhi actually said similar ones--

During the 1914 biennial convention of the Amalgamated Clothing Workers of America  Nicholas Klein of Cincinnati, talking about that union, said, "First they ignore you. Then they ridicule you. And then they attack you and want to burn you. And then they build monuments to you. And this is what is going to happen to the Amalgamated Clothing Workers of America."

Well they haven’t built monuments to Quentin Young yet.  But they are not ignoring or ridiculing us.   They are fighting us.            And we will win.

It is said that imitation is the sincerest form of flattery.  In politics, imitation is a sincere form of cooptation.  Part of the attack/fight, conscious or not, well-meaning or not,  is to divert and or coopt our energy our  work our language.

You do and will hear about “Universal Coverage”, “Universal Healthcare” , “Universal Access”,    Oregon’s Senator Jeff Merkley has introduced a “MediCare Option for All”   and, in the language of California’s AB 2517— a “Unified Publicly Funded Healthcare System”.    Is that Politician for Single Payer ?  Who knows--  the purpose of the Politician language is to confound and confuse. 

They talk of incremental steps towards SP.   Really what They are proposing are  incremental steps towards improving health care.  Steps that may be  good in their own right.   But they are not steps towards SP and the elimination of Insurance Corporations’ controlling our health care.   Perhaps some incremental steps in THAT direction would involve legally forbidding for-profit insurance companies and capping “surpluses” of so-called non-profit systems.  Then, doing the same thing for for-profit and Non-profit hospitals.

 Our language is seeping into Legisation—Federal and State…  With the exceptions, of course,  of Bernie Sanders’  and Ellison/Conyers M/C for All bills --  this is to be regarded more with concern than celebration.
 

Merkley’s “Chose Medicare”- Medicare Option ,S 2708  (co-sponsored by Kamala Harris and Dianne Feinstein) proposes a Medicare option for the ACA exchanges.  Similarly, the  Medicare X-Choice (S 1970/HR 4094--Bennet/Higgins) requires   a Medicare option on some exchanges by 2020, all by 2023.   This is also co-sponsored by Feinstein and Harris

These are  supported by the likes of the  Progressive Change Campaign Committee/Bold Progressive, Democracy for America   and Daily Kos   I think  they actually believe they are doing some good… much like Obamacare was doing some  good…  but now we need to  be  clear about  the diversion and back tracking it is…  it furthers empowers  and entrenches the corporation

This is a BAD idea.   It would 1.  Further confuse/complicate Medicare structures and 2. Having done so will undermine the general support for  an Improved Medicare for All approach.  

It is being pitched as a step towards single payer--  but, if it is,  it is because, like the Affordable Care Act, it ultimately proves unsuccessful and subject to undermining.    The corporate effort to confuse  this Medicare Option with Medicare for All  will  make things more difficult for us.    This is adding another layer of payment/administrative structures-- not making it a single structure.  It will  make Medicare (gov't and private) more confusing, complicated and frustrating .  Corporate MediCare Advantage plans, as they do now, will surely find ways to scoop money into their coffers.

Bills  have  also been introduced in the California Legislature that are being touted as a “Road Map to Single Payer”   Actually, since there appears to be no words in Politician for “Single Payer”,--  It is being called the “Road Map to Universal Health Coverage”.

  AB3087,

Would establish a state agency "California Health Care Cost, Quality, and Equity Commission" which would have the power to set reimbursement rates for all heath care providers in California.

from the bill :

- The chief cause of high health care spending in the United States is high prices.

- to regulate the cost of health care by regulating health care prices for health plans, hospitals, physicians, physician groups, and other health care cost drivers

- Set the amounts accepted as payment by health plans, hospitals, physicians, physician groups, and other health care providers
 
What this would mean--

- High payments  generally go towards hospitals and other institutions not  to clinicians. The primary problem is the existence of health care insurance companies. Their existence creates a loss of 20-30% of expenditures towards profit,  administration, advertising, and costs to health care  offices for filing claims and getting authorizations for care.

- It will include limits on "non-contracting health professionals", further inhibiting private practice.

- The savings will not go to individuals, but the insurance companies will pay less to their providers. If you think that they will pass on their savings to their customers, as  a friend of mine says—"You are unclear on the concept.”

- We already face a shortage of clinicians in all fields of primary and mental health care- This will only further exacerbate the situation …

This bill is “in suspense”  and likely will not pass—at least this year.

Of more immediate concern is AB  2517

 

It would establish an Advisory Panel on Health Care Delivery Systems and Universal Coverage as an independent body, to develop a plan to achieve universal coverage and a "unified publicly financed health care system." Some of the proposed timelines are---

--On or before March 20, 2020, the advisory panel shall submit to the Legislature for approval a proposal to control health care costs.

--On or before March 1, 2021, the advisory panel shall submit to the legislature for review, a proposal for the state to seek necessary  federal waivers and federal statutory changes

--On or before December 1, 2022, and contingent upon the fulfillment of the requirements of the above subdivisions, the advisory panel shall submit to the Legislature, a proposal of the state constitutional and statutory amendments necessary to create a publicly financed health care system along with a proposal to submit to the voter at the next statewide primary or general election.

4 more years!!??  We don't need no 4 years.  We already know what we need to do, we just need to do it-- TO continue on the Road of Single Payer.  We need not to be diverted by detours created by this Road Block to Single Payer.  ...  Created by politicians and officials who are unduly influenced by their corporate donors and conflict of interests...4 more years is 4 more years of declining health care, 4 more years of furthering unequal distribution of healthcare, 4 more years of enriching and empowering the insurance corporations, Big Pharma and their political cronies!
 
This bill is working its way through the California  Senate at this moment.  If passed it will continue to provide cover for the corporate democrats to not stand up for an Improved Medicare NOW!

Churchill said you can always count on the Americans to do the  Right  Thing,  once they’ve tried everything else…    There are far too many other things we have tried and there are far too many more things that could be tried, that they will try to divert us by---   We just need to step straight forward to SP

The stronger and more powerful we are the more will be the efforts to undermine, obfuscate and adopt our language towards deferring our ultimate success.