Single Payer Is on the National Agenda—And It’s Thanks to People’s Movements

It’s up to grassroots movements to demand—and win—the healthcare system we need.

Ben Palmquist

Put People First! Pennsylvania rallies on November 3, 2016 in Philadelphia, Penn. (Photo courtesy of Put People First! Pennsylvania)

As Sen­a­tor Bernie Sanders intro­duces a bill for uni­ver­sal, pub­licly financed health­care on Wednes­day, he has grow­ing polit­i­cal momen­tum behind him. Sen­a­tors Eliz­a­beth War­ren and Kamala Har­ris are cospon­sor­ing the bill, and even for­mer Sen­a­tor Max Bau­cus — who shut down con­sid­er­a­tion of sin­gle pay­er dur­ing the draft­ing of the Afford­able Care Act — is now say­ing that uni­ver­sal health­care is going to happen.”

"This is about our health, our dignity and our survival."

These state­ments among lead­ing Demo­c­ra­t­ic Sen­a­tors mark a poten­tial­ly momen­tous shift­ing of the polit­i­cal winds, but most media cov­er­age of the Sen­a­tors’ state­ments is mis­placed: It ignores the pow­er­ful cor­po­rate and ide­o­log­i­cal forces that have long dri­ven both par­ties’ oppo­si­tion to uni­ver­sal health­care. It ignores wide­spread pub­lic frus­tra­tion with both par­ties and the tec­ton­ic social and eco­nom­ic changes trans­form­ing Amer­i­can pol­i­tics. It ignores how peo­ple all over the coun­try are orga­niz­ing to chan­nel pop­u­lar anger into people’s move­ments that are inde­pen­dent of both polit­i­cal par­ties. And it ignores how these move­ments are begin­ning to com­plete­ly upend the pol­i­tics of healthcare.

Across the Unit­ed States, com­mu­ni­ties are orga­niz­ing for uni­ver­sal health­care. One of the most inno­v­a­tive and dynam­ic cam­paigns is led by Put Peo­ple First! Penn­syl­va­nia (PPF-PA), a grass­roots, mem­ber-led orga­ni­za­tion focused on build­ing pow­er among poor and work­ing-class peo­ple across their state. (I work with PPF-PA through my work at the Nation­al Eco­nom­ic and Social Rights Initiative.)

This sum­mer, PPF-PA has been turn­ing peo­ple out to tes­ti­fy at town hall meet­ings on insur­ance com­pa­nies’ requests to raise pre­mi­ums and deductibles on Afford­able Care Act mar­ket­place plans next year. The town halls have been host­ed around the state by the Penn­syl­va­nia Insur­ance Depart­ment at the request of PPF-PA.

In a coun­try where near­ly 30 mil­lion peo­ple are unin­sured, 60 mil­lion under­in­sured, and count­less res­i­dents die every year from inad­e­quate health­care access, PPF-PA’s focus on insur­ance rates for 5 per­cent of the pop­u­la­tion may seem, at first blush, to be miss­ing the point. But chal­leng­ing insur­ance com­pa­nies’ prof­i­teer­ing cuts to the heart of what ails the U.S. health­care system.

There has long been an unstat­ed polit­i­cal con­sen­sus between the Repub­li­can and Demo­c­ra­t­ic Par­ties that it is okay to deny mil­lions of peo­ple health­care and okay for some peo­ple to have qual­i­ty care while oth­ers have sub­stan­dard care. Whether these inequities are jus­ti­fied as a mat­ter of per­son­al respon­si­bil­i­ty, or an unfor­tu­nate real­i­ty of the world, both par­ties have always treat­ed health­care as a com­mod­i­ty rather than as a human right. PPF-PA is work­ing to crack that con­sen­sus and cleave it wide open.

The insur­ance industry’s prof­it motives are incom­pat­i­ble with our human right to health­care,” explains Ves­pera Bar­row, a PPF-PA mem­ber from Pitts­burgh. You can’t reform and advo­cate away those kinds of deep struc­tur­al prob­lems. We need to stop focus­ing on insur­ance cov­er­age and start focus­ing on human beings. This is about people’s lives. This is about our health, our dig­ni­ty and our survival.”

By using the town hall meet­ings to focus atten­tion on insur­ance com­pa­nies, PPF-PA is high­light­ing the con­tra­dic­tions at the heart of the pri­vate insur­ance system.

What pur­pose do insur­ance com­pa­nies serve in our lives?” asks Far­rah Samuels, a Philadel­phia PPF-PA mem­ber and can­cer sur­vivor who has repeat­ed­ly strug­gled with her insur­ance com­pa­ny to cov­er her care. Insur­ance com­pa­nies exist to make prof­its, plain and sim­ple. That prof­it motive leads them to lim­it where we can go to the doc­tor, charge us more mon­ey every year, and refuse to cov­er our bills when we need care. We need a health­care sys­tem that makes sure that every­one who needs care can get it.”

For PPF-PA, this year’s town halls are a strate­gic step toward that long-term vision.

Our goal,” explains Danelle Mor­row, a PPF-PA mem­ber in John­stown, is to cre­ate a uni­ver­sal, pub­licly financed health­care sys­tem that guar­an­tees health­care as human right to every­one in Penn­syl­va­nia. But we know it’s going to take a mass move­ment to bring that about.”

By orga­niz­ing peo­ple around the state to turn out for the town halls, PPF-PA is draw­ing atten­tion to the fail­ures of the pri­vate insur­ance sys­tem and devel­op­ing a statewide base of lead­ers who can bring the polit­i­cal pres­sure that is need­ed to effect change.

Nijmie Dzurinko, a PPF-PA co-founder in Philadel­phia, stress­es the impor­tance of build­ing a new polit­i­cal force — one ground­ed in the polit­i­cal lead­er­ship of the com­mu­ni­ties that have the great­est stake in trans­form­ing the health­care system.

Uni­ver­sal health­care would ben­e­fit every­one,” she says, and it’s a pol­i­cy that a major­i­ty of the pub­lic already sup­ports. But win­ning uni­ver­sal health­care isn’t about polling. It’s about pow­er. The health insur­ance indus­try is tremen­dous­ly wealthy, and they know how to use their mon­ey and weight to keep elect­ed offi­cials, media out­lets and oth­er insti­tu­tions under their thumb. The only way to win the health­care sys­tem we need is if the peo­ple who have the great­est stake in trans­form­ing the sys­tem come togeth­er to demand it.”

Build­ing an inclu­sive, ground-up move­ment that cen­ters the lead­er­ship of poor peo­ple, peo­ple of col­or, immi­grants and oth­er com­mu­ni­ties whose health­care needs aren’t met today is critical.

As Greg Fritz, a PPF-PA mem­ber in Lan­cast­er explains, The only way we’re going to come up with a health­care sys­tem that works for every­one — that lit­er­al­ly leaves not one per­son out — is if we fol­low the lead­er­ship of every­day peo­ple who know first­hand what’s not work­ing and what needs to change.”

To be sure, grass­roots orga­niz­ing in com­mu­ni­ties that are dis­en­chant­ed with pol­i­tics, divid­ed by lines of race and class, and strug­gling to meet every­day needs, is no easy task.

Poor com­mu­ni­ties in this coun­try are real­ly divid­ed by race and geog­ra­phy,” says Eliel Acos­ta of Adams Coun­ty. But at the end of the day, a Black fam­i­ly in South­west Philadel­phia, a Lati­no fam­i­ly in Get­tys­burg and a White fam­i­ly in John­stown are all strug­gling with a lot of the same things. We’re all writ­ten off and ignored, but in our com­mon strug­gles there’s incred­i­ble polit­i­cal potential.”

The future of health­care depends less on Bernie Sanders than it does on our abil­i­ty to over­come these divi­sions to take col­lec­tive action. Our move­ments are mak­ing great head­way, but we must con­tin­ue the long, hard work of orga­niz­ing to cre­ate the con­di­tions that force Con­gress to cre­ate a pub­lic insur­ance sys­tem that guar­an­tees health­care for all.

As Julia Willis, a PPF-PA mem­ber in Pitts­burgh, rec­og­nizes, the door is open to us, but we need to be strate­gic and ready to put in hard work.

I have no illu­sions that these hear­ings are going to end the health­care cri­sis,” she says. But orga­niz­ing around the hear­ings draws atten­tion to insur­ance com­pa­nies’ prof­i­teer­ing and is a step toward build­ing the pow­er we’ll need to win uni­ver­sal health­care that guar­an­tees care to every sin­gle per­son in Penn­syl­va­nia and the country.”

Ben Palmquist is a cam­paign man­ag­er at the Nation­al Eco­nom­ic and Social Rights Initiative.
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