[R-G] 'Single-Payer' Supporters Challenge Democrats

[Sid Shniad]

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/05/AR2009060503518.html?wprss=rss_politics 

Washington Post June 6, 2009 

'Single-Payer' Supporters Challenge Democrats 

"Obama is really the one who is puzzling to us. We were all supporters of 
him. . . . It's hard to understand how he can expect to rally support around 
a plan that will leave the big insurance companies in charge and keep 
hurting patients." 

Rose Ann DeMoro, executive director of the California Nurses Association 

By Dan Eggen 

When President Obama convened a town-hall meeting in Rio Rancho, N.M., last 
month, he wanted to talk about credit card reform. But many in the crowd had 
a different agenda. 

"So many people go bankrupt using their credit cards to pay for health 
care," the first questioner said to applause. "Why have they taken 
single-payer off the plate?" 

The "single-payer" activists had struck again. As Obama and congressional 
Democrats work to hammer out landmark health-care legislation, they face 
increasingly noisy protests from those on the left who complain that a 
national program like those in Europe has been excluded from the debate. 

The White House and Democratic leaders have made clear there is no chance 
that Congress will adopt a single-payer approach -- named for the idea that 
a single government-backed insurance plan would pay for all Americans' 
medical costs -- because it is too radical a change. 

That has not dissuaded single-payer activists, who have spent months 
hounding Democratic lawmakers and organizing demonstrations, including one 
that resulted in 13 arrests at a Senate hearing last month. The offensive 
continues this weekend with plans to swamp a series of "house parties" on 
health care hosted by Organizing for America, an Obama-backed project at the 
Democratic National Committee. 

Opportunity and Challenge 

The movement poses both an opportunity and a challenge for Obama, who is 
able to position himself as a centrist by opposing a single-payer plan but 
who risks angering a vocal part of the Democratic base. 

"Obama is really the one who is puzzling to us," said Rose Ann DeMoro, 
executive director of the California Nurses Association, a union that has 
been leading many of the single-payer protests. "We were all supporters of 
him. . . . It's hard to understand how he can expect to rally support around 
a plan that will leave the big insurance companies in charge and keep 
hurting patients." 

Many Republicans see the movement as evidence that Democrats are setting the 
country on the path to "government-run health care," as they describe it. 
Conservatives for Patients' Rights, an advocacy group bankrolled by ousted 
Columbia/HCA chief Rick Scott, unveiled a $1.2 million ad campaign Thursday 
that portrays Democratic plans as a "bulldozer" aimed at eliminating private 
insurance companies. 

"It's just one step removed from a single-payer system," Scott said in an 
interview, referring to current Democratic proposals. "The goal is to get 
rid of the insurance companies, and then the government makes all the 
decisions." 

Obama and other Democrats dispute such characterizations, saying they favor 
a plan that would marry private and public resources to control costs and 
expand coverage for 46 million uninsured Americans. Obama wrote in a letter 
to Democrats this week that he "strongly" backs creating a public insurance 
option to compete with private carriers, and also signaled that he is open 
to the idea of requiring coverage for all Americans. 

Obama has rejected the idea of establishing a single government insurance 
program, however, saying the U.S. tradition of providing health care through 
employers would make such a shift politically and practically impossible. 

"If I were starting a system from scratch, then I think that the idea of 
moving towards a single-payer system could very well make sense," Obama said 
in response to the questioner in New Mexico, echoing comments he made during 
his presidential campaign. "The only problem is that we're not starting from 
scratch. . . . We don't want a huge disruption as we go into health-care 
reform where suddenly we're trying to completely reinvent one-sixth of the 
economy." 

Advocates of a single national program argue that its benefits would far 
outweigh the drawbacks, noting that most other industrialized nations 
guarantee coverage for all at far lower costs with generally better health 
outcomes. They also dispute allegations by Scott and other conservatives 
that such a system would lead to rationing and waiting lists, saying that 
Americans face the same problems and worse now. 

"Single-payer on its merits can win," said Tim Carpenter, national director 
of Progressive Democrats of America. "But we've been cut out by the doctors, 
the insurance companies and other special interests." 

A Small Victory 

The single-payer activists won a small victory this week when Sen. Max 
Baucus (D-Mont.), who is leading health-care negotiations as chairman of the 
Senate Finance Committee, agreed to meet with them after months of tension. 
Those in attendance said Baucus apologized for not including single-payer 
advocates more prominently in earlier hearings, but he also said it is too 
late to change direction. 

Polling on single-payer insurance varies widely, based largely on how the 
issue is framed. In an April Kaiser Family Foundation poll about ways to 
increase the number of Americans covered by health insurance, the option 
finished last on an eight-item list, with 49 percent in favor and 47 percent 
opposed. Moreover, about a third of those who support a public insurance 
option would turn against the idea if it were an initial step toward 
single-payer care, the poll found 

Most mainstream progressive groups, including some that have previously 
advocated a single-payer approach, think Obama's strategy has the best hope 
for success. Many groups draw lessons from the Clinton administration, which 
buckled under attacks from Republicans and the medical lobby when it 
proposed a more centralized approach [NB: not single payer] . 

This time around, unions and groups such as Health Care for America Now plan 
to spend more than $80 million on ad buys, outreach and other efforts to 
support Obama and the Democrats. The DNC, using Obama's campaign e-mail list 
of 13 million names, kicks off its effort today with thousands of "house 
parties" focused on "the urgency of passing health care reform this year," 
according to a news release. 

In an e-mail this week, Progressive Democrats of America urged its 
supporters to "take the single-payer message" to the meetings. 

DNC spokesman Brad Woodhouse said the gatherings are open to all. "Their 
voices, energy and passion are welcome, and no one is looking at them as the 
enemy," he said. "It's just that with the system we have, single-payer is 
not something that's likely to happen." 

Polling director Jon Cohen contributed to this report.