HCAN! New York

Why We Need to Stand Together

Posted on March 30th, 2009 by David Vigoda

A recent article by Laura Meckler in The Wall Street Journal and a comment in a popular blog highlight the challenges of the health care reform campaign and the need for those working for real reform to respect each other’s position.

(The full text of the March 24 article, “Health-Care Battle Set to Focus on Public Plan” is at  http://online.wsj.com/article/SB123785156695519283.html
and the comment, “Battle over public option to private insurance plans,” posted by Don McCanne, MD on Tuesday, Mar 24, 2009 is at http://www.pnhp.org/blog/ .)

The article discusses whether a public health insurance plan that competes with private insurance will be part of health care reforms considered by Congress. The prediction is that it is likely to be included in legislation proposed by the House, but not by the Senate, where opposition is deemed to be too strong. Obviously, the insurance companies oppose a public plan, whereas it is the key principle advocated by the Health Care for America Now coalition and the only one supported by single payer only groups like Physicians for a National Health Program.

Dr. McCanne’s comment makes a number a good points, but then seems to despair about the prospects for real reform because the single payer only option has been “discarded… even before the negotiations began.” He continues:

“What is sad is that the enemies of reform have already won. They have managed to eliminate comprehensive reform from the national dialogue and have reduced the debate to whether or not we’ll add one more plan, a public plan, to our dysfunctional, fragmented, multi-payer system that costs so much and serves us so poorly.”

Dr. McCanne apparently shares the view that a single payer only option is the only really good one and must be achieved all at once or cannot be achieved at all. Others hold different views on both counts, but the point I want to make here is that it is way too early to throw in the towel on real health care reform. As the article makes clear, the political campaign is only now starting in earnest. Let’s not be tasting the bitterness of defeat when the battle is only beginning.

That it will be a battle, the article makes only too clear. With regard to a public health insurance plan, there are three possibilities: a stand-alone plan (single payer only), a stand-beside plan (public insurance as an alternative to private insurance), and NOTHING AT ALL.

The debate goes on among reform advocates over the first two options. That is healthy providing it is not self-destructive. But should we not be taking a hard look at the third option?

It may look like there are deep disagreements between those who support a single payer only plan and those who support a public health insurance plan as a choice alongside private insurance. What the article makes clear is that the differences are mainly tactical.

On the one hand there is the real possibility that, if the advocates of single payer only and a stand-beside public plan can’t get together at some point, we’ll get nothing at all. On the other hand, here’s AHIP, the insurance lobby, worrying OUT LOUD that a public plan is only “a very short step to a… single payer [only] system.”

Isn’t the question—the crucial question—how do we win the political battle for real reform?

If we acknowledge this, then a great opportunity presents itself. That is the opportunity for all reform advocates to work together against our common adversary. If we don’t work together, we work against each other, and that is self-defeating.

Let’s win this battle and let AHIP taste the bitterness of defeat.

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