Another week, another health care coalition. But this one isn't like most of the others. It's not a Washington project. It's not playing an inside game. Rather, The Leadership Conference for Guaranteed Health Care advocates for a "single payer national health program [that] would eliminate the wasteful role played by private health insurance companies." The coalition includes the National Nurses Organizing Committee/ California Nurses Association, Healthcare NOW!, Physicians for a National Health Care Program, Progressive Democrats of America, All Unions Committee for Single Payer H.R. 676, and the California School Employees Association. It's not clear what sort of money will buttress their campaign, but there will certainly be some. And whether or not the Conference is competitive on the air wars, they'll muster an impressive grassroots force (anyone who attends health reform panels or events knows that single payer supporters are much better organized and vocally present than supporters of alternative options). The question is where they'll be aimed. My sense of the single payer movement, having watched and interacted with them for some time, is that they think, not necessarily wrongly, that their enemies are on the left. Their targets tend not to be those blocking reform, but those promoting the wrong type of reform. See their attacks on the reform initiative in California, or on the Health Care for America Now coalition (which promotes something close to the Edwards/Clinton/Obama plan). It's a sincere disagreement, and there's a compelling strategy to the approach: Single payer can't become the consensus choice for the country if it doesn't first become the consensus on the left. But what if it doesn't? At the end of the day, some form of incrementalism is likely to advance in Congress. Does the Conference then campaign against the bill the Administration eventually champions? That was what the Nurses did in California. Or do they throw their lot in with the reformers, quisling liberals though they may be, in the interest of short-term improvements in the lives of the uninsured (subsidies! insurance regulation!) and the promise of sequentialism (the theory that getting everyone covered and better regulating the private insurers makes a national health system more likely because it makes it a smaller step)? Or is there a set of policies that single-payer advocates want to see inserted into hybrid legislation and could stomach supporting even if the final legislation stops short of full single-payer?
