Second Annual Convention of Labor Campaign for Single Payer, March 5-7, 2010

The 2010 convention of Labor Campaign for Single Payer at the National Labor College, in Washington DC, showed a high level of commitment by the group to move ahead with the campaign for national single payer legislation. At the 2009 founding convention of LCSP, there was a sense of foreboding that union and community groups would not end up with much to show for their efforts. The reports at this second convention from the different areas of the country indicated that there have been significant accomplishments. Whatever happens with the effort to win Obama-style reform, LCSP is poised to make gains both in recruiting activists, working with a range of other groups, and advancing tactics for the health care reform movement.

Over the past year, the LCSP joined with other groups on several occasions. The leaders of LCSP joined with those of other groups to create a coalition, known as the Leadership Conference for Guaranteed Health Care. This umbrella group includes Health Care Now, Physicians for a National Health Program, California Nursing Association-National Nursing Organizing Committee, and All-Unions for Single Payer. On March 8, the day after this LCSP convention, the leaders of these groups met to work out a unified strategy for the next step toward single payer.

Running through the convention was a tension between an emphasis on agitation and an emphasis on working with politicians. As a number of speakers noted, though agitation and politics imply different tasks, each flows into the other. After all, single payer is not just a slogan but a legislative goal.

Margaret Flowers, of PNHP, spoke for the agitation side of the tension when she said that politicians would come to us once we move away from parties and politicians to build a movement of activists in various constituencies. After all, if your group meets with an elected official, the attention it commands will depend on the size of its base. Michael Lighty, of CNA-NNU, called for building a movement with a wide range of groups. Kay Tillow of All-Unions for Single Payer said we couldn’t be too bold, pointing to the occupation of the foyer of the Humana headquarters in Louisville in October. Peter Knowlton of UE said single payer must become a bargaining issue in his and other unions. This will engage the interest of the rank and file; persuasion is not enough, he said. Employers can be asked to sign a Medicare for All proposal as a part of collective bargaining. They have nothing to lose since employer health plans are unsustainable, whereas Medicare for All brings would bring stability to the firm.

On the other side of the tension, were speakers who addressed political issues directly. Rep. John Conyers’(MI) presence during all three days of the conference, along with that of his assistant, was a reminder that the legislative task and all that comes with it is vital. They suggested the forming of a national headquarters for single payer in Washington that could function as a place for sharing information among single payer groups and as an organizer of conferences around the country. Rep. Donna Edwards (MD) called on us to keep going so an HR676 bill could pass, and a legal assistant to Rep. Dennis Kucinich (OH), Vic Edgarton, explained why getting the Congress to carve out an exception to ERISA was needed to ward off time- and money-consuming challenges to state single payer laws. Jerry Tucker (UAW) pointed to the need to organize Medicare for All groups in every congressional district in order to get the attention of the Congress.

The expectation of burn-out in the aftermath of the debate in Washington over Obama-style reform hardly got a mention. Moreover, no debate crystallized over whether, in the aftermath of the focus on mandates and subsidies in Washington, the focus should turn to state plans for single payer.

Against the idea that there will be another decade of letdown like the one after the Clinton bill of 1993 went nowhere, the LCSP convention latched onto the repeated polls showing majority support for single payer. In addition, it latched onto the widespread anger over the way that Obama-style health care favors the insurers. But this much is no different than it was after the Clinton Bill.

However, there is something different now that can keep the movement for single payer growing. In the wake of the Clinton bill, insurers retreated enough to keep increases in premiums modest until the end of the ‘90s. Now they are emboldened to raise premiums, seeing serious regulation of their profits as only a remote possibility. People can then anticipate that, with or without Obama-style reform, there will be premium inflation that will continue to erode their standard of living. With a slow recession recovery, premium inflation will aggravate the loss of earned income.

Concerning state versus federal plans, Mark Dudzic (USW), the national coordinator of LCSP, said the focus of our organization is to call for full implementation of Resolution 34 passed at the 2009 convention of the AFL-CIO. He interpreted this to mean, at present, a call for passage of HR676 in the Congress. Therefore, he said, state plans are not LCSPs primary concern. There was no intention to say that the two concerns were incompatible. But the convention scant attention to whether, in the wake of the failure or the passage of Obama-style reform, it will be important to pursue, along with a federal strategy, a state tactic as a step to federal single payer.

Organizations like HCN and All-Unions for Single Payer that previously had shunned state campaigns expressed themselves at the convention as more open to the idea, or at least as more tolerant of the idea, that others might pursue state plans.

Mike Stout’s (USW) presentation on the campaign for single payer in Pennsylvania drew the attention of everyone. He started four years ago by contacting two sympathetic legislators. One of them asked him where his army was. This led him to organizing. Now the campaign has 27 chapters around the state. With pressure from these chapters, there are now 55 sponsors in the House for their bill, including 12 Republicans, and 30 sponsors in the Senate, again with 12 Republicans. He commented that little support came from the State AFL-CIO. Most support came from those out of work or uninsured. His group distributed a list of savings from the bill by county governments.

In Vermont, as reported by Traven Leyshon, president of a Vermont CLC, gains are being made toward passage of a Vermont single payer bill by the Vermont Worker’s Center, a JwJ group, which has created the Healthcare is a Human Right campaign. The later sponsored a rally for single payer that drew 1,200 to the State House. Leyshon says framing the issue as one of health care being a human right has been useful in building activism among those facing a cost crunch on their insurance. Every major union in Vermont is part of the HCiHR campaign, though some are silent or ambivalent about single payer. Both the Vermont and the Pennsylvania bills include a formula for funding single payer. But according to Martha Kuhl, (secretary-treasurer of CAN/NNU), if the current single payer bill in California gets through the legislature and avoids a veto, a separate financing proposal must be introduced, which will need a two-thirds majority to pass.

LCSP gets much of it financial support from unions and individual unionists. Unionists make up the greatest part of its membership. Yet, much of the discussion at the convention centered on building a broad movement. This is understandable since many of the people present at the convention are active in single payer community organizations. Speakers urged allying with groups seeking health equity for people of color, immigrants, and women that are not now involved with single payer. Although there were repeated calls at the convention to push the AFL-CIO into activity on single payer, few speakers addressed how to win over rank and file union members, though the need to do so underlay much of the discussion.

The challenge for LCSP is to mobilize unionists sufficiently to push their leaders into making single payer a major campaign. The AFL-CIO, the State Feds, the international unions, and the CLCs have been generous with their endorsements of single payer. But members of the labor hierarchy at this LCSP convention praised single payer as the answer while at the same time mumbling, “You have to do what you have to do!”

This is a tough nut to crack, as we all know. One way to crack it was Knowlton’s tactic of bringing single payer to the bargaining table. This would catch the attention of employees and gain their support. The employer would sign an agreement with the union to seek single payer as a solution to the problem of paying higher premiums for poorer health plans for employees.

Another way to crack the problem came up in answer to a question from the floor about how to overcome the faith many employees have in their company health plans. Peter Shapiro (Portland, OR JWJ) noted that company plans look good until you are sick. Then you realize that the deductibles are higher, the coverage is skimpier, and you’ve been sacrificing wages to pay more for less. And if you are unemployed and eventually quality for Medicaid, you may find that the state is unable to fund it.

Community single payer groups are not going to be neglected by unionists, but if the AFL-CIO is to use its resources for getting single payer, an upheaval from the ranks of unionists is crucial.

Milton Fisk, South Central Indiana Jobs with Justice, March 11, 2010