Medicare for All, Not for Some

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 I attended the March for Medicare for All in Seattle on Saturday, July 24. This was one of 56 marches organized across the country by grassroots volunteers.  This march was well organized with speakers throughout the day, a car and bicycle escort, and a community-based security team. Medicare for All has wide support throughout the nation. Unfortunately, the turnout for the march was mediocre at best – I estimate a few hundred marched with us. Other towns reported low turnout as well. While it would have been nice to have thousands in the streets in every city, the fact people turned out across the entire US was impressive. These marches were organized on a local basis with only grassroots support. There was no media coverage. It was only spread through word of mouth and social media. As we know in the drought-ravaged West, it only takes a spark to start a fire. While the Medicare for All fire Bernie ignited was largely smothered by the DNC, Biden, and other corporate mouthpieces, the movement has not died. I saw some of that passion during the Seattle march.  

The Count Bleed Ya Dry puppet at the Seattle March, created by inspired marchers.   

If there is one issue the left is united around, it is universal single payer healthcare. At the Seattle march, I saw members of Democratic Socialists of America, Party for Socialist Liberation, the Green Party, Yellow Vest Actions, The People’s Party, the International Marxist Tendency, Socialist Alternative, the Black Panther Party, Black Action Coalition, Physicians for National Health Care, Real Progressives, and numerous local organizations such as Whole Washington, Washington Community Action Network and Healthcare is a Right WA. All these organizations have different political outlooks and platforms but on a sunny Saturday in Seattle, they came together to march for justice in healthcare. There is beauty in solidarity.  

Local Endorsements of the Seattle M4M4ALL. 

Real Progressives Volunteer Vandana Whitney (center) and others march for M4A in Seattle 

Why do we march? 

Marches such as these bring a greater awareness of the issue of injustice in healthcare and the solution, universal single payer healthcare. I talked to a man who was drawn to the crowd and wanted to know how Medicare for All was better than Obamacare. I later saw him marching with us. While I didn’t get a chance to talk to him later, I expect he will be lending his voice in support of single payer in the future. He would not have learned about Medicare for All if not for this march. Even if he was the only person influenced, that makes the march a success in my mind.  

Twitter post from another attendee at the Seattle march

For those who are critical of marches and non-violent protests, they are an essential part of movement building. Martin Luther King Jr. led and organized marches because he believed in the power of non-violent protest. The Black Panther Party held peaceful Free Huey rallies and marches across the country. Marches, protests, and demonstrations are just one crucial element of any movement. As Marx wrote in a letter to Friedrich Bolte: 

Where the working class is not yet far enough advanced in its organisation to undertake a decisive campaign against the collective power, i.e., the political power of the ruling classes, it must at any rate be trained for this by continual agitation against and a hostile attitude towards the policy of the ruling classes.  

This is what these marches represent, the beginning of a decisive campaign against the collective power. When the ruling class denies us healthcare, we must stand up against them. People dying from lack of healthcare is a policy decision. The people preventing us from having healthcare are the very people who were elected to represent us. Instead, they have abandoned the working class and have become shills for the corporate oligarchy.   

As Speaker of the House, Nancy Pelosi could have a vote on Medicare for all any time.  She refuses to do so.  While her husband is making millions off of stock options, Pelosi is allowing people to die from lack of healthcare.   As she has said:  

There is a comfort level that some people have with their current private insurance that they have, and if that is to be phased out, let’s talk about it, but let’s not just have one bill that would do that.   

In 2020, Nancy Pelosi took $299,264 from insurance companies.  This included $45,797 from Kaiser Permanente.  In 2019, Nancy Pelosi’s top aid, Windell Primus met with Blue Cross Blue Shield executives and reportedly “assured them that party leadership had strong reservations about single-payer health care and was more focused on lowering drug prices.” Corrupt party leadership is actively colluding with insurance corporations to make sure that single payer healthcare never happens.  Nancy Pelosi has also expressed her opinion that healthcare should be passed on a state-by-state basis saying:  

“So I say to people, if you want that, do it in your States. States are laboratories. It can work out. It is the least expensive, least administrative way to go about this, but the comfort level with a broader base of the American people is not there yet. It does not mean it could not be. States are a good place to start.” 

If Nancy Pelosi, one of the greatest roadblocks to a national system, thinks that a state-by-state strategy is the way to go, this indicates that we must fight all the harder for national Medicare for All.   

While Nancy Pelosi has the power to allow a vote on Medicare for All, President Joe Biden could actually give us Medicare for All without Congress.  Through Section 1881A of the Social Security Act, Joe Biden could declare the entire United States a part of an environmental emergency and enroll us in a single payer system.  He has this power and refuses to use it.  During his presidential campaign, he took $13,620,673 from Pharmaceutical and Health companies and $8,619,330 from Insurance companies.  The corruption starts at the top.  What kind of monsters allow tens of thousands of people to die each year when they have the ability to stop it?  

Yellow Vests Action founder and Real Progressives volunteer Eric Kestner marches for M4A 

 State Based vs. National 

As a state pushing for a state-based healthcare system, Washington is ground zero for the dispute between state-based and national healthcare. I would be remiss if I did not at least mention this conflict.  

This is not an interpersonal dispute. I have nothing against the volunteers and activists working for a state-based healthcare system in Washington or California or New York or Colorado. I know how much work it takes to knock on doors and gather signatures and raise awareness. I saw the amount of effort they put into the Seattle march. These people showed up at the march, which is more than could be said of the squad and Bernie, who have not even mentioned that a march happened. Cori Bush was the only Congress member to show up at any of the marches across the country. We need thousands of others with the heart and conviction of these volunteers, fighting for National Improved Medicare for All. Nevertheless, while I admire their work and drive, I wholeheartedly disagree with their strategy.  

The goal is to unite the working class but there is nothing unusual in differing opinions on how to achieve that goal. The Bolsheviks split from the Mensheviks largely over strategy. While the situation is different in the details, I think we can still learn much from how Lenin responded to the split in 1903. Lenin was never one to shy away from conflict, especially over matters of theory and strategy. After all, as he said, “Without revolutionary theory there can be no revolutionary movement.” As we saw with two Bernie Sanders presidential campaigns, a movement that follows a flawed strategy, no matter how strong it is, is still doomed to fail. The following two statements come from a letter Lenin wrote shortly after the split:  

“We even go further: when we have a Party programme and a Party organisation, we must not only hospitably throw open the columns of the Party organ for exchanges of opinion, but must afford those groups—or grouplets, as the author calls them—which from inconsistency support some of the dogmas of revisionism, or for one reason or another insist upon their separate and individual existence as groups, the opportunity of systematically setting forth their differences, however slight these may be. Precisely in order to avoid being too harsh and stiff-necked a la Sobakevich towards “anarchistic individualism”, it is necessary, in our opinion, to do the utmost—even if it involves a certain departure from tidy patterns of centralism and from absolute obedience to discipline—to enable these grouplets to speak out and give the whole Party the opportunity to weigh the importance or unimportance of these differences and determine just where, how and on whose part inconsistency is shown.  

Only through a series of such open discussions can we get a really harmonious ensemble of leaders; only given this condition will it be impossible for the workers to cease to understand us; only then will our “general staff” really be backed by the good and conscious will of an army that follows and at the same time directs its general staff! “

Rather than shy away from conflict, these discussions need to be had. The state-based strategy relies on states passing their own healthcare systems. As states are not currency issuers, they must fund these programs on their own. This primarily comes from taxes, usually in the form of a payroll tax. This constraint means only a very few states are even capable of carrying out this strategy. These are necessarily the richest states in the nation.  

Economist Fadhel Kaboub on the Macro and Cheese Podcast talking about how we need a Federal single payer system

Even if these states all achieve their own state-based system and somehow can maintain the funds to continue the system (something Vermont was unable to do when they attempted their own state-based system), there is no way poor states who need it more than ever could follow their example. If Washington, California, Colorado, and New York pass state-based systems, Alabama, South Carolina, Montana, Idaho, and the rest of the country are still going to be relying on a broken healthcare system. 

Will people from these other states be forced to move to states offering a state-based system? What happens then? Will employers flee from states because of higher taxes required to fund their healthcare system? What happens during a recession when tax revenues fall, and states must make cuts? Will their healthcare be the first on the chopping block? Due to its inherent contradictions, the capitalist system consistently fails – recessions are going to happen, even in the wealthier states that can afford a state-based system.  As currency users, they will still need the funds to pay for their healthcare and it will be difficult or impossible to come up with them during crash years.   

We cannot rely on corporations and the rich to fund our system. These are the same people that oppose Medicare for all – do we simply expect them to sit down and be taxed in their states to provide the funding for a state-based system? State-based systems only pose questions, they do not have answers. On this issue, there can be no compromises – we need Medicare for All, not Medicare for some.  

So this way, once we understand the power of the federal government to do this, then we should look back at everything we’ve been doing, shifting all of these burdens and responsibilities on individuals who can’t afford it and therefore end up in neglect and states and municipalities who by definition don’t have the resources and must race to the bottom to attract a little bit more business, either from fracking companies or pipeline companies or Amazon headquarters or whatever you can get.  

Fadhel Kaboub

This conflict between Medicare for All and Medicare for some was starkly apparent in the Los Angeles march where CalCare proponents took over the branding.  The M4M4All logo takes a backseat to CalCare in this promotional material.  

This was something Margaret Flowers addressed in her speech at the Washington, DC march. She used the Gandhi quote, “All compromise is based on give and take, but there can be no give and take on fundamentals. Any compromise on mere fundamentals is a surrender, for it is all give and no take.” As she said, in this fight, we have to be independent, clear, and uncompromising. Artemis Salisbury refers to the Minimum Acceptable Compromise (MAC). When it comes to healthcare, a Medicare for all single payer system is the MAC. We must not allow the distraction of a state-based system to keep us from the goal of everybody in, nobody out.  

State-based is a compromise. Fighting for a Federal system is the only way everyone will be covered.  State-based has no path forward to get there.  As currency users, states must compete with each other for tax money. There are an extremely limited number of states which can afford a state-based healthcare system. When I march, it is for Medicare for All, not for Medicare for the richest states. 

A sign at the M4A march in Seattle identifying the problem with the US healthcare system 

Moving Forward  

Throughout the day in Seattle, we heard from a variety of speakers. We heard stories demonstrating just how broken our for-profit capitalist healthcare system is.  The sheer inhumanity of the system is heartbreaking.  People are forced to choose between dying and living in perpetual debt.   

“The people know we need Medicare for all, what they’re looking for is a strategy to actually win it.” – Seattle Councilwoman Kshama Sawant  

The Keynote speaker of the day was socialist Seattle councilwoman Kshama Sawant. In a fiery speech, she did not shy away from calling out the establishment and the Democratic Party. Instead, she focused on strategy. We know the people want Medicare for All, but we need a strategy to get there. What is this strategy? It is not working within the Democratic Party. As she explained, “Workers in both Canada and in western Europe have long fought for their right to health care. But the major reforms began only in the period after WW2 when mass workers’ parties started to be formed as a challenge to the mainstream establishment parties.” She described how the Canadian system came to be through the creation of a new worker’s party and through direct pressure from mass movements on the streets:  

In 1966, under the twin pressures of organized labor and ordinary workers marching on the streets and the NDP holding the balance of power in parliament, the capitalist liberal party then in power was forced to pass Medicare universal single payer healthcare plan in Canada. 

Kshama emphasized elected officials are there to represent and fight for the people. Elected officials have a platform, it is their duty to use it to expose the betrayal of the establishment on behalf of big business. It is only through the power of the people united that we can take on the billionaire class. Kshama won her victories in Seattle by opposing the Democratic party, because she focused on the working people and their needs.  

“Working people, young people, and the left, we have a historic opportunity and an urgent necessity. That is why this day of action is so crucial, because this is the moment to actually fight to win Medicare for all.” – Kshama Sawant  

What Kshama’s speech truly illustrated was that the fight for Medicare for All is part of a larger struggle, the class struggle. We know the majority of the working class supports Medicare for all. It is the corporations and the capitalists who oppose it. Medicare for All will only be won through class warfare. The state-by-state approach largely ignores this national class struggle. Poor states like Mississippi, Arkansas, and West Virginia cannot take this approach. Yet the poorest states are the ones who are suffering the most under the capitalist healthcare system. For example, Georgia has a poverty rate of 13.3% yet “Gov. Brian P. Kemp’s proposed budget for Fiscal Year (FY) 2022 maintains $697 million in cuts to education, $283 million in cuts to health agencies and largely preserves the status quo of significantly underfunding core areas of state government.” Those who are suffering the most under our healthcare system are those in poverty. According to a 2016 study using data from 2001-2014: 

First, life expectancy increased continuously with income. There was no dividing line above or below which higher income was not associated with higher life expectancy. Between the top 1% and bottom 1% of the income distribution, life expectancy differed by 15 years for men and 10 years for women. 

National Institutes of Health
Eric Kestner telling us it is a class war  

Life expectancy by state largely correlates to income by state. The poorest states are those who would most benefit from universal healthcare, they are also those who cannot pay for it on a state level. To ignore this is to ignore the true nature of the class struggle.  

Many of the speakers at the Seattle event mentioned medical debt. A new study recently found that US citizens held $140 billion in unpaid medical bills in collections in June 2020 before most of the impact of the pandemic. According to the NYT, “The new paper finds that medical debts are higher in poorer neighborhoods. In the lowest-income ZIP codes that researchers studied, people owed an average of $677. Those in the highest-income ZIP codes owed an average of $126.” It is not a coincidence that the lowest income ZIP codes also have a higher proportion of BIPOC. Racial capitalism has made sure those most impacted by poverty are minorities. Ishmael Geter of the Black Action Coalition emphasized the ties between race and healthcare in his speech before the march. Healthcare justice is racial justice.  When we say everybody in, nobody out, that includes all races and genders.   

Marchers for M4A in Seattle  

I hope theses marches are just the start of a prolonged campaign against the Democratic and Republican parties. These marches were not on the scale of the Women’s March or the March for Science, but they were high quality marches. The people need healthcare. The Cuban Revolution looked like it was doomed to failure after only 20 of the original 82 revolutionaries survived the Battle of Alegria de Pio. Big changes often have small beginnings.  Solidarity forever.  

9 thoughts on “Medicare for All, Not for Some”

  1. A few state-by-state successes will empower the national movement. People in poorer states may be more motivated to stand up for it if they see others getting it. Any and all proponents of a state plan, that I know, also fight for national M4A and would continue the fight for national M4A, even after they and their neighbors were covered.

    1. This is absolutely true. As founder of the creative coalition, Red Berets Medicare for All and Board member of Whole Washington, this is a given. For example, but not limited to, Jason Call for Congress, board members of Whole Wa, would have access to entire state of organizers, once he’s elected, to put to very specific direct actions!

    2. State-based health care is a neoliberal scam.
      Corrupt scum like Nancy Pelosi encourage state funded health care BECAUSE it will fail miserably, and be an example for why ‘single payer’ can’t work.
      We need health care advocates in every state to push for, and demand in unison, national, federally funded, Medicare For All…
      Learning the economics and organizing based on the reality/feasibility/understanding of “how we pay for it” will do more to advance the health care fight than knitting a million silly ass red hats.

    3. Marches and protests are old school. They don’t work because the effort is unsustainable and they don’t hold reps. accountable. I suggest we organize in many small local and decentralized groups that can directly pressure reps. and media with little effort. There’s no cost or need to march. The idea needs discussion and exposure. If you see how this can work,, then please register and let’s get work. Here’s a way to do it.

    1. If you read the whole article, you would understand. While Stephanie is a great MMT scholar, she also advises a great number of politicians. This means she must be careful to not alienate them. However, the truth is the truth: state based options are setup to fail so that neoliberals can use it deny #M4A

  2. Pingback: The Pied Piper of State Based Single Payer Initiatives – Critical News Autoblog

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