Mark me down for 'unreasonable,' thanks
Reasonable men adapt themselves to their environment; unreasonable men try to adapt their environment to themselves. Thus all progress is the result of the efforts of unreasonable men.
- George Bernard Shaw
The argument that single-payer health care would be more efficient is a straw man. Both health care reform plans would increase efficiencies and save a great deal of money. But only one can get 60 votes in the Senate.
The HCAN strategy all along has been to calculate based on some unknown formula what is politically feasible at the moment (curiously, without seeming to take into account the effect that energetic activism can have on feasibility) and direct all its energy towards that goal. It's a reasonable and legitimate plan, I wish them success on it, and for reform advocates generally (including single payer) their success is all our success. I still don't like it, though.
First, it's asymmetrical. Do you think AHIP is so finely calibrating its strategy? Hell no. They're trying to burn the motherfucker clear to the ground. We need to be the equal and opposite reaction by repeatedly and loudly demanding our entire wish list. Second, it's not our job to think about, or even care, if the perfect is being the enemy of the good. That's for politicians to consider, not activists. Our job is to ceaseless agitate for the best policy. Our elected representatives can worry about the perfect, the good, the realistic and the rest of the sausage-making process.
We may end up with a robust public option, and if so it will be a vast improvement on the status quo. It would also potentially create a firm, reliable progressive voting bloc in Congress to offset Blue Dogs. It would be a paradigm shift in Washington too, as the first example since perhaps Medicare of government taking on a large project in order to provide for the common good. We've been nibbling at the edges for decades. All that could change if the savvy approach of HCAN and others comes to pass. But should they be inclined to pat themselves on the back, they should consider that just maybe it was single-payer activism that created the political room for it. And in any event that's just a nice, big step towards single payer - not the end of the effort. I won't be going anywhere. How 'bout you?