Sam Smith
While it is certain that single payer - and likely that a public option - will go down to defeat, there remains the question of how progressives should best approach the situation.
While the airwaves and columns of the left are filled with anger, there doesn't seem to be a lot of strategy involved.
For example, the other day I cited a group of little discussed provisions in various bills that would definitely improve healthcare.
Included were an end to denial of coverage for preexisting conditions, an end to discriminatory pricing, a ban on insurance companies canceling policies for any reason other than failure to pay the bill, an end to lifetime or annual caps on benefits, subsidized coverage for the poor, tax credits for small business and lifting the income limits on Medicaid eligibility.
If the showboaters in both parties weren't so obsessed with scoring one major victory, one could imagine a bill that did not do much more than the aforementioned items. It would be a good bill and it would make life better for many Americans.
The insurance companies would hate it, but support for the measure would grow greatly because it would be a true - if modest - reform of the existing system without any of the dubious, extraneous or presumptuous aspects of the bills that have gotten the Democrats in such trouble.
On the other hand, it would fail to provide universal coverage, the initial point of the exercise. Of course, not passing any healthcare bill would suffer the same fault.
The real question, thus, is this: is it better to go down to total defeat or to make a number of improvements even if they seem trivial compared to what one set out to do?
Further, would passing such a modest measure hinder or help the course of single payer? Would it serve as an excuse to forget about the issue for another decade?
(The same questions, incidentally, are worth asking about the so-called public option)
I suspect we won't have to make that decision since even the mild suggestions listed above would probably fail to get significant Democratic support because the party is so beholden to the insurance companies.
What progressive members of Congress can do, however, is to establish a paper trail by proposing amendments that would put politicians on record as to whether they support the interests of the citizens or of the insurance companies. And then use that trail in primary campaigns against the worst sinners in 2010 and 2012, which - the way things are going - might even include the current president.
Obama and the congressional Democrats have made an ungodly mess of this issue. There seems no good way out. But while sticking with single payer is certainly an honorable position, it would also help to find ways to expose the hypocrisy and shame of those who have done it such damage. For example, banning denial of coverage for preexisting conditions is not socialism, it's not some wacky British system and it's not going to kill your grandmother before her time. Making foes of public healthcare vote on just that one issue might help better expose how mean and selfish they really are.
