Submitted by Illinoisnoki1 on Wed, 07/25/2012 - 14:34

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By Bill Bianchi, PDA and Illinois Single Payer Coalition

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After a long career as a marketing executive for health insurance giant Cigna, Wendell Potter several years ago, turned against his former employer and became a strong public advocate for health care reform and I thought, Single Payer-Medicare for All (S-P). But in an article appearing in a recent issue of the Nation, “Healthcare Advocates: Time to Bury the Hachet”, Potter seems to turn in a puzzling direction.

After building the case for compromise, he calls on S-P advocates to swallow their objections to the President’s Affordable Care Act (ACA) and join its supporters in a coalition that can fend off anticipated attacks on ACA.

Disturbingly, Potter’s advice mirrors that of many other “leaders” in the nation’s health care reform movement, namely that single payer advocates should compromise by down-playing their “purest” demands and accepting “imperfect” reform measures like the ACA, which presumable will lead to our goal or something close to it.

He accuses us of being “die-hard” ideologues who actually harm the cause of S-P by criticizing the President’s health care reform. Our actions, he says play right into the insurance companies’ strategy of destroying reform.

Potter implores the S-P camp to bury our disappointments and join with ACA supporters from the President on down to union leaders and astro-turf groups like Health Care for All Now (HCAN). Together, he says we can “move forward”, toward what, he doesn’t say. The path forward, however, lies through a unified effort to protect ACA from the ambushes and attacks from Republicans and the insurance industry.

Potter is right about our resentment toward ACA supporters who banned S-P from the Congressional hearings on health care reform and said little when PNHP physicians were arrested for attempting to give testimony favorable to S-P. Something about being hauled out of a public building in handcuffs makes people kind of prickly.

However, the split between Medicare for All supporters and ACA supporters stems from much more than personal grudges or our alleged unbending ideological commitment. The split is fundamental because ACA and S-P are irreconcilable. One destroys the other.

S-P advocates believe that private for-profit health insurance is the very root cause of America’s cruel, unfair and dysfunctional health care financing system. That’s why S-P specifically does away with the industry’s role and allows the government to bargain on drug prices. ACA, on the other hand actually, strengthens the role of for-profit insurance companies and HMOs and most likely was fashioned in part to prevent S-P from being enacted.

I do agree that leading up to the November elections attacks on ACA will increase. They will come from both the Republicans who resent the Democrats deft syphoning off of health industry donations.  They will also come from the health insurance industry, which will seek to reduce and eliminate the complex array of regulations and standards built into ACA.*

But I’m guessing that insurance and drug company executives are confident about their ability to reduce those regulations and standards to mincemeat-- just as the financial services industry has bamboozled and captured its federal regulators at the SEC, Treasury and other agencies.  (The whole corporate liberal approach to reform, --placing bandaids on serious wounds--should be rejected in favor of structural change.) 

Despite ACA's vulnerabilies, I advise S-P supporters to reject Potter’s appeal to us to soft pedal Single Payer and help fend off attacks on ACA. That battle will be a never ending, losing game that saps energy away from Single Payer work.

And given the corruption of our political system and the “pragmatic/opportunistic” bent of the corporate liberal elites, some of the very people asking us to defend ACA today may soon be working for lobbying firms devoted to destroying the ACA’s regulations. 

Our focus before and after the November election should continue to be on building support for Single Payer here in Illinois and at the national level.   

Mr. Potter, you call for pragmatic compromise; fine but doesn’t honest compromise require all the parties involved to give up something in exchange for something else in return? ACA supporters do compromise, but it seems only with the right, as they did by eliminating the public option.  What do they offer S-P supporters in exchange for our help protecting the ACA? 

When will ACA supporters like SEIU and HCAN join us in crafting a strategy for getting to Single Payer? Please let us know. It’s important to keep talking.
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* Recall that ACA was designed by health insurance industry lobbyist (Liz Fowler, former V. P. Wellpoint) and steered through Congress by the industry’s chief political representatives such as Senator Max Baucus, (D-Montana and K Street). As Potter asserts, the industry supports ACA’s key provisions. The mandate and premium subsidies provide the solution to the industry’s long term profitability problem, namely the increasing inability of many Americans to pay health insurance premiums. Through ACA, insurance companies receive an additional 30 million customers, government subsidized premium payments, and the prospect of growing profits for decades to come.