> it's important to combine (1) what issues those outside
> the "usual suspects" are interest in with (2) a long-term
> perspective. Sneering at "wonk rooms" suggests that
> you've forgotten about the latter, Nathan.
I think that this is the right approach. I happen to disagree with Nathan's line of argument -- or at least implied line -- through much of this discussion that single-payer would be a step backward if it did not include everyone (undocumented immigrants, funding for abortion services, etc.). The reality is that the current system already excludes tens of millions, and single-payor would be a monumental step forward.
At the same time, I think that Nathan has been right on balance and tone when he criticizes the use of "maximalist demands" to make the perfect the enemy of the good. I have come to the conclusion that there are few things more frustrating in life than letterhead coalitions headed by groups with names like the Unitarian Universalists for the Propagation of Guatemalan Handicrafts, all put together to issue broad, wonderful statements on big issues but never to actually get anything accomplished -- because even when big organizations formally sign on, they never turn out members, either, because the campaign is so obviously not politically realistic.
I agree with Nathan's sentiment that he's more excited about the efforts to make Wal-Mart pay than he is about single-payer -- not because single-payor would not be a good thing, but because the efforts to make Wal-Mart pay involve a lot more people and are really on the agenda. They're a ray of sunshine in a cloudy atmosphere of Medicare and Medicaid cuts. Unserious, paper "coalitions" about single-payor -- especially at the federal level! -- are "pie-in-the-sky" in the current context. It would be different if the political atmosphere were different and serious proposals for health care reform could be considered -- even the atmosphere of the early 1990s might have been more favorable to this, but that is not now. Things may be different in five or ten years, but to a large extent, these circumstances are beyond our control. The unions are weak and incapable of forcing changes on their own until they are able to grow stronger through significant organizing; meanwhile, there is no larger labor movement (around the unions) or social movement of any kind to force this kind of reform onto the agenda. And I hasten to remind everyone that the Republicans control the presidency, Congress, and the courts as well as most statehouses and governors' mansions -- though I suppose this latter point will be dismissed as irrelevant by our resident "facts are bourgeois" cohort.
- - - - - - - - - - John Lacny http://www.johnlacny.com
Tell no lies, claim no easy victories