In Washington State we added 5,000 people to basic health. So that was an incremental reform that was won. The question is not if you can win incremental reforms, but whether they can be won in a way that promote bigger step. Because huge resources went into getting those 5,000 people added, and almost no education took place about single payer. That is the question about incremental reform vs. big steps; can incremental reform be done in a way that builds movements towards bigger steps? Because if not, then your argument becomes essentially true.
internal dialog:
Voice 1: 5,000 freakin people (or maybe 10,000 - last I heard is was going to be pushed up a bit) in a state with the population of Washington States. The number of uninsured has several more zeros than that, and the number of uninsured even more.
Voice 2: 5,000 more than were covered before it was passed. That is one heck of a lot human suffering relieved, even if much more remains
Voice 1: Yeah, until the next temporary state budget surplus gets pissed away on taxes for the rich; those basic health slots will be cut right back. And basic health is pretty crappy coverage. Only the worst doctors along with a few saints accept it. And those slots weren't a victory; they were a booby prize. The incremental reform sought was a fair share bill. And your freakin statel Democratic speaker killed that one.
Voice 2: those new people on basic health sure as hell prefer it to no coverage. Besides, we didn't just win those basic health slots; we funded a whole program to provide health insurance to employees of small busines. And what is your alternative? Put single payer on the ballot, with current state of public awareness on the issue, and the other side can kill it by shouting "socialized medicine".
Voice 1: that is because all the resources that could have gone to educate the public went to lobby unsuccessfuly for a Walmart fair share, and win a few added slots in the basic health program. Put some of that money and time into education and the public will be ready to support. And as to the small business program; the state provides 40% of the premium; the business pays 40%; the individual 20%. We'll see how many small businesses choose to pay for that, and how many workers in those small businesses can afford the remaining premium.
So you can see why I'm looking for a synthesis. But please don't tell
me incremental reforms can't be won; what does seem true is that incremental improvements can't be won. You have all these "reforms" but the situation keeps getting worse.
Mostly I'm on the "big step" side of the argument. But I also hate the idea of leaving people to suffer while waiting for that big step. And I have doubts about the effectiveness of telling people, "we won't even try to do anything for you while working on that big step". But again, fighting for those incremental steps consume vital resources that could help educate and organize for bigger steps - like single payer.
So, anyone have a gripping hand here?