The problem with an argument about the impossibility of little reforms is that they are not only untrue, but obviously untrue. We have a large number of little reforms passed over the past decade, some of them in the past year. Little tweaks pass at the state level all the time. What I think is a fairer statement, and perhaps what you and Carrol intend, is that incremental *improvement* is impossible. As I said in my previous post, reforms everywhere, but things keep getting worse.
And I agree with two things; incremental reforms short of single payer won't solve the problem. If they are small incremental reforms, things will continue to get worse immediately. If they are large ones, you may buy some time; but even they make a short term improvment it will be a marginal one, perhaps not reversed immediately, but certainly shortly.
But the fundamental problem is that people don't know about single payer. And you know there have been single payer activists around for quite some time, and we have not succeeded in educating people about it.
So I'm looking at a possible change in tactics for single payer activists. Can we take some of energy to the incremental reform movements, and use it to support those incremental reforms in way that promote single payer health, as those currently leading such movements do not? Is there any reason why going door to door for a tiny change can't be used as a door opener and conversation starter to educate people about the issue of single payer health. Is there any reason why a forum about single payer health can't include both support for an incremental reform, and an explaination of why any good in that reform will be undermined unless our current system is replaced by single payer one?
And a challenge for Nathan too. Incremental reformers pour huge resources into those reforms. If you folks are serious about single payer as a long term goal, how about putting a percentage (you name it 20%? 10%?) in each campaign to educating the those you reach about single payer. Explain that this is a temporary fix, relieving some pain for some people, but leaving many others unhelped, and not reversing the slow deterioration in quality and increase in insecurity that affects everyone; explain while campaigining for "fair share" or smal business insurance or whatever that single payer is where we have to go in the long run.
Doug started this list to try and promote this type of synthesis. Maybe this is not it; but I don't think I've not convinced by the arguments against it yet. I'm not suggesting diverting single payer health energy into incremental reforms. I'm suggesting that single payer advocates can use those campaigns to reach people they currently don't talk to with the single payer message - while also helping the incremental campaigns marginally, I'm also suggesting that the incremental reformers start diveriting a significant portion of their incremental campaign resources into single payer eduction
Think about medicare Part D mess. The right is actually benefitting from it, portraying it as an example of how "the government" messes up everything it touches. One way to structure a "fix part D" campaign is to yammer about donut holes, bulk purchasing, one wonkish thing after another. Or you could take the time to explain single payer, then point out that the problem with part D is that it works like private insurance rather than like single payer. A campaign like that would educate about single payer as well as a "pure" single payer campaign would. It would educate about part D as well (probably better) than a "Pure" part D campaign would. You get double the results for the same effort. Even if the incrementalists don't do this, tell me why our local single payer group shouldn't. Even if single payer focused groups don't do this, explain to me why incrementalists shouldn't. And a hell of a lot people are concerned about part D. A lot of the elderly are indignant; a lot of their younger relatives are too. Tell me that Part D, a specific problem is not an opportunity to educate and agitate.