[lbo-talk] Cloward-Piven strategy for single payer?

[Chris Maisano]

Back in the 60s, Richard Cloward and Frances Fox-Piven formulated a strategy for winning a guaranteed national income that sought to get everyone that was eligible for welfare on the rolls - see the Wikipedia page for how they thought it would work: http://en.wikipedia.org/wiki/Cloward%E2%80%93Piven_strategy.
 
Obviously they didn't win, but I think that their basic idea may have some new relevance at this point in the fight for single payer healthcare. The plan that's going to be passed relies on Medicaid expansion to cover about half of the 30 million or so people that would now be able to get insurance. Medicaid already struggles to meet its obligations, and as Doug noted in a recent radio commentary, there are 5-7 million people who are eligible for Medicaid but are not enrolled. Millions more people are soon going to be eligible for it. The feds are going to partially finance this expansion, but only for a couple of years, and then the costs would shift back to the states, which are already in fiscal crisis.

So here's what I think the left should be focusing on in the coming years: explode the Medicaid rolls. Sign up as many people as possible for Medicaid. The system could not possibly support all of them when the financial burden shifts back to the states, and would probably force some drastic measures at the national level to deal with the ensuing crisis, possibly including single payer. Of course there would be the possibility that such a crisis could be settled on right-wing terms, but I'm having trouble thinking of any other strategy to get to single payer on the new terrain we're about to confront. I'd be interested in hearing what people think about this.