Friday, June 19, 2009

Organizing for Healthcare, Part Two

By Marc Korman.

Last time, we discussed the Organizing for America healthcare event that took place earlier this month to build up grassroots support for healthcare reform. This time we will talk a bit more about some of the discontent at the meeting.

President Obama may have three priorities for healthcare (costs, choice, and coverage), but many of the grassroots supporters at the OFA event had just one: single payer. Sharon Dooley gave a preview of the desire by many progressives for a single payer system, instead of tinkering with the current marketplace of competing insurance companies. That same desire was expressed at the OFA event.

There was always a bit of unrest among progressives over some of candidate Obama’s positions, such as a troop increase in Afghanistan or his failure to support gay marriage. But people were willing to shove that aside in order to get a progressive Democrat elected. But with healthcare, many attendees expressed a willingness to let healthcare reform die entirely instead of allowing a system resembling the current mix of public plans like Medicare and private insurance exist.

Delegate Barve spoke about the importance of securing 60 votes and Karen McManus from Congressman Van Hollen’s office conceded that the final product would not be perfect. But those reality checks did little to settle down anxious activists. I have heard that many of the earlier house parties had a similar vibe.

One way to calm the base might be to provide a little more information. Costs, choice, and coverage make nice talking points, but many of those in the room wanted more information. A few were even honest enough to admit to not knowing the difference between a public option (where a government run plan would compete against the private insurers) and single payer (where all health coverage would flow through one entity). The idea of the public option is something of a “single payer lite.” A robust, government run program could use its bargaining power to negotiate low prices and provide comprehensive services, theoretically requiring its public sector competitors to do the same. One of the downsides of the current cooperative compromise put forth by Senator Kent Conrad (D-ND) is that they would likely be local cooperatives, total lacking in the bargaining power that makes a federal public option appealing.

But President Obama may not really be that interested in what the OFA attendees know or support. He may be using a disgruntled base for Machiavellian purposes. The assumption has been that the purpose of the healthcare house parties is to encourage grassroots supporters to contact their legislators and educate their neighbors about healthcare reform. But a slightly unhappy progressive base could allow President Obama to tell moderates in both parties he cannot compromise any further. That could lead to him getting more of what he wants in a final plan.

Maybe the Obama faithful will fall in line once a plan starts moving through Congress, but as of today they do not appear sold, at least not in Montgomery County. But with a vast network of Congressional liaisons and a high approval rating, perhaps President Obama can bring them around.