Who Will Be at the Table? Part VI

Single-payer advocates are almost left off the invite list

During the campaign, Barack Obama promised his cheering crowds that, when he rolled up his sleeves to work on health care, he would “have insurance company representatives and drug company representatives at the table. They just won’t be able to buy every chair.” Now is a good time to take a look at just what kind of seats special interest groups will have at Obama’s table, and what they’re doing to bring the public around to their ways of thinking. This is the sixth of an occasional series of posts that will analyze their activities and how the media are covering them. The entire series is archived here.

The White House invited all kinds of stakeholders to its health care summit Thursday. But until three days ago, it hadn’t requested the presence of any single-payer advocates organizations or supporters of a national health insurance program—like Michigan congressman John Conyers, whose single-payer bill has more than ninety co-sponsors. There has been little interest in the Conyers bill among Washington’s health care cognoscenti, who apparently believe that any reform legislation must build on the current system of public and private insurance, embrace elements of the Massachusetts health plan, and not upset the status quo too much.

As one member of that group told CUNY students last year: “Mainstream progressives and what health care professionals are recommending is a variation of the Massachusetts plan.” Saul Friedman, who writes a popular column called Gray Matters for Newsday, has been almost alone in writing about what he has called a “blackout” on discussions of a single-payer health system. Last month, AARP’s chief (and super influential) lobbyist, John Rother, told Friedman that although there is broad support for single-payer, the cognoscenti didn’t feel that it was a pragmatic solution. Then Rother became downright blunt. “Single-payer advocates could play a destructive role in the coming debate,” he said. In other words, Rother was saying: “Get out of our way.”

There are vocal pockets of single-payer activism around the country—in Pennsylvania, in California, in New York, in Massachusetts. A woman named Laura Bonham wrote an impassioned piece for OpEdNews.com urging Americans to reject the lockdown on a single-payer discussion. The activists didn’t like being excluded from Obama’s expanding table. So when an invitation didn’t arrive, they decided to protest outside the White House while expressing their unhappiness via e-mails and phone calls. Late in the day Tuesday Conyers got his invitation. On Wednesday, Dr. Oliver Fein, president of Physicians for a National Health Program (PNHP), got his. PNHP called off the protest and issued a press release saying the invitations represented a victory. Fein said:

Single-payer health reform, an improved Medicare for All, is the only reform model that offers $400 billion in annual savings in administrative costs. It is the only approach that contains effective cost-containment provisions such as bulk purchasing and global budgeting. Such economies would allow for expanding health coverage to everyone—with no co-pays or deductibles –with no overall increase in health care spending.

Word got around about the snub/belated invitation. On a phone briefing with reporters Thursday, one journalist asked about the exclusion of Conyers. Melody Barnes, who directs the White House Domestic Policy Council, said “we always wanted him to be here,” adding that there were “any number of people who were invited in the last couple of days. There was no resistance on our side.” Barnes also repeated what the President had said during the campaign: that if we could start over, he would support a single-payer system, but since we can’t, he believes we have to build on our current system—in other words, the position advanced by the health care cognoscenti. During yesterday’s White House press briefing, Helen Thomas asked why the President is against single-payer. Press secretary Robert Gibbs replied: “The President doesn’t believe that’s the best way to achieve the goal of cutting costs and increasing access.”

Single-payer health care may not have legs this time around, but there are plenty of supporters who want to be heard. It’s good to see the press beginning to pay some attention to another point of view. We at Campaign Desk have often noted the lack of diversity in the public discourse over reform. In late January, Congressional Quarterly published a piece about the Leadership Conference for Guaranteed Health Coverage, a new coalition of liberal advocacy groups and labor unions which, CQ said, was “trying to breathe new life into the idea of a European-style, single-payer health system in the United States.”

In Montana, Mike Dennison, a state house reporter for Lee Newspapers, has been writing about what he calls the “familiar mantra” of Sen. Max Baucus, who says everything is on the table except single-payer. “America is not ready for single-payer,” Baucus told reporters the other day. “We’re not Europe; we’re not Canada. We’re Americans. I think this country does not want single-payer.”

Perhaps now the media have an opening to do some investigating on their own to find out whether Baucus is right.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.