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  March 8, 2010

Single payer fight moves to states

Swanson: Obama pushes out Kucinich single payer amendment that enables states single payer health care.
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PAUL JAY, SENIOR EDITOR, TRNN: Welcome back to The Real News Network. I'm Paul Jay in Washington. And here in Washington the conversation's still about health care. Well, about a year and a half ago there was a debate during the election campaign, in the primaries, about single payer or public option, and how robust would the public option be, and the role of government, especially if you look in the primary of the Democratic Party, when Edwards was still in the campaign. There was a pretty vigorous fight about whether there'd be a legitimate government insurance option. Well, then the debate becomes single-payer versus public option, and then the debate becomes is there going to be a public option, and now the question is: is there going to be any health-care reform at all? Now joining us to look at all this is someone who's been an activist in the single-payer campaign. It's David Swanson. He's cofounder of He's the author of the book Daybreak: Undoing the Imperial Presidency and Forming a More Perfect Union. Thanks for joining us.


JAY: So the health-care debate here has gone this big arc to is anything going to get through. So talk just quickly about what's in front of Congress now, and do you want it to pass, or do you want it to go down.

SWANSON: There's a bill that has lots of good things in it, but overwhelmingly what it does is enrich and empower the corporations that have been destroying our health-care system. You know, it puts another 30 million people in as customers of these health insurance companies, transfers another $350-$400 billion to them, a chunk of which you can expect to be funneled back to Congress members.

JAY: Now, just quickly, the counterargument is they're setting up a regulated industry now where it was more or less unregulated. They claim they're going to have some kind of price control mechanism at the state level, they're going to stop them from excluding people with pre-existing conditions, and that this is better than nothing.

SWANSON: Some of those things are better than nothing, but you have to look at the bill as a whole. Every time it looks like it might pass, the stocks go up in these insurance companies, which are being protested by the supporters of the bill, of all strange circumstances, and who are responsible for writing most of the details of the bill. I'm not confident that this is reform. And when you create this system where those corporations are entrenched and empowered and enriched, and you've created this new public service and privatized it immediately, before the money even got to Washington, and funneled it to these corporations, you're not going to come back after that and improve it or do something better. It's going to be that much more difficult to address health care.

JAY: Well, I guess the argument will be [that] at some point people could come back and say, okay, let's make Medicare for five years younger, and then five years younger. There's ways to kind of to do this. But a defeat, according to these people, sets any talk of health-care reform back another 10 or 20 years.

SWANSON: I think a defeat or a success ends health care for the foreseeable future in Washington. There are useful things that can and should be done, and should be done instead of this bill.

JAY: So you mean at the state level. So talk a little bit, first of all, about Kucinich's amendment and what this has to do with states being able to have single-payer or Medicare-for-all, and then take us [through] what's happening state-by-state.

SWANSON: Well, you'll recall last July in the House Education and Labor Committee, the only thing bipartisan in this whole ordeal was the passage of this amendment from Congressman Dennis Kucinich that would facilitate states going further. States in particular that want to do single-payer health care at the state level would wave federal restrictions, ERISA, the Employee Retirement Income Security Act, problems. This is to say that states will need waivers with regard to money that goes into Medicare and Medicaid, and now this new health-care exchange, if they are to use all of their money at the state level for a real health-care system, for a single-payer health-care system.

JAY: So the Kucinich amendment to the health-care reform bill would allow states to opt out and create their own single-payer system.

SWANSON: There are states that have bills that they claim will get around this problem even without that amendment. But everybody wants that amendment, to make it much easier to head off lawsuits that will come from the industry when a state takes this step. And this amendment passed 25 to 19 back in July and was put into the bill and didn't conflict with anything in any of the other versions of the bill and so forth, but the president asked the speaker of the house to take it out, and she took it out. So it's not in there. And so one proposal that some health-care activist groups are making and that I've pushed at is that these 14 Democrats who voted "yes" that day say that they won't vote for the health-care bill now unless that amendment is put back in. That would be something worth fighting for. That would be something good to have in that bill.

JAY: So you'd support passing the bill if the Kucinich amendment gets back in?

SWANSON: I would look much more favorably on it.

JAY: And where are you at with the 14 and any chance of them taking such a step?

SWANSON: Congressman Kucinich, it's entirely plausible that he's going to stick with that stand and refuse his vote unless that amendment gets put back in. How hard, if at all, he's pushing his colleagues I don't know. Certainly a lot of us outside of Washington are pushing his colleagues to stand with him, and it would be good not just in terms of the policy, but in terms of the record of progressives actually taking a stand on something, which, as you know, things have gone the other way over the past year on health care.

JAY: So talk state-by-state: where is this movement at the state level to have a single-payer system?

SWANSON: Well, California's legislature has passed a single-payer bill twice through both houses, and three times now through the Senate. It's been vetoed twice by the governor, Arnold Schwarzenegger. They need a new governor. They may get a new governor. It may be Jerry Brown. They may be able to compel him to sign the bill. What they need is to get it signed. Pennsylvania has a great bill that has support in both houses and has a great deal of Republican support, which is not something you would hear about in our nation's capital.

JAY: And why does it?

SWANSON: It's not, you know, actually a communist idea. It's actually an idea that businesses outside of this nation benefit tremendously from. If you're running a business and you don't have to provide your employees with health care, just like you don't have to provide their kids with schooling, that's a benefit to you, and it actually helps in terms of the competition with other countries where businesses don't have to do that.

JAY: Yeah, it's something the auto industry's wanted for quite a long time.

SWANSON: Oh, absolutely, but hasn't quite fought for hard enough. Neither have their labor unions fought for it hard enough. But single-payer health care is depicted as leftist in this country, and there's no reason why it should have to be. It's simply the most efficient way to do something and take the burden off businesses and individuals.

JAY: So where is it at in Pennsylvania? Where in the legislative process is it?

SWANSON: They're having hearings in both houses. They have a great deal of support in both houses. They're doing an economic impact study as they're raising money to do it. And in Pennsylvania they have a governor—a current Governor, at least, for the next year—who has said he will sign it if they pass it. There are several states where you see good progress. Pennsylvania and Ohio and Maryland—you could have a whole region develop single-payer.

JAY: Well, take the Pennsylvania situation. Let's say the legislature passes it; let's say the governor's ready to sign it. Why does the Kucinich amendment matter to Pennsylvania?

SWANSON: Well, the insurance companies will sue immediately. They will take the state of Pennsylvania to court. They will argue, among other things, that this law conflicts with federal law—and it very well might, depending on what Congress passes, if anything. If Congress passes this bill and it includes language from the Senate bill that forbids states from providing their residents with health care, now, that could be fought as unconstitutional in court; but if that language is in there, it will be on the side of the insurance companies when it goes to court—and it will go to court.

JAY: So do we know why President Obama asked for that amendment to be taken out?

SWANSON: Well, I haven't talked to him personally, but—.

JAY: But has he been questioned, confronted with it?

SWANSON: No, not to my knowledge. You know, we don't have a press corps, really, in the White House anymore. Maybe Helen Thomas is an exception, and maybe she'll get a question in there. But we routinely point to the money when we're looking at senators and congressmembers, and the president has, of course, taken ten times the money of any senator or congressmember from these industries. So that's clearly a factor.

JAY: So if the amendment doesn't pass, does it stop the Pennsylvania legislation from passing, or it just makes a more complicated court case?

SWANSON: It makes it more likely that there will be a lawsuit, and it makes it more difficult to win that lawsuit, but not necessarily impossible. And the advocates in Pennsylvania think that they've crafted their legislation in a way that it will pass regardless, depending, again, on what new anti-state language is included in the congressional legislation.

JAY: And what other states are moving in the same direction?

SWANSON: Well, look at Minnesota. They've got legislation and they've got a serious Democratic candidate for governor who's the leader in the push there. So he's guaranteed to sign it if elected. A good candidate for lieutenant governor in New Mexico. Illinois has a good bill that's advancing, at least in the House if not in the Senate. You've got new candidates for state office in places like Missouri and North Carolina saying that their first act in office will be to introduce single-payer health care, and they're raising a lot of money off that promise. There are a dozen states or more where there are serious campaigns underway. And you now have this huge movement of labor unions and advocacy groups and activists groups that have been pushing single-payer health care nationally, and some have been pushing the public option and other lesser steps nationally, that are turning their focus now to single-payer at the state level, giving up on Washington, moving on. And, you know, it costs a lot less, and it's a lot easier to win things at the state level. And this is how Canada did it. They got a couple of provinces and then got the nation. And this is of course how we will do it, if we do it.

JAY: Thanks for joining us.

SWANSON: Thank you.

JAY: And thank you for joining us on The Real News Network. And don't forget: the donate button is here or there. Or you can get out your mobile phone—I have a mobile phone—and if you text 85944 and you send the word "news", you'll be sending us five bucks. Thanks for joining us on The Real News Network.


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