The dynamics of health care reform

Editor's note: Excerpted from report to CPUSA National Committee November 13, 2009.

The current struggle for health care reform gives us a concrete glimpse of the contours, dynamics, and complexities of the issue.

It has been a pitched battle. At one point there appeared to be a crack in the Republican edifice when Olympia Snowe voted to move the bill out of the Senate Finance Committee, but she quickly backpedaled when Majority Leader Harry Reid raised the issue of a public option.

On the other side of the aisle, nearly all the Democrats favor reform, though they quarrel over its nature.

Across the country a movement is charging forward. Early on the mobilization was inadequate, but that changed, thanks to the so-called tea parties that were a wakeup call for many who were enjoying the afterglow of the 2008 elections and underestimated what it would take to consolidate and extend that victory.

All sides in this struggle have gone to great lengths to frame the debate and shape public opinion. In the early going the right had some success with its fear mongering - talk of death panels, socialism, Nazism, etc. - but that changed as health care supporters answered the challenge.

While many sections of labor favor a single payer system, they have avoided painting themselves into a corner. Instead they have stated their support for single payer while battling for the inclusion of the public option, and greeted the House bill with enthusiasm.

While labor differed with the Obama administration on some matters, it has done so in a thoughtful, respectful and unifying manner. It has not sought to score points, demonstrate superior wisdom, or expose Obama as a ‘do-nothing centrist.'

Other organizations of the popular movement - NOW, the NAACP, National Council of La Raza - as well as many of the health care organizations and coalitions take much the same approach.

The passage of the legislation by the House constitutes an important victory for comprehensive health care reform and progressive change generally. If the bill had been defeated, we would not be simply back to square one, as some suggest.

Rather, health care reform would be off the agenda, indefinitely. Political momentum would shift to the right wing, and prospects would be bleak for a second stimulus, Employee Free Choice, climate change legislation, immigration reform, and other key battles.

Some left and progressive people dismiss this danger, but politics is not only about passing laws, as important as that is - it is also about gaining and maintaining the initiative, building on victories no matter how small, and expanding the breadth and depth of the coalition at every opportunity. It's higher math, not elementary addition and subtraction.

The health care reform fight is not over, of course, since the Senate has yet to act and the balance of power is less favorable there. Still, the House vote gives fresh impetus to the broader movement to bring its weight to bear on Senate deliberations and then on to the reconciliation process where the bill can be improved, including through deletion of toxic elements like the Stupak amendment that would curtail access to abortions.

The health care reform movement has to "keep the pedal to the metal." All kinds of actions are planned over the next month, from congressional lobbying to "thank you parties" for those who have supported reform, to phone banking to influence the Senate vote. Everyone should be a part of this.



Post your comment

Comments are moderated. See guidelines here.


  • The House Bill on Health Care Reform was undoubtedly a step forward but as Comrade Sam said the fight is not over. We knew what was gained in the House could be lost in the Senate. We may not be win everything but that is no reason to loose everything. We should by all means be self-critical, and ruthlessly thorough in examining all possible roads forward. There will be times when one step forward will end in two steps backward because of a drastic shift in the relationship of forces. The struggle is zig-zac not straight forward, nonetheless we must press forward.
    This is what I get out of Sams article. We must make the necessary tactical adjustments that will take us forward at any given moment.
    Lenin defined dialectics as concrete analysis of concrete conditions. Reality isn't determined by subjective evaluation. Screaming that "we've been sold out by the democrats and President Obama" and then doing nothing and offering nothing interms of fighting for whatever gains we can get is not in my opinion what Communists do.

    Posted by Frank Chapman, 12/14/2009 12:11pm (6 years ago)

  • Great article. I think it clearly shows how working families benefit both from the fight for meaningful health reform and from the reform itself!

    Posted by Rosalyn, 12/14/2009 10:12am (6 years ago)

  • So far in the criticism I hear nothing about a strategy to move forward, to get votes for a better health care situation. I hear utopian platitudes. Then what about the prohibitions for denials for pre existing conditions, etc, the subsidies and other things especially in the House bill. Many of these things will benefit me an my options and millions of others, Where are the votes in congress for your ideas? Truth is concrete

    Posted by Rosalio Munoz, 12/12/2009 9:28pm (6 years ago)

  • This was depressingly long on the "contours, dynamics, and complexities" of legislative process, and offered precious little to the workers.

    Posted by Andrew Taylor, 12/11/2009 1:44am (6 years ago)

  • Fresh out a meet with brother Bob Burns,ex-Teamster and Field Rep. for Senator McCaskill with 5 peace activists,we reviewed the colossal waste and robbery of the militarists and health care monopoly conglomerates,the dearth of health care delivery for women,the poor,working poor,the middle class,retirees,and especially people of color.
    We concluded again,that we must,as this piece suggests,"keep the pedal to the metal" for heat and progress of all-out activism.
    Truly,"Everyone should be part of this."

    Posted by E.E.W.Clay, 12/10/2009 5:44pm (6 years ago)

RSS feed for comments on this page | RSS feed for all comments