Mid-day Saturday 55-60 people gathered at Forest Park Community College to hear representatives of a wide-ranging coalition, Healthcare for America Now (HCAN), at the Health Care Can’t Wait! townhall discussion. The moderator, Jennifer Judd,  was clear about the goal of the meeting — to fire up a well-organized and vocal grass roots campaign to demand that we fix our broken health care system and insure access to quality health care for all.  

A more controversial corollary to this goal was the up-front assertion that a hybrid approach that would allow individuals to choose between private and public health care delivery is the best strategic choice to ensure the success of health care reform. This goal was coupled with an operational goal to lobby Congress to  use budget reconciliation, a parliamentary process which would allow the health-related spending to pass with a simple, filibuster-proof majority — a goal, incidentally, that may already have been achieved.    


The formal part of the meeting consisted of brief presentations intended to emphasize the importance of fixing our health care system.  Speakers included:

–a cancer victim who described the travails of securing chemotherapy after losing his job — and his insurance;

–a psychiatrist described the wastefulness and suffering that ensues from our haphazard, after-the-fact approach to dealing with mental health issues such as drug addiction and suicide;

–a priest who described the problem of access to health care from a religious perspective that privileges human dignity which, from a holistic vantage, involves the physical as well as the spiritual person;  

–a representative of the UAW  who talked about the right of everybody to the type of insurance that his Union members enjoy now.

Finally, State Senator Robin Wright Jones, who was present in the audience, took the stage and raised the call to arms (or, actually, ballots), making the point that people get what they don’t vote for — if they don’t vote, that is.  So if you want quality health care for all, her message was that you have to vote for those who will work to to get it for you.

Question and Answer Session

The Q&A session, where a polite version of “the perfect is the enemy of the possible” debate surfaced, was perhaps the most interesting part of the roughly hour-long meeting. At issue was single-payer vs. the hybrid approach advocated by the organizers.

One questioner brought up the superiority of the  single-payer system, specifically as it is represented in HR676. Others also indicated that they believed single-payer was preferable to the hybrid approach that the HCAN alliance intends to pursue.  

The main argument for the hybrid approach advocated by HCAN was that it is the most realistic strategy given the enormous resources that the insurance and related health care industries will bring to bear on the debate. It is the possible as opposed to the perfect if you will. To illustrate the difficulty of the task ahead, an audience member noted that Senator Max Baucus of Montana had become the third largest recipient of funds (i.e., bribes) from the health care industry since he had emerged as one of the leaders in the health care reform effort.

One audience member noted that the hybrid approach could also be understood as the first incremental step on the way to a truly national health care system.  Making realistic decisions about what we can achieve at this point does not preclude an ongoing reform process.

The most pragmatic argument against the hybrid approach was the concern that the public option could not compete in an environment where private providers could refuse all but the young and  healthy. And if publicly delivered health care does not succeed, the ongoing progress toward a true national health care system could be irrevocably damaged. In this scenario, the possible is so far from the perfect that it amounts to essentially nothing.

One audience member, a representative of a retired  steelworkers group, indicated that although he preferred a single-payer option, he understood the strategic implications of the HCAN choice.  In a telling coda, however, he added that if the health care reform failed because of this choice, he and his fellows would turn their anger against the Obama administration for bungling this chance for reform. Comments like this make it clear that hopes are high, but that the cost of failure will also be very high.