universale

Forcing the Vote on Medicare for All: A Proven and Imperative Strategy

[Photo credit: CNN]

By Karthik Pasupula

Republished from Michigan Specter.

14.6 million. That’s the lower estimate of the number of Americans who have lost their health insurance during this pandemic. Want to guess the number of people in the same situation in other developed countries? Zero if you live in Canada, the UK, Germany, France, Australia, Japan, South Korea, Taiwan, Denmark, Finland, Norway, etc.

You’ve probably seen the polls. More than 70% of Americans believe that the government should be responsible for insuring all Americans, with around 88% of Democrats supporting a single-payer system. Support for government healthcare has risen across the board, presumably because pandemic-induced mass unemployment has exposed the folly of employer-based insurance.

Yet, the fight for Medicare for All isn’t happening in the halls of Congress right now. And that is a huge mistake. National media is dominated by coverage of an inept administration whose will to govern has been broken by the (un)dynamic duo of Senators Manchin and Sinema. The constant ceding of ground must end. It’s time to #ForceTheVote in order to put public pressure on establishment politicians and get them on the record.

Ever since the emergence of “The Squad” in 2018, interest in Medicare for All (M4A) has soared. This is especially relevant to Michigan voters, since 16% of residents live in poverty, including one in four children and 17% of senior citizens. These problems are especially bad in Detroit where around 30.6% of people live below the poverty level — the highest among big cities. The insane grip that corporate health insurance companies have on America harms more than just America’s very poorest. One in five voters struggle to pay their medical bills and one in three fear that they won’t be able to pay for healthcare. In order to pay those bills, they have to resort to extraordinary measures: dipping into savings, borrowing money, selling jewelry, crowdsourcing, etc. This would not exist under a single-payer system.

A single-payer healthcare system would also set prices for each service. This solves one of the biggest problems of our healthcare system, which is the variety in rates for different services. An appendectomy, for example, can cost anywhere from $1,529 to $186,955. Under single-payer, that rate would be much lower and consistent across hospitals. Administrative costs for doctors and hospitals would also go way down due to the reduction of negotiation costs. As of 2017, administrative spending made up 34.2% of total health expenditures in the United States. That is more than twice what Canada spends.

But how do we win a cheaper and more efficient healthcare system? The strategic and principled move is to demand a floor vote from House Speaker Nancy Pelosi. This would prompt an “on-the-record” vote on M4A from all representatives. Right now, there are 221 Democrats in the House and 211 Republicans (and three vacancies). There are more than enough progressives to threaten the stoppage of any legislation Democrats propose. And they could use that leverage to demand a vote on M4A. But one of the main arguments against a floor vote for M4A is that it would just be an immediate flop.

So? When M4A polls so well, why should we be worried about if it flops or not? The viability of a piece of legislation is in the hands of the people, and the people have spoken: they support M4A. Putting elected representatives on the spot and showing how they’re actively voting against their constituents is absolutely crucial. If the bill fails, then it immediately lets progressives know which representatives they need to primary.

Opponents of this strategy have said that we can just look at the cosponsor list to ascertain who supports M4A. Senators Cory Booker and Kamala Harris have both cosponsored an M4A bill. But, when pressed on the issue during the Democratic presidential primary, they immediately backed down. It would be reasonable to assume many other cosponsors would do the same if forced to vote.

Moreover, a message that certain representatives argued against healthcare coverage for Americans during a pandemic would help progressives in future elections. With our healthcare system absolutely failing during this crisis, American citizens will be more open than ever to healthcare reform. With media coverage of liberal representatives voting to deny them coverage, voters will be reminded of the necessity to elect more progressives to Congress.

Historically, the president’s party tends to lose seats during midterms. Obama lost 63 House seats in 2010, the largest loss since FDR, after his Wall Street bailout. Forcing a vote on M4A would make it much easier to capitalize on dissatisfaction with the president’s party during the midterm elections. 2022 would be the perfect time to campaign against incumbent Democrats, as history shows they are weaker during midterms.

Not only that, but forcing a vote on M4A would use the exact same tactics the Tea Party used to ultimately excise former House Speaker John Boehner. The Tea Party tried to repeal Obamacare numerous times, to no avail, but they rode the enthusiasm from those failed attempts to enormous wins and quickly became a force to be reckoned with in Congress. By blocking nearly every piece of legislation, and thereby tying Boehner’s hands behind his back, the Tea Party effectively forced him to resign. In short, Boehner stepped down because the Tea Party used the leverage they had. Progressive Democrats should use similar leverage to bring Chuck Schumer and Nancy Pelosi to their knees.

If you disagree with forcing the vote, then what is your plan to bring M4A into effect? What do you think we need to do before getting a vote on M4A? How do we do this, and what is the timeline? These questions are not being answered by sitting politicians. All we have are ideologies; not action on those ideologies. Denying this strategy means denying that the Tea Party was successful in being a commanding presence, and that is verifiably false. The incremental approach that doesn’t utilize the bully pulpit is failing. Everything that Biden “compromised” with progressives on during the campaign trail is falling dead in its tracks: $15 minimum wage (God save the Parliamentarian), ICE detention facilities, $2,000 checks, foreign policy, etc. Playing nice with the establishment does not work and that has been proven time and time again.

Democrats in Congress argued that we needed to impeach Donald Trump to hold him accountable for inciting the Capitol riots. Even though they didn’t have the votes to convict, I agreed with the motivations behind impeachment because it’s a moral imperative to get every single representative and senator on the record to keep them and Trump accountable. The same reasoning applies to forcing a vote on M4A.

Even recently, vote-forcing strategies have been successful at putting pressure on establishment politicians. Senator Bernie Sanders recently forced a vote and got eight senators, all of whom caucus with the Democrats, on the record as opposing a $15 minimum wage.

At this stage, opponents of this strategy complain that there is not enough thought given to step two. However, there’s a clear plan. We get politicians on record, and then exert political pressure on a popular issue. In this way, even if the bill fails, the issue only gets heightened. Just one piece of evidence is the huge outcry and shaming of Senator Sinema for her thumbs-down vote.

And what comes after this, you ask? The ammunition to primary these corrupt individuals is readily provided on an issue that the vast majority of Americans have a solid stance on. Denying a living wage is one thing, but denying healthcare during a pandemic will carry even graver consequences for Democrats who take that stance.

Something I’m completely against is calling opponents of this strategy corrupt. AOC and other members of “The Squad” have said that they are against forcing a vote on M4A because of aforementioned counterarguments, but they aren’t corrupt like the majority of DC. Progressives do NOT take money from super PACs, and that’s the main separator. We won’t always agree on everything, but we will agree on basic, reasonable political positions.

The foundations of #ForceTheVote are both principled and strategic. It’s principled because we’re fighting for something at a time when people need it most. Even if it’s “doomed to fail,” fighting for something that you believe is right is simply the morally principled action. And it’s strategic because, even if the vote fails, it gets representatives on the record as denying basic improvements in quality of life. That sets us up well to pressure incumbents and mount serious primary challenges against them.

The 2020 election showed that anti-Trump rhetoric by itself does not work. Democrats lost seats in the House and Biden won by smaller margins in swing states than Trump did in 2016. Sticking with their tradition of strategic cluelessness, the DNC recently announced that their primary focus will be on QAnon next election cycle.

Enough of this culture war bullshit, it’s time to fight for real policy. We need to have substantive arguments and a floor vote provides us with the ammunition, especially if it fails. The failure will not fall on progressives, it will fall on Democrats who voted no and they will be punished for it through democracy. There is nothing to lose from this strategy.

Keep in mind the 14.6 million people who have lost health insurance. Keep in mind the huge number of people who were already uninsured or underinsured. Keep these things in mind while consistently calling out politicians, so we can keep them accountable when the opportunity arises.