Colin Powell pitches single-payer health care in U.S.

Former Secretary of State Colin Powell has waded into the health care debate with a broad endorsement of the kind of universal health plan found in Europe, Canada and South Korea.

�I am not an expert in health care, or Obamacare, or the Affordable Care Act, or however you choose to describe it, but I do know this: I have benefited from that kind of universal health care in my 55 years of public life,� Powell said, according to the Puget Sound Business Journal, last week at an annual �survivors celebration breakfast� in Seattle for those who, like Powell, have battled prostate cancer. �And I don�t see why we can�t do what Europe is doing, what Canada is doing, what Korea is doing, what all these other places are doing.�

Europe, Canada and Korea all have a �single-payer� system, in which the government pays for the costs of health care.

Some Democrats who strongly advocated for, and failed to get, a single-payer system in the 2010 Affordable Care Act, still believe the current law doesn�t go far enough to reform the US health system.

A retired four-star general and former chairman of the Joint Chiefs of Staff, Powell told the audience about a woman named Anne, who as his firewood supplier, faced a healthcare scare of her own. Anne asked Powell to help pay for her healthcare bills, as her insurance didn�t cover an MRI she needed as a prerequisite to being treated for a growth in her brain. In addition, Powell�s wife Alma recently suffered from three aneurysms and an artery blockage. �After these two events, of Alma and Anne, I�ve been thinking, why is it like this?� said Powell.

�We are a wealthy enough country with the capacity to make sure that every one of our fellow citizens has access to quality health care,� Powell. �(Let�s show) the rest of the world what our democratic system is all about and how we take care of all of our citizens.�

Powell, who has taken heat from Republicans for twice endorsing President Obama�s election and reelection bids, said he hopes universal healthcare can one day become a reality in the U.S. �I think universal health care is one of the things we should really be focused on, and I hope that will happen,� said Powell. �Whether it�s Obamacare, or son of Obamacare, I don�t care. As long as we get it done.�

Single Payer Is Getting a Second Life as Obamacare Frustration Peaks

From the Daily Beast –

Could anger at the Obamacare rollout make Americans more receptive to a kind of Medicare-for-all system? That�s what activists are hoping�and they�re plotting a state-by-state fight.

As the rollout of Obamacare clunks forward, activists who opposed the law from the beginning say it is time to seize the moment, to tear down the current health-care edifice and start anew, especially now as frustration with the law�s implementation is reaching a peak.

These are not Tea Party activists but advocates for a single-payer health-care system who say some of the problems with the launch of the Affordable Care Act�in addition to built-in problems with the law itself�have made the American public more receptive than ever to a Medicare-for-all kind of coverage system.

On Monday, Sen. Bernie Sanders (I-VT) introduced the American Health Security Act, which would require each state to set up a single-payer health-care system and would undo the exchanges that have plagued Obamacare. Meanwhile, various state-led efforts are under way that advocates hope will sweep the country statehouse by statehouse, as soon as lawmakers see the advantage of a single-payer system. In Vermont, for example, lawmakers have set aside the financing and are already preparing to adopt a single-payer system when the federal government permits it, which according to provisions of the Affordable Care Act will be in 2015. In Massachusetts, Don Berwick, a former top Obama administration health official, is basing his campaign for governor on bringing a single-payer system to the commonwealth. And advocates in New York, Maryland, Oregon, and around the country say they see new energy around their cause.

�As the president fully understands, the rollout has been a disaster, the website has been a disaster,� said Sanders in an interview moments after his bill was introduced in the Senate. �But the truth is, even if all of those problems were corrected tomorrow and if the Affordable Care Act did all that it was supposed to do, it would be only a modest step forward to dealing with the dysfunction of the American health-care system. When you have a lot of complications, it is an opportunity for insurance companies and drug companies and medical equipment suppliers to make billions and billions of profits rather than to see our money go into health care and making people well.�

Democrats conceded that Republican efforts to sabotage Obamacare with endless lawsuits and by declining to set up state-run exchanges have damaged the law�s popularity, but they say the confusion will lead the public inevitably to conclude that a simple single-payer system, one that avoids malfunctioning websites and complicated gold/silver/bronze options, is preferable. Advocates pointed enthusiastically to a tweet last month from John Podesta, the former Clinton White House chief of staff who is joining President Obama to help with health care��Just applied online for Medicare. Took 5 minutes. Single payer anyone?��calling it proof that wild-eyed radicals are not the only ones supporting single payer. The notion is gradually becoming more mainstream among the Democratic establishment, advocates said.

�I think the thing that is most interesting about government is that populism gets its biggest support not from Democrats but from what Republicans do,� said former Pennsylvania governor Ed Rendell, who stressed that he did not count himself among the populist members of the Democratic Party. �They torpedo the Affordable Care Act, and I believe we will now have single payer in this country within the next 15 years.�

Opponents to single payer certainly have reasons to believe the momentum is on their side. Further meddling with the American health-care system, after not just the botched rollout of the Affordable Care Act but also the grueling five-year fight to get there, seems unlikely. But proponents of single payer pointed to polls that show a majority of Americans want some version of Medicare for all. It is up to Democratic pols to show leadership on the issue and risk defying the powerful health-care industry, advocates said.

�It is not possible to put together a good program unless you antagonize the powers that be,� said Dr. David Himmelstein, one of the leaders of Physicians for a National Health Program. The White House, he added, �largely played an inside-the-Beltway game in passing Obamacare. They refused to rally the American people for something truly radical which every poll shows that the American people really want.�

Sanders joked that he expected to have his bill passed by chambers of Congress and ready for President Obama�s signature by the time he returns from Nelson Mandela�s funeral in South Africa, but few proponents see much hope of gaining traction for single-payer health care in a Congress that has struggled to pass a routine budget.

Instead they are turning to a legislature-by-legislature fight in statehouses across the country. Advocates in New York and California said they were counting on labor unions� opposition to the Affordable Care Act�some labor leaders have feared that their members may pay higher premiums under the law and have pushed for exemptions. In Vermont, a single-payer bill passed in 2011, and Dr. Deb Richter, the president of Vermont Health Care for All, said that if anything, the passage of Obamcare slowed the group�s work there.

�We had all the momentum going on the single-payer side, and it was really slowed by the Affordable Care Act,� she said. A state measure similar to Obamacare faltered, she added, because it lacked the appropriate enforcement mechanisms. Now, with the law set to take effect in 2015, advocates are working to calm fears among Vermonters who have been scared off by talk of �socialized medicine.�

�We have all of the right ingredients, but there is a lot of room for mischief. You can confuse people, freak them about rationing and all of that stuff,� said Richter. She said she thought Obamacare�s failure to deal with the spiraling cost of health care would lead more and more people to see the logic of single payer.

�I think that eventually most states will recognize this,� she said. �We keep talking about how the health-care system is unsustainable. We haven�t reached that point yet, but when health care starts eating up 25 percent of GDP and you have hospitals failing, they will look for guaranteed financing, and the only way you get there is through a single-payer system. It is not a matter of if but of when.�

Single Payer Is Getting a Second Life as Obamacare Frustration Peaks

From the Daily Beast –

Could anger at the Obamacare rollout make Americans more receptive to a kind of Medicare-for-all system? That�s what activists are hoping�and they�re plotting a state-by-state fight.

As the rollout of Obamacare clunks forward, activists who opposed the law from the beginning say it is time to seize the moment, to tear down the current health-care edifice and start anew, especially now as frustration with the law�s implementation is reaching a peak.

These are not Tea Party activists but advocates for a single-payer health-care system who say some of the problems with the launch of the Affordable Care Act�in addition to built-in problems with the law itself�have made the American public more receptive than ever to a Medicare-for-all kind of coverage system.

On Monday, Sen. Bernie Sanders (I-VT) introduced the American Health Security Act, which would require each state to set up a single-payer health-care system and would undo the exchanges that have plagued Obamacare. Meanwhile, various state-led efforts are under way that advocates hope will sweep the country statehouse by statehouse, as soon as lawmakers see the advantage of a single-payer system. In Vermont, for example, lawmakers have set aside the financing and are already preparing to adopt a single-payer system when the federal government permits it, which according to provisions of the Affordable Care Act will be in 2015. In Massachusetts, Don Berwick, a former top Obama administration health official, is basing his campaign for governor on bringing a single-payer system to the commonwealth. And advocates in New York, Maryland, Oregon, and around the country say they see new energy around their cause.

�As the president fully understands, the rollout has been a disaster, the website has been a disaster,� said Sanders in an interview moments after his bill was introduced in the Senate. �But the truth is, even if all of those problems were corrected tomorrow and if the Affordable Care Act did all that it was supposed to do, it would be only a modest step forward to dealing with the dysfunction of the American health-care system. When you have a lot of complications, it is an opportunity for insurance companies and drug companies and medical equipment suppliers to make billions and billions of profits rather than to see our money go into health care and making people well.�

Democrats conceded that Republican efforts to sabotage Obamacare with endless lawsuits and by declining to set up state-run exchanges have damaged the law�s popularity, but they say the confusion will lead the public inevitably to conclude that a simple single-payer system, one that avoids malfunctioning websites and complicated gold/silver/bronze options, is preferable. Advocates pointed enthusiastically to a tweet last month from John Podesta, the former Clinton White House chief of staff who is joining President Obama to help with health care��Just applied online for Medicare. Took 5 minutes. Single payer anyone?��calling it proof that wild-eyed radicals are not the only ones supporting single payer. The notion is gradually becoming more mainstream among the Democratic establishment, advocates said.

�I think the thing that is most interesting about government is that populism gets its biggest support not from Democrats but from what Republicans do,� said former Pennsylvania governor Ed Rendell, who stressed that he did not count himself among the populist members of the Democratic Party. �They torpedo the Affordable Care Act, and I believe we will now have single payer in this country within the next 15 years.�

Opponents to single payer certainly have reasons to believe the momentum is on their side. Further meddling with the American health-care system, after not just the botched rollout of the Affordable Care Act but also the grueling five-year fight to get there, seems unlikely. But proponents of single payer pointed to polls that show a majority of Americans want some version of Medicare for all. It is up to Democratic pols to show leadership on the issue and risk defying the powerful health-care industry, advocates said.

�It is not possible to put together a good program unless you antagonize the powers that be,� said Dr. David Himmelstein, one of the leaders of Physicians for a National Health Program. The White House, he added, �largely played an inside-the-Beltway game in passing Obamacare. They refused to rally the American people for something truly radical which every poll shows that the American people really want.�

Sanders joked that he expected to have his bill passed by chambers of Congress and ready for President Obama�s signature by the time he returns from Nelson Mandela�s funeral in South Africa, but few proponents see much hope of gaining traction for single-payer health care in a Congress that has struggled to pass a routine budget.

Instead they are turning to a legislature-by-legislature fight in statehouses across the country. Advocates in New York and California said they were counting on labor unions� opposition to the Affordable Care Act�some labor leaders have feared that their members may pay higher premiums under the law and have pushed for exemptions. In Vermont, a single-payer bill passed in 2011, and Dr. Deb Richter, the president of Vermont Health Care for All, said that if anything, the passage of Obamcare slowed the group�s work there.

�We had all the momentum going on the single-payer side, and it was really slowed by the Affordable Care Act,� she said. A state measure similar to Obamacare faltered, she added, because it lacked the appropriate enforcement mechanisms. Now, with the law set to take effect in 2015, advocates are working to calm fears among Vermonters who have been scared off by talk of �socialized medicine.�

�We have all of the right ingredients, but there is a lot of room for mischief. You can confuse people, freak them about rationing and all of that stuff,� said Richter. She said she thought Obamacare�s failure to deal with the spiraling cost of health care would lead more and more people to see the logic of single payer.

�I think that eventually most states will recognize this,� she said. �We keep talking about how the health-care system is unsustainable. We haven�t reached that point yet, but when health care starts eating up 25 percent of GDP and you have hospitals failing, they will look for guaranteed financing, and the only way you get there is through a single-payer system. It is not a matter of if but of when.�

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Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

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An Outsider on the Inside

Though battling terminal illness, Tim Carpenter is still busy moving Congress left.

Tim Carpenter is the national director of Progressive Democrats of America (PDA). Founded in 2004 in the aftermath of Rep. Dennis Kucinich�s (D-Ohio) presidential run, the group works what it calls an �inside-outside� strategy�aimed at translating the activism of outside social movements into progressive legislation in Congress. PDA works closely with progressive advocacy groups and about a dozen activist members of the Congressional Progressive Caucus, aiming to push the 72-member voting block to take more aggressive stances on issues as diverse as the welfare state, healthcare, trade and foreign policy. This year, PDA has lobbied Congress and helped organize rallies against reductions in Social Security and pushed for a so-called Robin Hood tax on financial transactions.

A native of Southern California, Carpenter is a longtime activist with history in the grassroots campaigns against anti-nuclear power, the Catholic Worker movement and Democratic Socialists of America. When he is not on the road organizing, he lives with his family in western Massachusetts.

Do progressives in Congress have anything to learn from the Tea Party?

Progressives can learn a lot from the Tea Party in regards to the inside-outside strategy of holding elected officials accountable. The Congressional Progressive Caucus took a number of missteps and miscues leading up to the Affordable Care Act. We should never have abandoned the fight on single payer. We should have never opted for a public option. We divided our forces much too early. What we can learn from the Tea Baggers is to hold elected officials accountable and not give up�certainly not before we�re deep into a fight.

You have been working with the Progressive Caucus since the founding of PDA in 2004. How effective is the caucus?

The Progressive Caucus has been a landing point for progressive activists who are working inside the Democratic Party. If you�re working an inside-outside strategy, you have to have a base to come home to, and the Progressive Caucus has offered us that. In reality, of those 72 members, only about 10 are what we would call leaders within the Progressive Caucus. Our work as Progressive Democrats of America is to strengthen those who are leading. To have a place where we as progressives can come together and work is important. Over the course of the last year or two under the leadership of Rep. Keith Ellison (D-Minn.) and Rau�l Grijalva (D-Ariz.), we�ve seen the more progressive wing of the caucus hold the line, particularly in regard to making sure that no missiles were tossed into Damascus.

Some critics of the Progressive Caucus suggest that it would be more effective to have a smaller, more aggressive caucus. What do you think?

I agree. I would rather be in a meeting with 10 people who want to make a difference, get out and lead than be in a room with 60 people who call themselves progressives. I would rather surround myself with those who are willing to roll up their sleeves and go out and risk defeat. An aggressive, focused, principled caucus that held the line on single payer would have served our movement much better through this fight over the Affordable Care Act.

Steve Cobble, a co-founder of PDA, makes this analogy of the horseshoe, saying there are issues in Congress where you can link the left of the Progressive Caucus with some Tea Party, libertarian-minded Republicans. Is that an effective strategy?

We have political opportunities in this Congress, whether it�s the horseshoe analogy or in bed with strange bedfellows�whatever you want to term it. There are libertarians and Tea Baggers out there who agree with us that it�s unconscionable to spend the resources we do on the military budget. And we find agreement on not going into Syria. So if you can find the votes and if you can put together a majority to prevent our president from taking us into an unnecessary, illegal war, you�re going to take those votes wherever you can get them.

What kind of small victories are achievable in this political landscape?

I�m a glass-half-full person, so it�s not that difficult for me to find those little victories, beginning with the food stamp program. We began that fight when the Democratic Party leadership was absolutely silent. We had a phone call with Rep. Jim McGovern (D-Mass.) when PDA activists were delivering letters every month to their members of Congress in defense of food stamps. McGovern told us the Democratic Party leadership was silent on this question and that it was important that we simply have a vote of conscience to save the food stamp program. By the time it went on to the floor, we thought we had 133 votes but ended up with 188 votes [out of a possible 218 needed to win]. That was a victory. A vote of conscience in which 188 folks stood up to save food stamps. At the same time as we were garnering those votes, we were doing street actions in front of the offices of the Democratic leadership, Chief Deputy Minority Whip Debbie Wasserman Schultz (Fla.), Minority Whip Rep. Ste- ny Hoyer (Md.) and Minority Leader Nancy Pelosi (Calif.). By the time the Farm Bill came back around again then for a vote, all of those members in the leadership were on the floor voting to kill that bill.

An example of a major victory would be Syria. Again, our Democratic leadership was silent. Our president was willing to risk another war. And again activists around the country, led by Rep. Barbara Lee (D-Calif.), pushed Congress not to use military force but to begin a course of diplomacy.

What do you say to the critics on the Left who would claim that the PDA mission is ultimately hopeless, that the Democratic Party is not going to be reformed, and that if you really want to build progressive political power, it necessarily has to take place outside of that framework?

We live in a two-party system. Until we change the political realities of our two-party system, whether it be until we can get real public financing or until we can get real proportional representation, the playing field will be skewed. Before we have a third party, we need a strong second party. We�re the insurgency inside the Democratic Party fighting to return it to its progressive roots. We are hopeful that, through the work we do, we can begin to engage on the inside with those who are now on the outside and encourage them to do what they can to level the playing field.

A lot of PDA folks were part of Dennis Kucinich�s 2004 campaign for president. How important do you think it is in 2016 to have a progressive presidential candidate?

That�s a big debate. We need to be realistic. We are not going to elect a progressive president in 2016, just as we weren�t going to elect a progressive president in 2004, though Kucinich certainly didn�t want to hear it at the time. But if we�re going to transform the Democratic Party it�s important that we put in place a vision of what the Democratic Party can look like under a progressive presidency. So for that reason alone we need to have a horse in the race in 2016 who will challenge Hillary Clinton, the presumptive nominee. We need to re- mind folks that Hillary was wrong on the war in Iraq and she was wrong on trade. There are a lot of issues that as progressive Democrats we would want to challenge her on.

The Democratic Party, at its roots, is a progressive party. So my hope is that we would have a candidate who will be the standard-bearer for the progressive Democrats. I see the tide turning. It�s imperative that the progressive movement run a strong, articulate progressive candidate and campaign in 2016.

Given that you are waging an uphill battle against cancer, have you been preparing for what�s going to happen with PDA?

You�re definitely putting the elephant in the room in talking about the fact that I�ve got a terminal illness. It�s a question we�re wrestling with. The short answer is we honestly don�t know. We�re not a card-carrying organization; we�re a community of people. We�re going to meet in February as a community and we�ll talk about it. The work�s going to continue and I hope to be as productive, or even more productive, as we move on to the 2014 election season.