Medicare for All: Turning socialist politics into mass politics
This summer, delegates to the Democratic Socialists of America’s national convention overwhelmingly voted in a National Priorities Resolution mandating us to take up work on a national Medicare for All campaign. We on the NPC and activists throughout the organization are thrilled about getting this campaign off the ground — both to win a healthcare system that serves people’s needs rather than profits the few and because the campaign will help DSA itself grow massively.
Along with significant help from many others, Ari Marcantonio, Dustin Guastella, and I have written a Medicare for All campaign proposal that we will put forward at the DSA’s National Political Committee (NPC) meeting in Chicago this weekend. You can read the full text of this proposal here.
Our proposal is not a political blueprint nor the final word on a democratic socialist strategy for winning Medicare for All. Instead, it offers some preliminary directions, strategic perspective, and immediate actionable tasks for the NPC to consider in order to begin work on the Medicare for All campaign. This post introduces the proposal, but there’s a lot more to say that won’t fit here; I look forward to continued discussions on the topic.
The campaign proposal has three essential pieces.
First, we will organize around core principles of socialist healthcare, not around any particular piece of legislation. While we can and will fight to win legislation like Bernie Sanders’s Medicare for all bill (read DSA’s endorsement of this bill here), DSA-ers can also connect the federal level fight to state or local programs like state-based single-payer in California or Medicaid expansion in Florida. Socialists want to fight for all of these. (I go over other ways a national campaign will complement local campaigns in this post.)
Second, we will be using mass tactics like canvassing drives and demonstrations in order to engage the broadest possible constituency. These tactics reflect our commitment to mass politics.
And third, since these tactics can be flexibly adapted to local or regional conditions, DSA will develop new and sophisticated organizing skills and political consciousness among its members while building up a strong organizing infrastructure at the national, regional, and local levels.
This campaign will harness the new energy in DSA to make a strategic and historic intervention in American political life.
Medicare for All
Elected delegates enthusiastically and overwhelmingly chose this campaign at DSA’s national convention as a national priority because Medicare for All is the most popular and radical working-class demand to enter mainstream American politics in recent history. And as Shant Mesrobian writes in an article published today, “enacting a single-payer system would be one of the most liberating policy advances the US has seen in decades.”
(Shant’s piece is one of a raft of recent articles on the topic — read Tim Faust’s pieces on Medicare for All here, Meagan Day and Keith Brower Brown’s reflections on campaigning for universal healthcare in California here, and Robert Greene II’s argument after the Charlottesville attacks that proactive, clear demands like single-payer must be “the hallmark of the American left” here. Other articles on the topic can be found in this Google doc.)
Almost everyone has some experience with the indignities and outrages of our barbaric for-profit health system. Additionally, healthcare coverage is a vital issue — medical debt can make or break a person’s financial life, and treatment access is sometimes a matter of life and death. Because of these attributes, single-payer is an issue that enables socialists to talk about the high stakes of struggling against capitalism to millions of their neighbors and coworkers everywhere.
This is an opportunity to engage, activate, and radicalize countless regular people who would otherwise never have considered themselves leftists or even particularly political. And it’s a simple demand which doesn’t require any policy expertise — only the recognition that the profit-driven healthcare system which has hurt you or a family member is also harming millions of others, and that a just, universal, comprehensive, public, and democratically-controlled health insurance program is something worth fighting for.
The timing of this campaign — with DSA’s growth into the largest US socialist organization in generations and Bernie’s current Medicare for All bill, buoyed by a wave of left-wing enthusiasm coming out of his presidential campaign — couldn’t be better. We have a once-in-a-lifetime opportunity to both decommodify health insurance and win mass numbers of people to socialism in the process.
A Medicare for All campaign is not only morally urgent but strategically the best way to build the socialist movement today. To understand why, it’s helpful to recall the words of the late Peter Camejo, a long-time socialist activist in the United States.
In a 1970 speech about the movement to end the war in Vietnam, Camejo described the differences between three tendencies within the movement: liberalism, ultraleftism, and independent mass action. (You can read an abridged version of the speech here.)
Camejo faults liberals and ultraleftists alike for trying to win their demands not by engaging with the majority of the population, but by appealing to elites:
[A]n ultraleft is a liberal that has gone through an evolution….Sometimes a liberal becomes frustrated not getting the ear of the ruling class, and he concludes that he has been using the wrong tactics. So he adopts a lot of radical rhetoric. He says this ruling class is apparently so thickheaded that what we’ve got to do is really let loose a temper tantrum to get its attention.
At the time of Camejo’s speech, this meant attempts to wage guerrilla warfare in the US by groups that fetishized street battles with the police for their own sake, and later small revolutionary cells engaged in spectacular direct action. Fundamentally, Camejo argues, these types of groups “don’t believe that the masses can be won” to a majority bloc that can change the world; they have abandoned the millions, imagining politics instead as a battle between a small ruling minority and an even smaller militant dissenting minority.
But real power for the working class, Camejo writes, lies with the masses.
You see, you can take 200 or 300, or even a few thousand people and fight in the streets, throwing rocks at windows, and putting on a big show….But when you’re talking about 15 million workers who control basic industry in this country, you don’t play games. Because they don’t run around throwing things at windows. They do things like stop production, period.
Lenin is often quoted as saying that politics begins in the hundreds of thousands; in the US today, we could say that it really only picks up in the millions. Luckily, socialists in this country already know how to engage millions of ordinary, working-class people. We in DSA are ecstatic that we’ve reached 30,000 members. But 13 million people voted for Bernie Sanders’s vision of a “moral economy” in 2016.
These 13 million are not well-read Marxists waxing philosophic on the limits of social democracy or US imperialism. But if we were to confine our movement to those that have ideal socialist politics, we’d be powerless — correct, well-read, but powerless. Core left ideas like free and universal healthcare, education, and housing, or the democratization of work, would remain irrelevant and imaginary.
We don’t have to stay stuck in irrelevance. We can carry out mass action oriented towards and intelligible to tens of millions of working and oppressed people.
But how can we reach them, when socialists are still so few? We will not bring our movement into the mainstream and change the world by recruiting sympathizers by the ones and twos; we need to start reaching tens and hundreds of thousands.
For a model, we should look to Bernie and the UK Labour Party’s Jeremy Corbyn, who have energized millions by framing issues and demands of immediate importance to those struggling to get by in everyday terms of class struggle.
Sanders and Corbyn are popular because they tell the truth and frame societal problems not in terms of racial scapegoats or market imperatives, but in terms of power: the landlords, the banks, the insurance companies, and your bosses have all the power right now, and you have none. You are poor because they are rich; your healthcare costs are prohibitive because they are profiting from this healthcare system. And both politicians offer the same invitation: join our movement to build power, fight back, and take back what you are owed and what everyone deserves.
In the words of this ninety-second ad from Corbyn’s summer campaign,
We know that the health worker and the firefighter contribute no less than the stock broker and the merchant banker. We know there is no chief executive or shareholder value without the worker. We know that wealth, privilege and power are carved up in obscene fashion. We have had enough….We demand the full fruits of our labor.
This video still gives me the chills. The slogan of Corbyn’s campaign, and the refrain of this speech he delivered to the Labor Party Conference last month, was “For the many, not the few.” It is simple but radical rhetoric. It resonates with mass numbers of the British people, and has led to an astounding explosion of support and membership in the Labour Party. Without having yet implemented any legislation as party leader, Corbyn is now, like Sanders, the most popular politician in his country.
Left politics in the UK and the US are ascendant, but it is up to organizations like DSA and activists like us to help translate this nascent desire for new politics into real working-class power.
The popularity of Medicare for All, and Bernie’s incipient campaign for the legislation, offers the best opportunity for socialists to do that in this country today.
DSA members get that. That’s why they have expressed overwhelming support for such a campaign, as they did at the convention and in the leadup this summer where almost 90% of poll respondents chose single payer as a national priority, with the next closest priority getting less than 50%. Since the convention, hundreds of members have flocked to conference calls, panel discussions, and trainings on Medicare for All, with scores of chapters — rural and urban, red state and blue state — expressing interest in getting involved.
Reform and Revolution
We should be clear, of course, that “[t]he realization of socialism can never be the result of a gradual reform of the capitalist system,” as Andre Gorz wrote in 1967 in his famous essay, “Reform and Revolution”. We must fight for what he called “non-reformist reforms” like single-payer healthcare to build the class-consciousness and power of the working class and undermine capitalists’ power, all while challenging the logic and imperatives of capitalism and keeping our sights set on a social system beyond it.
Gorz continues, “the struggle will advance, on condition that within the capitalist system each battle reinforces the positions of strength, the weapons, and also the reasons which workers have for repelling the attacks of the conservative forces, and for preventing capitalism from regaining lost positions.”
DSA members know that the fight for Medicare for All is just this kind of struggle. As Camejo wrote,
There’s always one issue or another, depending on the objective conditions, which tends to wake a person up….Our concept is to unite people in action around the issues on which they’re moving. Not because we’re single-issue fetishists. Our aim, in fact, is to move people around broader and broader issues, but we’ve got to deal with reality, not with abstractions…
Our campaigns speak for the full program necessary to mobilize people in struggle to do away with war, poverty, racial oppression and the oppression of women. They point the way to the goal of our struggle: socialism. But at the same time we will unite on any issue around which people are willing to struggle against the ruling class, no matter what their level of understanding of this society. This is the way to move masses in this country, to build a revolutionary party, and not only play, but make, a revolution.
That is why it is essential for socialists in this moment to start, in the words of our proposal, “to build a mass constituency for Medicare for All.” While the NPC will decide on first steps for the campaign at the meeting in Chicago, and while we will engage in broader and more inclusive strategy discussions with activists in the coming months to debate and refine our approach, our Medicare for All campaign proposal does contain this broad commitment to mass politics.
There’s a lot to say on the discussion of “winnability” which I will save for another post. In short, I believe that, as part of a broad working-class movement, we can fight for and win Medicare for All in the years to come. In the process, millions of working people will be touched by the movement and learn the unforgettable lesson that working people have power when they fight together.
In our proposal for the first concrete steps to building a Medicare for All campaign, we advocate for mass tactics:
We can’t out spend the insurance companies, and we can’t just out message them; we have to be able to build a political insurgency that’s visible and threatening enough to make Medicare for All a political necessity.…We propose the use of mass tactics like petition drives, targeted pressure protests, mass organizational coordination, a mass political education initiative, political interventions in townhalls, Medicare and Medicaid sign-up drives and the development of an array of digital and visual outreach tools.
At the core of this kind of mass organizing is the petition: in order to talk to average people about our politics and bring them into our movement and build our political and organization infrastructure, canvassing is essential.
There are three features to canvassing that make it important to the kind of mass work DSA must start engaging in now.
First, unlike shallow “get out the vote” or donation-seeking canvassing, dozens of DSA chapters have already started or are right now planning to start canvassing in a much deeper sense.
As East Bay DSA comrade Andrew Richner wrote in a recent blog post, “The goal of canvassing interactions is to get our neighbors to identify their own self-interest. We ask people to open up about their healthcare and when they do, our role is to listen, to affirm, and to ask questions that let them draw their own conclusions about how their personal struggles are linked to a broader, class-based struggle.” (Read Andrew’s fantastic post here.)
Since this approach is fundamentally about building class consciousness and inviting people into a movement, it can easily be adapted to other campaigns. For example, Andrew writes, “[i]f as a chapter we decided to campaign for better rent control protections, we would ask the same kinds of questions: what is your current situation like? Who benefits from that? Do you think that’s fair? What do you think it will take to change that?”
Ultimately, these kinds of conversations are at the root of how ordinary people who happen to be socialist activists can connect with, activate, and radicalize thousands more ordinary people.
Second, canvassing operations are a great way for chapters to build their own organizational infrastructure.
Putting on canvasses, especially (but not exclusively) when going door-to-door, is difficult. Not only does it require training dozens or hundreds of canvassers to lead these kinds of conversations, but it requires a huge logistical operation: doing turnout to recruit canvassers, teaching all the canvassers the important political arguments and policy facts, arranging the trainings in pairs or small groups, printing and supplying the materials and clipboards to everyone, coordinating transportation to and from turfs, keeping track of data, and more — that most new chapters and activists will not have done yet.
That is why our proposal creates a “canvassing toolkit,” a system of coaching, and a political education operation which will make putting on a canvass the path of least resistance for chapters to get started on their first mass organizing campaign if they so choose. Of course, there are lots of other tactics to incorporate, and while the national organization has extremely limited resources, chapters can continue develop and share tactics and tools that they’ve developed along the way.
Third, canvassing is complementary to all other mass tactics. East Bay DSA canvassers have gathered thousands of signatures at the doors of our neighbors. Each signature represents an interaction between an engaged and engaging socialist and an interested not-yet socialist — a meaningful, sometimes long conversation of the type that Andrew describes.
If the canvasser is successful, it is a conversation people will remember. That means that the lists of contacts we have built are very powerful. When chapters have held phone banks to call through their lists to recruit single payer supporters to a rally or a sit-in at the state capitol, the person on the other end of the phone is often excited to take part. When we need to get our neighbors to call elected representatives to pressure them, hold a teach-in on the politics of healthcare, or turn out voters to support a ballot measure, the lists we build through thousands of hours of deep canvassing will be invaluable.
Canvassing itself is not a strategy, merely a tactic. But it is a damn good tactic. This is why canvassing and the kinds of organizing conversations it teaches are implied in phrases like “building power” and “grassroots organizing.” In my chapter alone, organizers have trained over four hundred canvassers, many of them coming back to multiple canvassing events since February.
A national campaign for Medicare for All based on socialist principles, mass organizing, and a coherent national-to-local political infrastructure could make DSA a fighting left political force unlike anything seen since the early seventies. Within a year, we can imagine up to a hundred chapters in fifty states fielding hundreds of leaders who in turn train thousands of canvassers in the streets, statehouses, and at their neighbors doors.
The next few months are about building the floor of a mass campaign for left politics and single-payer. This part is hard and slow. But once you’ve laid the floor, the only way to build is up. Now is the time to organize in the literal sense: harness the energies that are now coming to the left from all over, build this movement and fight.
Video from the Spring in support of East Bay DSA’s single-payer campaign.