Shortly after noon on Friday, state Rep. Michael Dembrow stepped to the microphone and addressed a crowd of about 150 people gathered on the steps of the Oregon Capitol in Salem.
“You look so healthy,” he told his audience. “You must all have good health insurance.”
The line got a big laugh for the Portland Democrat, as he must have known it would. Dembrow is the chief sponsor of House Bill 3510, the Affordable Health Care for All Oregon Act, which would all but eliminate private health insurance in Oregon and replace it with a taxpayer-funded system covering everyone in the state: single-payer health care.
Dembrow’s bill was scheduled for a hearing before the House Health Care Committee on Friday afternoon, and the lunchtime rally on the Capitol steps was a bit of political theater calculated to show support.
Toting signs with slogans such as “Patients Not Profits,” “Single Payer Now!” and “Everybody In, Nobody Out,” the crowd chanted and cheered for more than an hour as speaker after speaker slammed the insurance industry, shared horror stories of Americans bankrupted by medical expenses and called on the legislature to enact Dembrow’s proposal.
The really funny thing was, none of them seemed to think it has a ghost of a chance.
Rep. Jules Bailey, one of the bill’s co-sponsors, exhorted the crowd to settle in for a long fight.
“Don’t stop,” Bailey said. “If we don’t get there right away, we will get there eventually. We will get there.”
As Dembrow himself put it, “It’s not all about the bill. Single payer is a movement.”
“A long-term effort”
For hardcore health care reformers, single payer is the holy grail, a system that would rein in out-of-control medical costs while extending coverage to everyone. But they face determined and well-financed opposition from insurers, pharmaceutical companies and tea party Republicans, who deride the idea as socialized medicine.
HB 3510 is not the first attempt to create a single-payer health care system in Oregon. That distinction belongs to Senate Bill 1066, which was introduced in 1995 — and promptly faded into obscurity.
The issue was resuscitated in 2002, when Health Care for All-Oregon mounted a statewide signature-gathering campaign that succeeded in placing Measure 23 before the voters — who shot it down by a 700,000-vote margin.
Now it’s back, and while Dembrow has no illusions that his bill will pass, he’s crossing his fingers that it will stay alive long enough to generate some genuine discussion in the legislature. He has two co-sponsors on the Senate side, where he’s hoping the proposal could get additional hearings.
If he can get enough lawmakers interested in the concept, they might be willing to commission an in-depth cost analysis, a step that could build additional support. And even if 3510 dies this session, as expected, he’ll push to send it to Oregon voters again as a referendum, possibly in 2013.
“The likelihood of this bill passing and us having a single-payer system in the next year or two is remote,” Dembrow acknowledged in an interview last week.
“I see the effort for single payer as being a long-term effort,” he added. “There is still a lot of education that has to happen and a lot of organizing that has to happen, and this bill is a vehicle for that.”
As health care costs continue to rise faster than American incomes, more and more people are flocking to the single-payer banner. In Oregon as in other states, the coalition that has formed around the issue includes labor unions, doctors and nurses, churches and social justice organizations, all of which were well represented at Friday’s rally in Salem.
Peter Shapiro was the master of ceremonies, introducing the speakers and setting the tone for the event with his rabble-rousing commentary.
A retired mailman who now works as an organizer for Portland Jobs With Justice, Shapiro urged the audience to fight back against the attacks on public employee unions around the country.
“I have one of those gold-plated plans,” he told the crowd. “I’m one of those people you’re supposed to hate. And 25 percent of my federal annuity goes to insurance premiums.”
In an interview, Shapiro talked about organized labor’s shift toward single payer after years of fighting to protect hard-won insurance benefits — often achieved at the cost of significant concessions on wages.
“It’s a difficult transition for union members to make. It’s a mark of how badly our health care system has deteriorated,” he said.
“More and more unions are realizing we’re living on borrowed time as far as benefits are concerned, and they’re paying a greater and greater price to keep those benefits at the bargaining table.”
Portland Jobs With Justice has thrown itself into the campaign for single payer, reaching out to other labor organizations to broaden the coalition supporting HB 3510. So far, nine Oregon unions have officially endorsed the measure — including two that represent teachers, often targeted for having Cadillac health benefits.
In January, Shapiro helped organize a highly successful conference on single payer in Portland. More than 400 people turned out for the event, which featured keynoters such as Dr. Margaret Flowers of Physicians for a National Health Program and Michigan Rep. John Conyers, one of the champions of single payer in Congress.
And on Friday, Shapiro brought a dose of fiery union rhetoric to the rally for HB 3510.
“We have the most profit-driven health care system in the world, and you see where that gets us,” he reminded the crowd as the event came to a close.
“The fact of the matter is, health care is not a commodity, it is a human right. And we are not consumers of health care, we are human beings!”
Mad as hell
Radiation oncologist Mike Huntington of Corvallis has devoted himself to health care reform since retiring in 2006. He became convinced of the need for change after seeing too many of his patients delay treatment because they lacked insurance coverage, with disastrous results.
“I saw it happen so often that it made me sick and then sad and then mad,” Huntington said.
In 2009 Huntington and fellow Corvallis physician Paul Hochfeld helped launch the Mad as Hell Doctors, an Oregon offshoot of Physicians for a National Health Program. The group mounted a cross-country tour, holding raucous single-payer rallies in more than two dozen cities en route to a demonstration on the White House lawn in a bid to influence the congressional debate on health care reform.
No trace of single payer made it into the federal health care reform law, which failed to include even the “public option” initially promoted by President Barack Obama.
But the Mad as Hell Doctors are still on the case. Last year they staged a California road trip to promote a single-payer measure in that state, and they’ve been touring Oregon for several weeks in support of the Dembrow bill.
On Friday, a white-coated contingent of Mad Docs was on hand for the Capitol rally, including Huntington.
The way he sees it, the financial logic of single payer is simply inescapable.
“Even health insurance CEOs privately say it. How can health care expenses keep increasing 25 percent a year? Eventually they’ll run out of customers,” Huntington said in an interview before the rally.
“It’s a false reality, and I’m going to stick around until the real reality is too hard to ignore.”
In it for the long haul
Betty Johnson is a battle-scarred veteran of the fight for single-payer health care in Oregon. She got involved in health care reform in 1991 through her church, and her faith continues to inform her work for the cause.
“It is a moral imperative to ensure that everyone has the health care they need,” she said.
The Corvallis resident, a widely respected leader in the state’s Health Care for All chapter, was a key player in the campaigns for SB 1066 and Measure 23 and now is pushing hard for HB 3510. In fact, she had a hand in writing all three proposals.
Johnson attended the rally, too, but before that she led a small cadre of Corvallis and Albany health care activists through the Capitol corridors on a mission to lobby as many lawmakers as possible to support HB 3510.
The group started on the House side of the building, stopping by the offices of Sara Gelser, Jim Thompson and Andy Olson before crossing over to the Senate wing in search of Frank Morse.
None of the legislators was in, so the mid-valley activists spent their time chatting up secretaries and aides, passing out copies of testimony to be given in the afternoon hearing and laying the groundwork for future meetings.
At Olson’s office, Johnson and Edie Orner, a retired schoolteacher who heads the Albany chapter of the Archimedes Movement, won a small victory: the promise of a breakfast meeting early next month.
Olson, an Albany Republican, is not known as a supporter of single payer, but he is willing to listen. Orner considers it progress.
“Everything that you do is building momentum,” she said, “and you just have to keep doing what you’re doing and hope that eventually there will be a tipping point.”
Johnson agrees. Like Dembrow, she has no expectations that 3510 will actually pass this session. And like him, she takes the long view of the fight for single payer.
The campaigns for SB 1066 in 1995 and Measure 23 in 2002, she said, started the conversation about single payer in Oregon, and Dembrow’s bill has created the opportunity to take the discussion one step further.
“The world is a different place than it was in 2002 — and I can’t help but think that it’s a different place, at least here in Oregon, in part because of what we did in 2002. We informed a lot of people,” Johnson said.
“That was a building block. This is a building block. And this campaign is not going to die.”