Healthcare Memo: Don’t Mourn, Escalate

By Deborah Burger, R.N., President of the California Nurses Assn.

There’s a fundamental lesson in collective bargaining that seems to have been lost on the White House, and those in Congress who devised their failing strategy on healthcare reform:

Don’t make all your compromises before you walk in the room.

For all those now wringing their hands over the apparent abandonment of the public option dissecting the train wreck of the once promising opportunity for genuine healthcare reform, it’s time to ask: what happened? who could have foreseen that semi barreling down the highway? and what do we do now?

To answer the first two questions, it’s worth noting the comments to MSNBC’s Keith Olbermann Monday night by Lawrence O’Donnell, a Democratic Party consultant and participant in Bill and Hillary Clinton’s failed healthcare plan of 1994:

Obama, O’Donnell aptly noted, “completely misjudged it, but so has the White House” in following the “conventional wisdom of the leaders of his party in the House and in the Senate and his staff in the White House.”

“The lesson they don’t get here, is they compromised at the outset. They didn’t go for the best bill at the outset. The president said that if he was doing this his own way it would be single payer, it would effectively be Medicare for all. He would be with those 100 House members who want Medicare for all.”

“But he compromised right off the bat to go for something that would preserve the private health insurance industry, and tortured that thing into a shape that they thought would be acceptable to the middle of American politics, all in the fear if they went for Medicare for all they were terribly afraid of being called socialists.”

What did this strategy produce?

“Trying to go over in this direction into this tortured way of supporting an industry that doesn’t work. They are now still called socialists for having preserved the medical insurance industry.”

And stuck with a plan that was inferior from the outset, that is still widely denounced by the right, with further compromises being made to this half baked loaf every day.

After all the further concessions are made to attract one or two Republican votes and some of the conservative Democrats, what will be left? A plan that is not universal, that comes close only by forcing people to buy private insurance at whatever rates the insurers set. Sounds like another unpopular bailout in the making.

A plan that will be ineffective in controlling costs, especially after the shameful deal with the drug companies to remove the clout of the federal government to lower prescription drug price gouging. A plan, in short, that will fall far short of solving the healthcare crisis, and leave many Americans more cynical about government, and still facing healthcare insecurity and financial calamity if they get really sick.

O’Donnell concludes that Democrats learned the exact wrong lessons from the 1994 fiasco:

“My experience having failed at this kind of legislation in 1994, there’s a lot of people trying to blame Hillary Clinton for making different mistakes at different times. And she made all of those mistakes, but I don’t think it mattered. I think we were going to get nothing in the end because the basic concept of what we were trying to do was flawed.

What the Democrats should have been doing for the last 15 years after that defeat is selling Medicare for all. And maybe 15 years later, 15 years after that, maybe with the election of this president, Congress would be ready for a clean yes or no vote on that question, because that would be worth fighting for.”

So what should we do now? Well, that yes or no vote is still worth fighting for.

Ultimately, a final bill will be the one that comes out of a Senate-House Conference Committee process, and don’t we all look forward to the pleasure of watching the performance of Max Baucus and Chuck Grassley in that room?

Let’s go back to collective bargaining, lesson one. For the House to squeeze the best bill possible out of the Conference committee, they need to walk in the door with their strongest bargaining stance possible. That would be the bill that would actually solve the healthcare crisis, not just tinker around the edges.

And, it ought to have a receptive audience. As Rep. Anna Eshoo put it Tuesday, “There are those who view themselves as having already compromised on single-payer.”

No bill would give them more clout than passing a Medicare for all bill, and having that at the table when they meet with Baucus and Grassley.

On MSNBC Tuesday, Rep. Anthony Wiener talked about the value of a Medicare for all vote in the House in September. He’s right.

And Weiner already got the Energy and Commerce Committee to vote unanimously to preserve Medicare, including every Republican. Medicare – the bi-partisan solution to our healthcare crisis. As has been echoed by all those turning out to the town hall meetings demanding that the government keep their hands off their Medicare.

But Weiner should not be there alone. The left, the liberal constituency groups, labor, and everyone else who is dedicated to genuine, comprehensive healthcare reform, should join in, and work to make that the bill that passes the House.

Deborah Burger, RN is a co-president of the California Nurses Association/National Nurses Organizing Committee


  1. Vashti Winterburg on August 20, 2009 at 6:46 pm

    Yes. We need to get up off our sorry heinies and get ourselves and all our friends to the Republican town hall meetings and show our support for reform, especially single payer. This is not the time to roll over and play dead! We have the best and most economical plan. More importantly, we have the only plan that will work for all Americans and save Medicare and Medicaid at the same time.
    I recently attended a forum for a congressman who has signed on to H.R.676. It was total chaos and the biggest pile of ignorance on health care I’ve ever encountered, and I especially include the Obama types in that assessment.
    Let’s get our supporters out the door and into our local Republican congressman’s forums. If we can get the Obama supporters there it’s a great opportunity to make conversions for H.R.676.
    Vashti Winterburg
    co-chair, Kansas Health Care for All, Lawrence
    “We’re paying for a Cadillac! Why are we driving a Yugo?! H.R.676!

  2. Joe on August 21, 2009 at 10:15 am

    I’ve been thinking it but now there’s proof. Democrats in congress have no guts. Republicans in congress have no heart!

  3. John Barker on August 21, 2009 at 12:29 pm

    If you haven’t written, emailed or faxed a letter to your representative in support of HR676 which will come up for an up or down vote sometime after the August recess, NOW is the time to do so. Now is the time to urge your Senators to support S703. While you are at it urge your congress people to enact public financing of elections to restore democracy in America.

  4. MaineBob on August 22, 2009 at 12:06 pm

    [Resubmit due to error in URL]
    I have been watching Senator Bernie Sanders and now on his new “Brave New Films” weekly message at After his latest video, I submitted my own video question for next week’s show: Perhaps others would like to pose questions for the only senator that has a Single Payer bill S.703.

  5. ET on August 25, 2009 at 5:36 pm

    I have yet to understand why the Dems don’t go after the industry instead of tax payers. I agree that afordable healthcare is necessary but not by the plans that are being discussed. There has got to be a better way. Sorry, but I hope your reform bills fail as a tax payer the goevernment gets enough money now. Do it without rasiing taxes on the middle class then lets do something.