Passing on Single-Payer Health Care

The following article was printed in the October/November issue of Dollars and Sense magazine.

Passing On Single-Payer Health Care
Union leadership is out of touch with the rank and file—and the public—on health care.

By Jeffrey Muckensturm

A coalition of major labor unions and liberal organizations has recently created what it calls “a national grassroots campaign organizing millions of Americans to win a guarantee of quality, affordable health care for all.”

Health Care for America Now (HCAN) is a project of three major unions, the American Federation of State, County, and Municipal Employees (AFSCME), the Service Employees International Union (SEIU), and the United Food and Commercial Workers (UFCW), along with MoveOn and the Association of Community Organizations for Reform Now (ACORN). Elizabeth Edwards is a spokesperson for the new coalition.

With its $40 million budget, HCAN could put a lot of muscle into the fight for a universal, single-payer system that would make the government the sole insurer (the “single payer” to doctors and hospitals). Unfortunately, instead HCAN favors a mixed public/private system that would allow Americans to “keep your current private insurance plan, pick a new private insurance plan, or join a public health insurance plan.”

While HCAN’s “health care for all” slogan will resonate with labor and the left, the group’s actual proposal has met with a skeptical response from, among others, the California Nurses Association and Physicians for a National Health Program. Both fault HCAN for failing to support the United States National Health Insurance Act (H.R. 676), aka “Medicare for All,” introduced in February by Rep. John Conyers (D-Mich.). The bill now has over 91 co-sponsors.

So why doesn’t HCAN support single-payer? According to Richard Kirsch, HCAN’s national campaign director, “One point of this approach [giving people the choice of private insurance or Medicare] was not to scare people away from reform or to make it easier for the opponents of reform to panic the public.” HCAN apparently thinks single-payer is not popular enough among labor, elected officials, or the public to be politically feasible—but they’re wrong.

H.R. 676 has significant labor support. To date, over 445 labor organizations, including 36 state AFL-CIO chapters, 110 Central Labor Councils, the United Steel Workers, the United Auto Workers, and at least 14 AFSCME and SEIU locals have passed resolutions supporting the bill. Interestingly, both SEIU and AFSCME have passed resolutions supporting H.R. 676 at national conventions, showing that there is strong rank-and-file support for single-payer.

Why? Because H.R. 676 takes health benefits off the bargaining table, allowing labor to focus on other key issues. A position paper from the New Jersey State Industrial Union Council explains: “H.R. 676 can create a real opportunity for white- and blue-collar workers. When negotiating a contract the final two issues always are wages and medical benefits. The benefits will always affect wages, and the employer will cry that their health insurance costs limit their ability to give raises.” With health care a non-issue, unions can concentrate on wages, safety, and organizing more workplaces.

And given the budget crisis states and municipalities across the country are facing, the support of AFSCME’s leadership for HCAN rather than single-payer is particularly questionable. According to the National Conference of State Legislatures, more than 30 states face deficits totaling a projected $40 billion this year. The U.S. Conference of Mayors, representing over 1,000 cities with populations over 30,000, unanimously adopted a resolution supporting H.R. 676, which, in their view, will save municipalities millions. According to Healthcare-NOW!, a national organization founded five years ago (not to be confused with HCAN), even a small city could save millions of dollars.

HCAN seems to be out of touch with the American public as well. People aren’t scared of a national health program—quite the opposite. USA Today reported the results of a December 2007 Associated Press/Yahoo! poll: “Sixty-five percent of those polled said the United States should adopt universal health insurance that covers everyone under a program such as Medicare that is run by the government and financed by taxpayers.”

While mixed public/private plans like Massachusetts’ are beset by problems and have left many uninsured and over-charged, single-payer has become increasingly popular. With HCAN’s full support, H.R. 676 could be even closer to becoming reality. It’s our only hope if we truly want quality “health care for all.”

Jeffrey Muckensturm is a freelance writer and activist living in Philadelphia.  He can be reached through

Resources: Health Care for America Now,; Jim Kuhnhenn and Trevor Tompson, “Poll: Economy, Health Care Top Issues,” USA Today, December 28, 2007; Richard Kirsch, “Why Not Single-Payer?,” the Now! Blog,, July 15, 2008; New Jersey State Industrial Union Council, “For HR 676 One Plan, One Nation Campaign And Regarding Health Care for America Now The Trojan Horse,”


  1. PETRA MACHAR on December 11, 2008 at 3:44 am

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