Saying Goodbye to Another Single-Payer Warrior, a Shooting Star

By Donna Smith

For those of us who advocate for a single-payer healthcare system, publicly funded and privately delivered care for everyone, the past few weeks have included tremendous gains and two devastating losses. The gains came in our shared victories as single-payer advocates in Congress secured legislative opportunities for real progress. In the fall, single-payer arguments will be heard in Congress, and in large part due to the work of hundreds of thousands of people who have refused to have ethical and economic sanity shut out of the health reform debate.

But as we celebrated our successes and planned for our future actions, we first mourned the loss of Marilyn Clement, the leader of Healthcare-NOW, who died on August 3, 2009, and who helped shape the single-payer grassroots movement and so very much more. Marilyn learned her earliest advocacy skills alongside Dr. Martin Luther King, Jr., and throughout her 74 years, she stood for justice, for compassion and for peace. Her love and life were beacons of hope in some of the darkest places of our struggle.

Then we learned this week of yet another devastating loss. On Sunday, August 9, 2009, Nicholas Skala died in his sleep in Chicago. Nick was only 27 years old, but as a third year law student at Northwestern University and as a researcher for Physicians for a National Health Program, Nick’s influence reached far beyond what most of us will ever achieve. His death was not only shocking and unexpected, it was an absolute reminder of the finite nature of our time on this earth and of our responsibility to one another to leave this a better place than we found it.

For those of us who knew Nick (and I can say this as someone who loved him and shared this very conversation with him in DC just 10 days ago), he could be brash and even a tad pompous at times – in a way that young and brilliant people can be when the world in theirs to conquer and the rest of us seem to move and think too slowly. He was ready to change the world and equipped with an intellect and drive that moved from thought to action in an instant.

In his work for PNHP, Nick found a glorious niche – a place where other intelligent people wanted change and a place where his mind could work to its fullest capabilities. He helped write the Illinois single-payer legislation before he was 25 years old – and he was well able to explain and defend it passionately even to the most unlikely audiences.

Early in his interactions with other single-payer advocates, he could ruffle feathers by dispensing with lengthy personal, friendly discourse in favor of detailed displays of his knowledge of single-payer reform policy and economics and taxation and other legal issues. Few would have suspected that under all that bravado and raw intelligence was a giant and kind spirit yet to be unleashed.

I first met Nick as I returned to my native Chicago to live and work with the California Nurses Association/National Nurses Organizing Committee. About the same time, I was meeting and growing to know scores of PNHP doctors from venues all over the country where I traveled to speak about single-payer reform. It was clear to me that the doctors I met who are a part of PNHP share a special sort of passion for humanity along with the intelligence required to be physicians – they carried a concern for healthcare as a human right just like so many nurses do that goes well beyond the nuts and bolts policy issues Nick could articulate so well. And that was exactly the sort of mentoring Nick needed and welcomed from those he considered intellectual equals.

But the incredible capacity for love and the deepening humanistic quality Nick was beginning to absorb and develop came about in a fascinating way over the past several months. Over and over again I watched him travel to events with his beloved Dr. Quentin Young, and I watched Nick study the interactions and the reactions among participants at the events – he was learning all the while. Whether at a formal hearing on single-payer legislation or at a protest action, it was an opportunity to take it all in and take from it a lesson about personal effectiveness and potential.

What began for him as a way to teach others about single-payer from a position of intellectual superiority became a living, breathing evolution from young, invincible policy genius into rich human interactions flavored with kindness, appreciation and true concern for others.

Nick came to Washington, DC, this summer to work for John Conyers in the House Judiciary. I remember he shared with me that he had been “air-lifted” into DC to see if he could help with healthcare reform. I chuckled a bit to myself at how much “like Nick” that sounded. But I also did the mental gymnastics I had done many times before when Nick said something that seemed self-congratulatory, I acknowledged to myself that perhaps we needed a little air-lifted and dynamic energy inside the Congressional offices where other advocates rarely are allowed to linger. Perhaps a, little Nick in the mix for the summer would be exactly the right thing, I had to admit to myself.

And so it was. In a few short weeks, Nick ensconced himself with staff members and in situations where he could help move the single-payer agenda forward. Perhaps we’d still be looking at a state-based single-payer amendment and a floor vote on single-payer in the House in September. I think the incredible efforts of nurses and doctors and patients and advocates all over the nation have moved single-payer forward as never before. But I also think we’ve had some amazing effort right here in DC, and Nick certainly was an incredibly gifted and committed part of that DC effort.

A shooting star in our movement has streaked across our lives and vanished too soon.

When I opened the email that announced Nick’s death, I felt like I am sure many others did. It hurt to even see the words. When I woke up this morning I had to do one of those shaking-the-head, wake-up moments I hate so in life when the reality has to be acknowledged once again in the light of a new day – Nick is indeed dead. At 27. I also know he died at home – in Chicago with Quentin – where his mind and his soul were most at peace.

And just 10 days ago, I sat next to him at a restaurant here in DC listening to his aspirations to use his law degree and the deepening love he was learning to give and receive to build a meaningful life not just for himself but for many. We will carry on the fight. For Marilyn, for Nick and for each other.

Hold out for single payer – By Nick Skala

An interview with Nick


  1. JamesE on August 13, 2009 at 12:53 am

    Donna, I only had the pleasure of seeing Nick at a single payer presentation with Mr Conyers, and he was one of the presenters, a great one at that….what a big loss this is…we must now all do what we can to get single payer passed,for Marilyn, Nick and all of us!!!

  2. Adolph Reed on August 19, 2009 at 6:43 pm

    It was devastating to learn of Nick’s death. He was a wonderful person, comrade and friend, and exactly the sort of clear-headed, politically serious and sophisticated young person we need if we’re ever to rebuild a serious left movement in this country.

  3. Fred Sieger on August 21, 2009 at 5:34 pm

    pass hr676 and get on with it!

  4. Deenie on August 26, 2009 at 10:09 am

    Wow, I watched the video and I could see this guy was a really caring person with a razor sharp mind. He was exactly the type desperately needed to get this country going in the right direction, not just on health-care. He was dangerous to the lizard-people that occupy all the key positions in Wash DC though. I feel something fishy about his untimely death.

  5. Nina on August 29, 2009 at 7:52 am

    That’s so sad. A young, healthy man dies unexpected. Did they found already a reason for his death?

  6. Laura on September 7, 2009 at 3:55 pm

    That is really weird – was there an autopsy? What was cause of death? So sorry for your loss and for America’s loss. That may sound cheesy but I feel it is true.