A 20-year struggle for reform

Twenty years ago this month, in October 1991, longtime Chico resident and activist Tom Reed decided he wanted to focus his energy on health-care reform, and specifically on promoting a single-payer universal health-insurance system, or “Medicare for all.” So he sent out 25 letters to people he thought might be interested in joining him, inviting them to a meeting.

Four showed up.

As it turned out, that was sufficient. The group that became known as the Butte County Health Care Coalition was formed. Reed is the only founder still in the group, but several members who joined in the early years—he mentioned Linda Furr and Georgie Summers in particular—are still involved.

Reed seems amazed that it happened at all. “It’s like I just decided the organization existed, and voilà, it did!” That it’s lasted this long and steadily grown, despite being a totally volunteer operation, is testament to the group’s “pathological persistence,” as Reed put it, laughing, during a recent interview. Its 20th-anniversary dinner last week, he noted, was sold out, with more than 100 people in attendance.

“We made $3,000!” he exulted. “That’s enough for a year!”

The group began by writing letters—to newspaper editors, politicians, anybody who could be influential or might be interested.

And its members began educating—first themselves, then others. Reed’s professional work has been as a vocational rehabilitation counselor and, most recently, a private consultant, so at the time he had a lot to learn about health insurance.

The group sponsored visiting speakers and community forums. And its members were big supporters of Proposition 186, the constitutional amendment on the November 1994 ballot that would have established a single-payer system in California.

The group helped qualify it for the ballot by collecting 10,000 signatures in Butte County, a remarkable achievement, but few influential Democrats—including gubernatorial candidate Kathleen Brown—endorsed it, and it lost miserably statewide, garnering only 27 percent of the vote. “The campaign was wonderful, but the outcome was terrible,” Reed said.

The important thing, though, the “key point,” was that afterward the group didn’t give up. Members continued to push their cause and take the long view. “We have a historical perspective,” Reed explained. Other movements—women’s suffrage, the black civil-rights struggle—took decades to succeed, so why not this one?

“These people [in earlier movements] are our inspiration,” Reed said. “Most major political-cultural shifts take a while.”

Health care in America has only gotten worse since the coalition formed. In 1991, 32 million Americans were without health insurance of any kind; today the figure is around 50 million. And 20 years ago health care was 13 percent of the economy; today it eats up more than 18 percent of our dollars.

The two decades since 1991 are littered with failed health-care reform efforts, of both the single-payer variety and those like the Clintons’ plan that sought to work with the private insurance industry. President Barack Obama’s Patient Protection and Affordable Care Act, which also relies on private insurance, is the first nationwide reform to pass.

It could yet fail, however. The act is designed to work only if everyone purchases insurance, so if the U.S. Supreme Court strikes down the so-called individual mandate, as congressional Republicans fervently desire, the arrangement is likely to collapse.

The irony is that this could give the single-payer advocates an opening, Reed said. The president could then argue that, since his plan didn’t work, it’s time to go with a Medicare-style program, since Medicare is fully tested and legal in all aspects.

The California Legislature has twice passed a single-payer bill, but it was twice vetoed by former Gov. Arnold Schwarzenegger. The bill, SB 810, is back before lawmakers again, sponsored by Sen. Mark Leno (D-San Francisco) and if passed no doubt would be signed by Gov. Jerry Brown.

However, Reed said, some Democratic lawmakers who supported single-payer when they knew it would be vetoed are reluctant to vote for it now that it might actually become law, out of fear of blowback at the ballot box. So groups like his are biding their time, working to build grassroots support for a nationwide single-payer plan while working to convince individual legislators to move forward.

At least two states—Vermont and Montana—are moving toward single-payer, but they must obtain waivers from the Affordable Care Act before they can move forward. Ordinarily states can’t apply for waivers before 2017, but President Obama has indicated his willingness to accelerate it to 2014 in both cases.

California is also pressing for a 2014 waiver. SB 810 will be before the Legislature again in the spring.

Butte County residents interested in what’s going on in Vermont will have an opportunity to learn more on Monday, Oct. 24, when the Butte County Health Care Coalition is hosting the traveling California Healthcare Justice Tour at Trinity United Methodist Church (see column note for details). Chico is the ninth and last stop on a tour that began Oct. 18 in Los Angeles and will have snaked its way through San Diego, Irvine, Fresno, San Jose, San Francisco, Watsonville and Sacramento by the time it arrives here.

One of the featured speakers at this “town hall meeting” is James Haslam, director of the Vermont Workers’ Center, a group that has led the fight toward single-payer in that state. He will share his and his group’s story, with a focus on how Californians can do the same.

Joining Haslam will be Donna S. Smith, a writer, speaker, legislative advocate and organizer (for National Nurses United) who is perhaps best known for her appearance in Michael Moore’s 2007 documentary SiCKO, in which Moore told her painful story of navigating the nation’s broken health-care system.

Members of the Campaign for a Healthy California include the California Nurses Association, the California School Employees Association (CSEA), Communication Workers of America, California Physicians for a National Health Program and several others.

As significant as it is that Vermont and Montana are moving toward single-payer, California is the real prize, Reed emphasized. And here the powerful health-insurance industry can be expected to do whatever it must to prevent being frozen out of the market by single-payer.

As Haslam has said, “We can’t do it in Vermont alone.”