Reform at the state level

Becoming more involved in Health Care for All Colorado has been a real education in the actual doing of citizen activism, rather than just the writing about it. Big difference.

I'd seen some of this with environmental and women's issues — and at the newspaper as well in a way, now that I think about it. Questions of how closely to ally your group with others, who have different priorities and strategies but the same values. Questions of strategy. Questions of personality and prioritizing.

Health Care for All Colorado's board decided last year to focus on Colorado's 208 Commission and to submit a single-payer proposal to them for consideration.

I agree with the decision, but it's one that members seem to frequently come back around to.

Can single-payer healthcare reform really take place at a state level? It did in Canada — so why not here?

There are a few good answers about why not. The best one seems to me to be because the insurance industry isn't going to let it happen — period. They're 5 percent of the U.S. economy, and they're too powerful to let anyone say they can't skim their shocking profits off an industry that they make inefficient by their very setup.

It's kind of like living in Sicily and wondering why the hell we can't get rid of the Cosa Nostra.

The insurance industry may be able to focus its amazing firepower on us more easily state by state, but it's so powerful that it can do the same at the national level — as it demonstrated in 1994 with the Clinton plan.

The statewide initiatives, however, allow more people to become educated about single-payer, get more people involved at a local level, and allow more people to become truly invested. That makes us more powerful, not less.

An equally powerful argument against trying to get a single-payer proposal passed in Colorado is TABOR. Then again, Oregon has a God-awful super-majority requirement for getting new taxes passed. So it's not just Colorado where the "drown-government-in-a-bathtub" forces have been able tilt the playing field in their direction. And then again, Colorado isn't Oregon. Liberal Denver can't hold a candle to Progressive Portland — which Bush I called "Little Beirut."

I'd be curious to know what the national organizations say about it. Does PNHP think we're wasting our time? There is only so much time and energy, after all. Should all the state organizations give it up, and just write letters to the editors and their representatives, calling for passage of John Conyers' and Dennis Kucinich's bill?