Getting the netroots strategy right on health care

Right on... (0.00 / 0)

...I like where you're going with this discussion.  I would point out that a few of the traditional advocacy organizations have actually been pretty effective at not only getting the word out about the movie, but also translating the energy from people back into their actions (mostly through the web).

However, there IS a lot of room for improvement, I completely agree with you.  I believe that the traditional orgs AND the progressive blogs/moveon type structures are both in need of working on this strategy.

I'd like to share a site that's been put together in the past few weeks that hopes to foster discussion online around these issues (health justice activism, local and national, strategizing, etc) -- Cure This.  There's even a recent post about netroots and other strategizing (or the lack of) with SICKO!

I'm excited about taking Cure This to the next level of tech assisted local activism.  I'd like to see other sites do that more effectively too.  I was recently at the United states Social Forum and there was MUCH talk of organizations wanting to have the ability to connect people on a local level.

thanks for starting this discussion!  (please connect with me about curethis! we should talk...)

Health justice blog community -- Cure This
Los Angeles, social justice, music, etc -- Los Anjalis

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by: los anjalis @ Sat Jul 07, 2007 at 18:29:12 PM UTC

Pieces To The Puzzle (6.50 / 2)

I just wandered over to your site.  Nice.

There are a number of pieces to the puzzle here:

• There needs to be places for "organizational memory".  Your blog's an example of how that can get done.


• There needs to be places to reach a large number people who are interested in single payer and health care issues, but are not deeply involved in some group to get active on it.  DailyKos seems to be the place for that: it's our "big media". I think it's working reasonably well for that, and there's an active community of people who post regularly. It's a bit scatter shot, since it's hard to get a diary seen there, but I think we're getting better at it.


• There needs to be local organization.  I'm not sure what the answer is here, since it's becoming clear to me that SiCKO is creating the "demand" for people to have a local place to meet and discuss these issues.  But the "supply" isn't here yet.  A MoveOn or DFA style site that helps people find one another would help.


• Track media and PR efforts.  This might be as simple as getting together a relatively small group to monitor cable news and track the affiliations of the talking heads, most of whom being industry shills "under cover".  We need to blow the cover of as many of these people as possible, and get the information into an accessible place, like CMD's SourceWatch wiki.


• There needs to be a way of influencing the larger political debate.  I'll write a bit more on this below, but I think the analogy to look at is what groups like Defenders Of Wildlife did in CA-11.  The environmental groups slammed Pombo very hard on his environmental record (or lack there of).  It was clearly a factor, since Pombo went to some lengths to suggest that he actually cared about the environment.  The issue unnerved and scared him.  That's what we need to do: set up a system for introducing this issue into congressional and state leg races that will intimidate and scare the GOP.

That's a quick outline of the problems we need to look at or solve.  I'm most interested in the last of these, but all of these things need doing.

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by: mbayrob @ Mon Jul 09, 2007 at 01:46:07 AM UTC

[ Parent ]

Here is my (0.00 / 0)

issues right now and I may sound like I am throwing a wet blanket on what you want to do, but I do want to state that I absolutely believe in and support single payer.  There are two things, one national and one local (state) that limit the ability to make a full on push in the netroots for single payer. 

In the next few weeks the California legislature is going to put universal health care on the Governor's desk.  He is going to veto it.  I absolutely encourage people to try and make a big stink using SiCKO as an example.  However, once that happens, the legislature is going to very quickly switch gears to pass health care reform that is within the private industry model.  We actually have a shot to pass something pretty decent and will need to work hard to pressure the legislature and the governor to ensure the eventual bill is a good one.  Then if it makes it through the legislative process it will need to be defended in the courts and most likely on the ballot.  Pushing forward with a single payer or nothing approach will greatly reduce the chances of actually passing reform in California and ensuring that millions have access to more affordable care. 

This is not the approach of the CNA, in fact it is in direct contrast with it.  They are organizing right now and holding "teach ins" with the explicit argument that anything less is unacceptable.  I have one of the flyers in my backpack right now.  I as you probably can tell do not support their tactics.  And I believe that other major players in the California blogosphere do not either.  That limits the actual potential for making a big push for single payer in the near future here in California and latching on to other organizations.

The national discussion of health care reform is currently dominated by the presidential candidates.  None of the front runners are pushing a single payer system.  You can pressure them and make a big stink, but I don't think that is particularly productive.

On a more broader point, the typical successful netroots coordinated campaign has a timeline on it.  We work best when there is a campaign coming, or a piece of legislation up for consideration.  There has not yet been an example of a multi-year legislative campaign being successful.  Congress is simply not going to take this up until at least we have a Democrat in office.

I actually believe that finding ways of encouraging non-traditional peer-to-peer communication is actually more effective at this stage of the game than having actual real world meetings.  What we need to do now is shift the public support of single payer.  That means talking up SiCKO with all of your friends.  The blogs could be really useful at creating a really brief message about SiCKO that can be emailed around to friends.  Or if there are right wing talking points on it, a point by point dissection.  If you really do want to game dkos, just ask people who leave comments in health care diaries if they want to be on an email list that gives them a heads up whenever a health care diary is up.  I have seen it work wonders, but to be frank, I think it is already getting a great deal of attention on the big orange.  Policy really isn't MyDD's thing.

As for MoveOn, they chose their action items and campaigns based on intensive polling of their members.  If they dont get a big support from their list on an issue they don't push it, case in point their attitude on impeachment.  DfA I am not sure on their pressure points.

Anyways, this was a rather long response, but I hope it was helpful.

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by: Julia Rosen @ Sun Jul 08, 2007 at 02:56:39 AM UTC

I guess (0.00 / 0)

I don't see why SiCKO should be used to promote halfway reform. That wasn't the message of the film and I don't think that is how it should be used politically.

The reform bills in Sacramento are important and we will have to help get them passed, but we must also remember that they are temporary and flawed compromises. If it's the best we can get in 2007 we'll take it, but the goal is single-payer, and that must remain our focus. The CNA is right to resist pressure to take our eyes off the ball.

You can check out any time you like but you can never leave

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by: Robert Cruickshank @ Mon Jul 09, 2007 at 00:32:31 AM UTC

[ Parent ]

I am (0.00 / 0)

not arguing that we should use SiCKO to promote private insurance based reform.  That is hard to do, though Moore did do a little of it here in Sacramento. Remember that he teamed up with both Nunez and CNA during the premier.  They do not have to be mutually exclusive.  One can support single payer and support the current viable legislative efforts.

Getting the best that we can get in 2007 will take our support.  Remember the lessons of HillaryCare.  Attacks from all sides will bring it down.  What is needed is positive pressure to influence the actual shape of the legislation.  And that means the left needs to be engaged and not be spending all of our time and resources saying only single payer.  Taking our eye off of the ball for the immediate future to make sure millions more have coverage is worth while.  Right now SB 840 is not viable in California until at least 2010.  We can get a lot of good accomplished in the interim period.

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by: Julia Rosen @ Mon Jul 09, 2007 at 15:46:23 PM UTC

[ Parent ]

Those legislative efforts have their place (0.00 / 0)

But at the same time, I believe that the momentum of SiCKO and of the netroots are best mobilized to advance a strategy for single-payer - to ensure that in 2010 we have a movement that Democratic nominees for governor cannot ignore, a movement that will either find fruition in the 2011 legislative session or at the ballot box. Find ways to attack our opponents' strengths and train and organize people to make single-payer real.

As we do that, sure, helping get a temporary and limited compromise passed this year is useful, both in who it will help and in getting us a bit closer to the goal of single-payer. But only as a step toward our ultimate goal, and one that we continue to devote most of our energy toward.

You can check out any time you like but you can never leave

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by: Robert Cruickshank @ Mon Jul 09, 2007 at 17:37:57 PM UTC

[ Parent ]

Big Stakes (8.00 / 1)

There are big stakes here in California. 

If the insurance companies can push through mandates--requiring every person to carry presumably-private health insurance--then we can kiss single-payer good-bye.  Certain legislators on their payroll are rushing to help make that happen.  And if they pass it here, they pass it everywhere.  And I just do not see how we recover from that horrible policy proposal. 

The best thing we can do for healthcare reform is stop the mandate movement being pushed by the private insurance companies that Michael Moore dimed out.


I am a healthcare activist for the National Nurses Organizing Committee/California Nurses Association.  We are the nation's largest RN union, the nation's fastest-growing union, and leading advocates for single-payer healthcare.

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by: California Nurses Shum @ Mon Jul 09, 2007 at 18:08:52 PM UTC

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Individual mandates are truly disastrous (0.00 / 0)

A few months back I wrote a diary here explaining the flaws of Arnold's mandated coverage plan - how a similar proposal in Massachusetts, that I'm sure you're familiar with, led to sky-high premiums for little in effective coverage.

A mandate plan is worse than the status quo. It would bankrupt millions of working Californians, and do little to guarantee they would actually get decent health care in return. Individual mandates are really little more than a forcible transfer of wealth from an average Californian to a multibillion dollar HMO. It must be stopped.

You can check out any time you like but you can never leave

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by: Robert Cruickshank @ Mon Jul 09, 2007 at 18:26:21 PM UTC

[ Parent ]

Oh (0.00 / 0)

I agree completely.  I have been railing about them for a long time now.  Notice that AB 8 does not have mandates.  Arnold wants them.  That is exactly the type of fight that we need to be engaged in when discussions of the bill starts heating up again.  We need to make sure that the Dems hold firm on that one.

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by: Julia Rosen @ Mon Jul 09, 2007 at 21:50:14 PM UTC

[ Parent ]

Individual mandates would have minimal benefit (8.00 / 1)

As near as I can tell, the whole push for individual mandates only helps to reduce the cost shifting you get from having uninsured people served by hospitals, especially in emergency rooms.  But if we are talking about private insurance we are still talking about a system where:

• Insurance companies will deny claims as they do now.


• Doctors and other providers will still be spending what they spend to recover claims from the vultures.


• Control of costs will be no better then than now.


• The system will be at least as complex as it is now, if not worse.

Most of the people who suffer in SiCKO would suffer under Nunes' bill.

There are a number of lessons to learn from the failure of the Clinton proposal in 1993:

• Complexity is not a selling point.


• Compromise bills have no political constituency.  Look how it worked out for immigration this year.


• Insurance companies are not reliable partners for negotiation on reform.

The political situation today is vastly different from 1993. We need to think bigger, and remember that we have the kind of leverage that we have not had in our life time.  Triangulation increasing is going to be the GOP's problem, and it is likely no longer to be ours.

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by: mbayrob @ Mon Jul 09, 2007 at 19:32:55 PM UTC

[ Parent ]

Shifting Attention To HR-676 (8.00 / 1)

Juls,

I think your analysis of how things are going to develop on SB-840 is spot on, and I don't have a lot to add to it.  The bill will pass out of the Assembly, and Arnold will veto it.  But I think it's worth examining more carefully what you see flowing from that event.

I think that Michael Moore has figured out how to reframe the health care issue, and we need to grab it and run with it.  In this respect, I agree with the CNA: now is the time to state clearly what the goals should be, and take advantage of the controversy over the film to reach as many "influentials" as possible, and as much of the public as a whole as we can. In doing this, nuance is not necessarily our friend. To the extent that the nurses are pushing a simple, clear message. This certainly will work against short term reform, as you point out.  But I no longer think that short term reform is the point of things.

That leads us to the Nunes bill.  There's a clear caveat here, and you can see it big and clear in Massachusetts right now.  The bill there is complex, and raises demand for health care without doing much of anything about price or quality.  I'm dubious that it will help much for access.  But the worse of it is that it looks to be a political disaster in the making that would not only preempt a single payer bill, but probably would inhibit other reforms on Fabian Nunes' or Mitt Romney's model.

The main reason these bills are so complex is the need to keep the insurance industry in the game. As someone with a bit of economic training, I'm very dubious that there's any value in this.  But counter to the conventional wisdom of the last 15 years, I don't think the politics work either: the main reason the HMOs and the insurance companies want a place at the table right now is to overturn the table -- to delay or scuttle any effort.  They still have enough clout in California that I don't think that the bass acward approach the compromise bill wants to take will go anywhere. The bill will just end up getting into another damn initiative campaign, and all the PhRMA money that will bring in.  This will lead no where.

So the real game is in influencing the national debate.  If we get a bill in California, nice, but I don't expect it.  And I am not very worried if folks like the Nurses make getting an agreement on it more difficult.

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by: mbayrob @ Mon Jul 09, 2007 at 02:09:26 AM UTC

[ Parent ]

How do we get there from here? (5.00 / 1)

I think that's the first question to be asked.

Right now we have from 30% to 45% of voters supporting single-payer, depending on the poll and how the question is asked. We have a state legislature that passed SB 840 last year and is poised to do so again, proving the use of a maximalist strategy.

We also have a governor who will veto SB 840 and would block universal single-payer no matter what the poll numbers. We also have Republicans in the state legislature who can and will block the taxes to make universal single-payer work. We have a health insurance industry that will spend whatever it takes to prevent Californians from going toward this system.

So we need to be finding ways to erode or avoid those obstacles. How can we pressure Arnold to stand aside? How can we deal with the Republican legislators? How can we counter disinformation? And how do we build more public support for single-payer?

The MeetUp style organizing you mention can help spread information to Californians about specific issues to this state. OK, they've seen SiCKO, what now can they do to make single-payer a reality here?

You mentioned diaries - what sort of diaries should we be writing more often, or what should we be getting more focused on? Concepts? Policy specifics? Legislative updates from Sacto? That goes for training as well - what specific skills or knowledge need to be taught?

This is the beginning of a good conversation.

You can check out any time you like but you can never leave

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by: Robert Cruickshank @ Mon Jul 09, 2007 at 00:52:38 AM UTC

Changing the political calculus for politicians (6.00 / 3)

I think the best approach here follows from the sorry state of the state and national GOP.  2006 and Bush's meltdown has them spooked. And the health care issue, along with Iraq, give us an enormous opportunity we cannot squander.

Most likely, once the primaries finish, we'll see the usual dissolution into lots of effort put into a limited number of states, as usual.  It won't be quite as bad as 2004, mostly because the whole 50-state strategy has become a new conventional wisdom.  But the Electoral College more or less dictates this as a strategy.

This is great news for health care, since if you look at what states are called "swing states", most of them have seen the biggest movement blue-ward of the country as a whole, Ohio being the classic example (but watch Virginia as well).

To win these states, the GOP nominee, whoever that might be, is going to need to rally local GOP politicians who are running very, very scared.  The national candidate will be lined up against any meaningful health care reform, much less single payer.  But suppose if the local GOP leaders were convinced that they could lose their seats over the health care issue?

I'll tell you what they'd do.  They'll behave like many Democratic politicians did in 1988, and desert the nominee.  Make themselves scarce when the nominee comes to the state.

I'd like to ratched up their fear level a couple more notches.

How to do this?  Select a fair number of congressional or state leg seats in the key states, and help Democrats in those districts organize over the health care issue.  Give them tools to do meet ups.  Give them tools to load their voter file up in a web server and run foot canvasses and phone banks. And supplement their efforts with imported volunteers, as we did for Jerry McNerney, rather than the "parachute in the marines" tactics we did for Kerry in 2004.

Canvassing tools, social networking tools as Juls suggests above, and the same sort of ActBlue fundraising for candidates we've been doing the last few years all have a part here, I think.

We need to get the tools ready, and start training people in them pretty quickly, so they will be ready by the time the primary season is over, and real fun begins.

If we do this, we will create the perception -- which may even turn out to be accurate -- that the single payer movement has clout, and that it will elect the next president.  That will change the situation greatly, and will create real momentum towards a meaningful reform.

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by: mbayrob @ Mon Jul 09, 2007 at 02:26:22 AM UTC

[ Parent ]

Great questions (0.00 / 0)

Thanks for starting this discussion.

I am a healthcare activist for the National Nurses Organizing Committee/California Nurses Association.  We are the nation's largest RN union, the nation's fastest-growing union, and leading advocates for single-payer healthcare.

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by: California Nurses Shum @ Mon Jul 09, 2007 at 21:48:35 PM UTC

[ Parent ]