The fight for health care reform has been full of twists and turns and changes on a daily basis reflecting the epic nature of this battle. Some conclude from whatever President Obama and the Democratic leadership of Congress say on a particular day they are caving in to the insurance industry and worse that Pres. Obama will raise the white flag content with a phyrric victory.

This approach mistakenly paints the Democrats in broad strokes as captive of the health care industry, not taking into account that many legislators are actually part of the health care reform movement and have been working with it for years, including President Obama.

This angst ignores the enormous pressures coming to bear on the legislative process and the challenge of getting enough votes to pass a bill through both chambers of Congress. President Obama and the Democratic Congressional leadership know how to count votes, including in their own caucus, which is not unified.

It ignores the power of the united opposition to any reform at all, including the entire ultra right and big sections of monopoly capital, and their ability to still influence Congress, mobilize and confuse a substantial section of the American people.

On the other hand, it insufficiently appreciates the power of the grassroots health care movement and the need to keep building and activating it to win, especially the millions of activists who took part in the Obama campaign. Passage of health care reform will need the same activism and energy, unity and determination that defeated the ultra right in the 2008 elections.

All this constitutes the political balance of forces at this moment in the country. Winning a reform necessarily means wresting a concession from a section of monopoly capital, in the form of the insurance and medical corporate complex. The question remains, is the broad democratic movement (and of which Pres. Obama is a reflection) sufficiently strong to accomplish this?

Nick Unger, organizer for the AFL-CIO cautioned an August 24 Illinois Campaign for Better Health Care statewide teleconference call that activists should avoid getting caught up in the day to day rumor mill, distortions and outright lies being circulated in the mass media.

Unger said the media has failed to report the real story: the current movement is the biggest movement for health care reform in history, far eclipsing the movement of 1993-94. And if we win a public option and other reforms this will be the decisive reason for the victory.

Over 77% of the American public wants reform and the movement is at least 10 times larger than the so-called “Tea Bagger” movement, said Unger. He cited the 280,000 religious activists who participated in a teleconference call with President Obama and the 270,000 who participated in the Organizing for America call with Obama a few days later.

Unger said the right wing offensive and “brown shirt” efforts to break up congressional town hall meetings, intimidate lawmakers and constituents alike in early August shifted momentum temporarily in favor of the opposition. But these tactics also backfired because they turned off the American public.

Since then the pro-reform forces, alarmed at what had happened and understanding the need to elevate the struggle, launched a counter offensive and shifted momentum back in the later part of August.

The pro-reform movement has stepped up efforts to mobilize the grassroots and the focus returned to the fight for the public insurance option, a key element of the reform. We are still seeing the early stages of this mobilization and it is already having an effect on lawmakers.

Democratic Senate leadership seems to be trying to find a way to pass health care reform through legislative reconciliation, understanding they will not be able to amass the 60 votes needed to avoid a filibuster.

This route is more growing in likelihood since it appears the so-called “gang of six” negotiations in the Senate are collapsing, producing an unacceptable compromise of “health care coops” while key Republican players obstruct.

On August 24, Sen. Charles Schumer told David Gregory, “I’ve talked to the president personally about this in the last few weeks. He believes strongly in the public option. Obviously he is working hard to get a bipartisan bill, because that would be a better bill. But I believe that at the end of the day we will have a public option…A public option (that) competes on a level playing field with the insurance companies, was backed in the House by both Blue Dog Democrats and more liberal Democrats. And I think that’s the direction we’re going to end up in.”

Rep. Jan Schakowsky reiterated her belief Sept. 2 that a public option will be won when she told Ed Schultz on MSNBC, “There are a lot of distortions in the mass media about what is happening in Congress, “Many Members of Congress — including myself — will not support a health insurance reform bill that does not break the strangle hold of private insurance companies on our health care system. That requires that consumers have a choice of a robust public health insurance plan. I will support nothing short of a robust public health insurance plan upon implementation, no triggers. I believe Congress will pass and the President will sign such a bill this fall.”

The key to overcoming the fierce and desperate opposition for a health reform victory and especially a strong public option component is the growing grassroots action in the neighborhoods and workplaces. Across Illinois, organized labor has made thousands of calls to legislators. Thousands of residents have attended congressional town hall events, scores turned out for Obama for America organized “send-off” events, and over 500 turned out for a rally in Grant Park on September 2.

Schakowsky held an overflow town hall meeting on August 31 attended by 2,000 people in Niles, IL. The meeting spilled out into the street and the right wing nuts were far outnumbered.

According to CBHC Reps. Bobbie Rush, Jesse Jackson Jr., Luis Gutierrez, Danny Davis, Phil Hare and Jan Schakowsky have all pledged to only vote for a House bill that contains a strong public option. Reps. Melissa Bean and Bill Foster have also stated they are in favor of a public option so focus now is on Reps. Lipinsky and Costello, who have made no commitment.

President Obama can’t win health care reform with a public option alone and said as much in his speech to the AFL-CIO in Cincinnati on Labor Day. He didn’t win the election alone and can’t govern alone. The depth and extent of the reforms being undertaken, including in the health care field, depend at the end of the day on the strength and unity of the democratic and peoples movement. That remains true for an immediate concession and further concessions down the road. The true test awaits.





John Bachtell
John Bachtell

John Bachtell is president of Long View Publishing Co., the publisher of People's World. He is active in electoral, labor, environmental, and social justice struggles. He grew up in Ohio, where he attended Antioch College in Yellow Springs. He currently lives in Chicago.