Single-payer: More than ever, the labor movement’s comeback opportunity
National Nurses Union activists for single-payer at a rally with Bernie Sanders in 2015. | Rick Reinhard / NNU

Unity, and the threats posed by disunity, were key themes of Richard Trumka’s opening address at the AFL-CIO’s 2017 convention in St. Louis this past weekend. “We gather together as America and the world hunger for solidarity. We need it like we need air… Yet fear, hatred, combined with a rigged economy and political system, stand in our way.”

To address this challenge, the federation held a special conference bringing together community leaders for racial justice and labor under the theme: All of Us or None of Us.

There is perhaps no greater cause to lead labor and the entire working class toward this unity than the struggle to win single-payer health care for all. It is also labor unions’ comeback opportunity to rebuild their membership.

In September, Bernie Sanders handed the labor movement such a chance when he introduced his Medicare for All plan in the U.S. Senate.

To lend Sanders’ bill clout, 15 senators co-signed. This is a first. The last time Sanders’ introduced such a bill, it lacked a single co-sponsor. Along with 117 House members supporting Rep. John Conyers’ single-payer bill, HR676, we could be within a few election cycles of relieving American workers from the worries and costs of health care.

What Sanders called a historic moment for the country, can also be one for the labor movement.

Unions have passed resolutions supporting single-payer in over 600 locals, many international unions, and at a national AFL-CIO convention. Missing, however, is an action plan and the organizers and resources necessary to wage a national struggle.

Labor unions have the expertise, membership, and skilled organizers that are key ingredients to making Bernie Sanders’ single-payer legislation a win for the entire working class. Conversations with seasoned labor organizers over the years often lead to a consensus that several hundred organizers across Southern states are required to turn the political tables in favor of single-payer. Perhaps, another 100 assigned across the nation. Why is the South the priority?

First, labor membership in the South is sparse, so union’s have less financial and organizational capacity than in other states. National resources are needed. Secondly, considerable distrust of unions is common among Southern workers, given the endless anti-union politics fostered by the GOP, corporations, and the chilling effects of right to work laws. Thirdly, the most strident opposition to single-payer is from Southern conservative politicians. Winning requires replacing at least some of them with single-payer supporters and persuading others with overwhelming constituent pressure.

And lastly, labor’s comeback depends on organizing Southern workers. For decades, this has proved elusive. Thus, fielding 200 union-sponsored organizers to win health care for all workers, union and non-union; Black, white, or immigrant; could win over Southern workers to back union organizing. Approached with a sound plan, union members might support a small increase in dues to make this happen.

The fight to defend Obamacare must also encapsulate the need for a transition to a struggle for single-payer. There are serious questions whether the Affordable Care Act can be sustained financially in the long run. Private insurers are not going to cooperate. They will not cut their bloated, cumbersome bureaucracy. It’s what makes them money. They will continue to waste our premiums and tax dollars on extravagant advertising campaigns, lobbyists, shareholder payouts, and lawyers. It is time the nation save money, end private insurers’ control of our health care dollars, and make Medicare for All a reality.

In doing so, labor must ensure all workers in the health insurance industry find new jobs and training. It’s not their fault the industry failed to deliver. Labor unions could play a key role here. Some of these workers and managers can be employed to handle the increased work load of Medicare. Others will find new careers and jobs elsewhere, as some estimated million-plus workers 55 and older indicate they could retire if they had health insurance coverage. Single-payer, then, is a no-cost jobs program. Just another reason for labor unions to invest resources in this fight now.

Single-payer will also free up billions of dollars of capital held captive in the bureaucratic structures of private insurers. Potentially, this means the real economy that produces manufactured goods and agricultural products could gain an influx of capital year-by-year as capital shifts into these sectors.

And finally, single-payer will save workers’ lives. Various studies show an estimated 36,000 Americans die every year because they either don’t have health insurance or can’t afford the deductible, so they delay seeing a doctor. One day, what could have been an avoidable heart attack or stroke becomes a premature death. Sanders rightly calls this a moral outrage.

In June 2017, polls showed 53 percent of Americans supported single-payer, this included nearly one-third of Republicans and 55 percent of independents. A political calculation would suggest 70 percent is the winning percentage. At that point, the political system would need to yield to the public’s will.

Trumka’s call for unity echoes the best traditions of American labor struggles. “You see, we stand together, as diverse as America in every way, and united by our shared brotherhood and sisterhood in our labor movement, which is built entirely on togetherness.” Shared social benefits, like Medicare for All, free post-secondary education, and paid paternity leave and vacation for all workers are the practical means by which to weld a united and equitable society.

The day Sanders introduced single-payer will truly be historic once it becomes law. Labor unions, more than any other organized group, can ensure this becomes a reality. Not just for their own members, but for all workers.


Wayne Nealis
Wayne Nealis

Wayne Nealis is a left political activist and writer in Minneapolis, Minnesota, focusing on communications and strategies for social change. He was a toolmaker and union activist in a Minnesota industrial union. Nealis earned a degree in journalism from the University of Minnesota and practiced journalism and public and media relations.