Preaching to the Converted

President's report:
Preaching to the Converted

When you, as an HCAO supporter, have an opportunity to speak before progressive audiences, especially folks who already support the idea of single payer health care, here is a draft speech template from which you may draw bits and pieces for your talk. It is an outline of where we have been, where we are and where we are going as a universal health care movement in Oregon and the U.S. Feel free to edit. Let me know if you have ideas on how to improve it! -
Lee Mercer, HCAO President and Mobilization Chair.

                  Lee Mercer speaks at the 2015 Annual Meting

                  Lee Mercer speaks at the 2015 Annual Meting

Yes! I Believe in Single Payer, But How Do We Get There?
(And How Do I Get Involved?)

  • So, it seems like everyone here supports the idea of a universal, publicly funded health care system in Oregon.
  • But, like many intelligent people and even many from among our active allies, the question is always, I believe in this, but, realistically, how do we get there?
  • We met with Ken Allen, former long-time and respected executive director of AFSCME, one of our member organizations, several years ago. He said “I have supported single payer since I spoke out for and worked for it in the '70s. But show me a realistic path to get there.”
  • You may be saying, “I am a busy activist, and I don’t want to waste my time on an idealistic but unrealistic political goal.”
  • Well let’s look at efforts in recent years to get to single payer, and how that is creating the foundation to achieve it, realistically.
  • And how you can get involved in making it happen.


  • The US has been trying to create a national health care program for a hundred years. Teddy Roosevelt and FDR both suggested it. Truman and others tried for a national health insurance program but were beat back by groups like the American Medical Association.

  • The Affordable Care Act expanded access, eliminated denial because of pre-existing conditions and made improvements but was never going to get us to universal care.

  • In terms of moving to single payer nationally, Congress has been virtually deadlocked on just about everything through the Obama years, and, under Trump is likely to move our national health care coverage backwards.

  • So, like in Canada, where one province passed single payer and then the nation followed, advocacy groups all over America are working on designing state based systems.

  • Oregon is among 25-plus states nationwide working on creating such a system.

  • Vermont passed a single payer plan legislatively in 2011.

  • Then when they started analyzing how to implement and pay for it, the business community got nervous about the revenue cost and the governor pulled the plug.

  • California actually has passed single payer bills twice through the legislature only to have Governor Schwarzenegger veto it.

  • New York recently passed a single payer bill in the Assembly, but has not yet passed it in the Senate.

  • And Colorado put a single-payer-like initiative on the ballot in 2016, only to be defeated by millions of dollars spent to defeat ColoradoCare by the insurance, pharma and other corporate interests.

  • But, especially with Congress working to repeal the Affordable Care Act and make millions of Americans lose their health care, we need to promote the single payer option as the streamlined, affordable way to get to universal health care.

  • In the national debate, we need to be promoting HR 676, the Expanded and Improved Medicare for All Act.

  • We need to get our Congressional Reps to sign on or promote other such legislation.

  • And we need to push for waivers for state-based health care innovation in whatever health care legislation Congress passes.

  • But, in the meantime, we need to fight on at the state level.

  • California has introduced a single payer bill for the 2016 session which has a lot of support and strong Democratic majorities in both legislative chambers.

  • If a state like California, the sixth largest economy in the world, passes single payer, it will be a game changer in getting universal health care into other states and for the rest of the U.S.

  • National single payer organizing is coordinated by national groups like Healthcare Now!, Labor Campaign For Single Payer Health Care, One Payer States and Physicians for a National Health Program. Everyone should sign up with these groups to stay informed on the national level.

State-Based Organizing

  • Oregon, again, is one of over 25 states working on passing a universal publicly funded health care system either legislatively or on the ballot.

  • From studies by Gerald Friedman of U of Mass Amherst and others, the economies of a given state can support establishing a single payer system.

  • It would require waivers from the federal government to use Medicare, Medicaid and other federal dollars in tandem with state dollars, to create a single risk pool system.

  • This is the most cost-effective and efficient way of providing health care

  • But defeats in Vermont, Colorado and even in Oregon when we tried a single payer ballot measure in 2002 indicate, before we can pass single payer, we need to educate voters to understand why this is the most affordable and efficient health care system.

  • Any single payer system will require new taxes to offset the removal of the inefficient multi payer insurance system.

  • And voters and legislators need to understand that the added tax cost is going to be cheaper than what they and their employers are paying now for health care.

History of Oregon’s Movement and Where We Are Going

  • After Measure 23, the Oregon single payer bill, was rejected by the voters in 2002, the fledgling Eugene-based Health Care for All-Oregon began trying to learn from their defeat.

  • The biggest lesson from 2002 was that not enough potential ally organizations were consulted in the designing of the plan.

  • In the future, many more groups—community, health care providers, labor, business, faith, organizations of color— would need to be engaged in planning Oregon’s universal health care system.

  • As the debate running up to Obamacare raged nationally, health care advocates from Oregon got involved.

  • Mad as Hell Doctors, many from the Oregon chapters of Physicians for a National Health Program with them, did a nationwide tour promoting single payer.

  • And after Obama and Congress knocked single payer off the table in the Affordable Care Act, advocates in Oregon got busy.

  • Health Care for All-Oregon grew from a regional to a statewide coalition.

  • HCAO convened groups like the Mad as Hell Doctors, Mid Valley Health Care Advocates, Portland Jobs with Justice Health Care Committee and a number of unions, community, faith and other groups into a coalition.

  • They began planning a multi-pronged strategy to pass single payer in Oregon.

  • The strategy is both legislative and working towards a ballot measure.

  • In the legislature, we are building towards universal health care but, legislators, due to the super majority required to pass new taxes, will not likely ever create the final bill.

  • But, in the legislature, we can educate and build relationships with our legislators and strengthen the foundations of support for universal health care.

  • In 2011, 2013, 2015 and 2017 we have run single payer bills, held hearings and educated the legislators and the public.

  • In 2013 we ran a bill to create a study on 4 ways to get to universal health care in Oregon: A public option, an essential health benefits plan, single payer or the Affordable Care Act as is. This bill passed with bipartisan support.

  • In 2015 we ran a bill to finance that study and it passed.

  • In 2016 the Oregon Health Authority put out a request for proposals and the national RAND Corporation won the bid to do the study.

  • In 2017 the RAND Report came out indicating a single payer system was the most likely to achieve universal health care and at no more cost than other options.

  • In 2017 we are asking the legislature to create a task force or work group to plan how to implement such a universal health care system in Oregon.

  • In 2018 and 19 we will ask the legislature to refer an initiative creating Health Care for All in Oregon to the voters in the next presidential election in 2020.

  • If the legislature fails to refer, we will begin collecting signatures for a 2020 ballot measure creating Health Care for All Oregon.

  • Several other states are also planning for 2020 ballot measures or legislation, which will increase the costs to the opposition of fighting universal health care.

How you can get involved!

  • Some people complain that 2020 seems like a long time to wait to get single payer.

  • But believe me, after the 100 years it has taken for the U.S. to consider creating a civilized health care system like the rest of the industrialized world enjoys, three and a half years is not a lot of time.

  • And there is a lot to do in the meantime.

  • We currently have 120-member organizations in our Health Care for All Oregon coalition, 150 business supporters and nearly 20,000 activists in our database.

  • We estimate that to begin to have a chance to win at the ballot in 2020, we need 200 plus member organizations, 500 endorsing businesses and 60,000 activists, or roughly 3% of likely voters in 2020, on our list.

  • We need volunteers out signing up new supporters, recruiting new organizations and business supporters.

  • We need people to attend rallies and testify in the Capitol in our legislative contact teams.

  • We need people to do social media, press and other communications work.

  • We need people to table at farmers’ markets, fairs and events.

  • We need people to do data input and IT support.

  • We need people to serve in the Speakers’ Bureau, do talks and Power Point presentations and do film screenings. To join the Speakers Bureau contact Mike Huntington in Corvallis

  • We have several films, for different audiences: The Health Care Movie (general audience), Now Is the Time: Healthcare for Everybody (for supporters, progressives), Fix It- Health Care at the Tipping Point (for business, moderate and conservative audiences) and (soon) Big Pharma: Market Failure (for all audiences worried about the cost of pharmaceuticals).

  • We need people to meet with the rank and file of member organizations to educate them on the single payer system and table at their conferences.

  • But first, we need you to join HCAO.

  • Sign our support form or go to the website and sign the Statement of Support.

  • Join HCAO as an individual member for $30 a year.

  • Join HCAO as a voting member organization for $100 a year. To join HCAO as an organization contact Membership Committee Chair, Lou Sinniger.

  • Sign on as a business endorser.

  • Fill out a Volunteer Interest Form or online.

  • Join a local chapter. There are chapters from Bandon to La Grande and from Washington County to Rogue Valley.

  • Consider Board or Committee participation!

  • If interested in committee work, contact HCAO Committee Chairs.

  • If interested in board work contact David Young Nominations and Elections chair.

  • And for many materials and resources and ways you can help go to Health Care for All-Oregon’s website.

Intersectionality and Rapid Response

  • Nationally, and at the state level, we realize we can’t succeed in our movement for health care justice without joining in the wider movement for social, environmental, racial, LGBTQ and economic justice.

  • HCAO works with allied organizations and individuals to support legislation and social activism which support our vision of a more just society.

  • To request HCAO support or endorsement of social or economic justice policies, contact Mobilization Chair Lee Mercer for Legislative Review Team and Executive Committee decision.

  • To request HCAO endorsement of rallies, picketing or other events, also contact Mobilization Chair Lee Mercer for Executive Committee decision at

  • HCAO is a member of the Oregon Health Equity Alliance and Allies for a Healthier Oregon.

  • We support the legislative agenda of OHEA including bills like Cover All Kids, Basic Health Care, Paid Family Leave and other issues.

  • We are working to defend the gains made in health care nationally under the Affordable Care Act, and to defend Medicaid against block granting and Medicare against privatization. To join efforts to defend national health programs and join rallies and events contact Lisa Stiller.

  • In broader circles, we are intersecting with those fighting to defend immigrant rights, the environment and many other causes, both strengthening our collective power and introducing those fighting for other issues, to our cause.

  • To learn more about HCAO rapid response and direct action organizing contact our Education Committee Chair, Hyung Nam.

These are some of the ways, if we work together, we can realistically win universal publicly funded health care in Oregon! For more information, contact Mobilization Chair Lee Mercer.