Tuesday, May 30, 2017

Beating the War Drums... Again

Tomgram: Danny Sjursen, Beating the War Drums... Again

Posted by Danny Sjursen at 7:46am, May 30, 2017.

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You couldn't make this up, could you? 

Just before President Trump’s recent visit to Saudi Arabia, a genuinely despotic land with an extreme ideology and lacking elections, Iran’s moderate president, Hassan Rouhani, was swept back into office.  It was an exuberant election campaign in which he trounced a hardline fundamentalist opponent, winning 57% of the vote.  Voter turnout was reportedly close to 73%, which, by the way, beat turnout in the 2016 American presidential election by about 18%.

In Riyadh, addressing an “Arab Islamic American summit,” Trump had no words of sympathy or encouragement for any “victims” in Saudi Arabia.  He was, however, little short of effusive on the Iranian “victims” who had just voted in that election.  “The Iranian regime’s longest-suffering victims,” he said, “are its own people. Iran has a rich history and culture, but the people of Iran have endured hardship and despair under their leaders’ reckless pursuit of conflict and terror.”  Undoubtedly with the hardships of the Iranian people in mind, he also came bearing a gift for the Saudis who now live with an increasingly brutal quagmire of a war in neighboring Yemen: $110 billion in shiny, “beautiful” new American weaponry of every sort and the implicit threat to Iran that some of those weapons might, in the future, be used against its military.

In response to the American presidential visit, Rouhani commented sardonically, “Mr. Trump arrived in the region at the time when he saw 45 million Iranians participating in the elections. Then he visited a country that I doubt knows the definition of elections. The poor things have never seen a ballot box.”  In what might be taken as a backhanded reference to Trump’s 2016 campaign claims that the Saudis were behind the 9/11 attacks, he added, “I do not think the American people are ready to trade the lives they lost in September 11th with billions of dollars gained through weapons sales.”

As it happens, from CIA Director Mike Pompeo to Secretary of Defense James Mattis, the Trump administration is filled with figures who seem to believe that, of all the countries in the Greater Middle East, Iran has the least in common with the United States and is the greatest threat to it.  Back in 2010, when he was still head of U.S. Central Command, for instance, then-General Mattis reportedly responded to a query from President Obama about the top three threats in his vast area of responsibility by saying, “Number one: Iran. Number two: Iran. Number three: Iran.” According to the Washington Post, before the White House reined him in, Mattis was also preparing to launch a “dead-of-night” attack on Iran to take out a power plant or an oil refinery (his idea of a measured response to Iranian-armed Iraqi Shiite militias then killing American soldiers). Little has seemingly changed since, except that Iran’s unique evil and the dangers it poses to the U.S. have emerged as something of an idée fixe of the new president, not just his commanders.  

Today, TomDispatch regular Army Major Danny Sjursen, author of Ghost Riders of Baghdad: Soldiers, Civilians, and the Myth of the Surge, explores the irrationality of Washington’s thinking when it comes to Iran, an obsessive hysteria that could lead to yet another catastrophic American conflict in the Greater Middle East. Tom

America’s Iran Hysteria

The Irrationality of Iran Vilification

“Everywhere you look, if there is trouble in the region,” Secretary of Defense James Mattis told reporters on a mid-April visit to Riyadh, Saudi Arabia, “you find Iran.”

I must admit that when I stumbled across that quote it brought up uncomfortable personal memories.

East Baghdad, January 25, 2007: my patrol had missed a turn and so we swung onto the next grimy avenue instead.  As platoon leader, I rode shotgun in the second of our four vehicles, yakking away on the radio.  The ensuing explosion rocked the senses: the sound, the blinding dust, and the smell -- a mix of burnt metal and, well... I still can’t bring myself to describe it.

Our lead HMMWV, a military utility vehicle, aimlessly swerved right and came to rest beside a telephone pole. Only then did the screams begin.

The “cost” would be two wounded and two dead: my then-unborn son’s namesakes, Specialist Michael Balsley and Sergeant Alexander Fuller.  These were our first, but not last, fatalities.  Nothing was ever the same again.  I’m reminded of poet Dylan Thomas’s line: “After the first death, there is no other.”

The local militia had shredded our truck with an advanced type of improvised explosive device that was then just hitting the streets of Baghdad -- an explosively formed projectile, or EFP.  These would ultimately kill hundreds of American troops.  Those EFPs and the requisite training to use them were provided to Iraqi militias by the Islamic Republic of Iran. It’s a detail I’m not likely to forget.

Still, there’s one major problem with bold, sweeping pronouncements (laced with one’s own prejudices) of the sort Secretary of Defense Mattis recently offered on Iran: they’re almost always wrong.  It’s the essential flaw of “lumping” -- that is, of folding countless events or ideas into one grand theory.  But, boy, does it sound profound!  The truth is that Iran is simply not behind most of the turmoil in the Middle East, and until Washington’s policymakers change their all-Iran-all-the-time mental model, they are doomed to failure.  One thing is guaranteed: they are going to misdiagnose the patient and attack the wrong disease.

Look, I’m emotionally invested myself.  After all, I fought Iranian-trained militiamen, but a serious, workable national strategy shouldn’t rely on such emotion.  It demands a detached, rational calculus.  With that in mind, perhaps this is the moment -- before the misdiagnosis sets in further -- to take a fresh look at the nature of America’s thorny relationship with Iran and the Islamic Republic’s true place in the pantheon of American problems in the Greater Middle East.

Let’s start this way: How many Americans even realize that there are only three countries in the world with which their country has no ongoing diplomatic relations at all? Actually, the number was four until the Obama administration began slowly normalizing bilateral ties with one longtime member of the naughty list: Cuba.  How many could name the three remaining states on that roll of shame?  The first and easiest to guess is surely North Korea; the most obscure is Bhutan (the “Switzerland of the Himalayas”).  And, yes, of course, last but by no means least is the Islamic Republic of Iran.

Think of all the scoundrels not on that list: Robert Mugabe’s Zimbabwe; our Pakistani “frenemy”; Vladimir Putin’s Russia; Equatorial Guinea with its craven, 40-year dictator, accused of cannibalism; and, until 2012, Bashar al-Assad’s grim Syrian regime.  Throughout the Cold War, the U.S. kept an embassy in the Soviet Union and it similarly maintained formal relations with apartheid South Africa.  As of 2014, the State Department officially dealt with nine-tenths of the globe’s most abusive regimes, according to the Human Rights Risk Atlas.

So, is the secretary of defense correct? Is Iran really behind all regional trouble in the Greater Middle East?

Hardly.  In fact, such an assertion -- and the language of absolutes that goes with it -- is by definition problematic.  In a Washington filled with Iranophobes, the demonization of that country is already a commonplace of everyday political chatter and it almost invariably rests on three inflated assumptions about Iran’s menacing nature: that it is on an eternal quest to develop and perhaps employ nuclear weapons (especially against Israel); that it massively supports regional “terrorists” and their proxies; and that it regularly exhibits an unquenchable desire to establish its regional hegemony by force of arms.  All three suppositions rest on another faulty assumption: that Iran has a straightforwardly dictatorial system of fundamentalism led by irrational “mad mullahs.”

Let’s consider each of these propositions.

The Iran Exaggeration

Close your eyes for a moment and imagine a Middle Eastern country -- no, not Israel -- but one with a sizeable, protected Jewish community, a place where Islam is the state religion but its president regularly tweets Rosh Hashanah greetings for the Jewish New Year.

Sounds like somebody’s wild fantasy, but it’s actually Iran.  In fact, the Islamic Republic sets aside one mandatory seat in its parliament for a Jew, three for Christians, and another for a Zoroastrian.  It would be a mistake to conclude from such token gestures that Iran is a paragon of tolerance.  But they do speak to the complexity of a diverse society full of paradox and contradiction.

It certainly is a land in which hardline fundamentalists chant “Death to America!” It’s also a country with an increasingly young, educated populace that holds remarkably positive views of Americans.  In fact, whatever you might imagine, Americans tend to have significantly more negative views of Iran than vice versa.   Don’t be shocked, but Iranians hold more positive views of the U.S. government than do the citizens of Washington's allies like Egypt, Jordan, and Turkey.  In reality, there’s long been a worrying paradox in the region: an inverse relationship between the amiability of a government’s relationship with Washington and the favorability ratings of this country among its people.

In other words, when it comes to Iran... well, it’s complicated.  The trouble is that Americans generally don’t do nuance.  We like our bad guys to be foreign and unmistakably vile, even if such a preference for digestible simplicity makes for poor policy.

If you want to grasp this point more fully, just think about Secretary of Defense Mattis’s recent statement again. He assures us that Iran’s shadow hovers over every regional crisis in the Middle East, which is empirically false.  Here, for instance, are just a few recent conflicts that Iran is not behind or where its role has been exaggerated:

* The Arab Spring and the subsequent chaos in Tunisia, Libya, and Egypt.  Iran didn’t start or significantly influence the uprisings in those countries.

* Turkey’s decades-long war with separatist Kurds in its southeast provinces.  Again, not Iran.

* The ongoing spread of al-Qaeda affiliates in Syria and on the Arabian Peninsula.  Iran actually abhors such groups, and certainly wasn’t behind their rise.

* Or, if you want, take Yemen, since supposed Iranian meddling in the Middle East’s poorest state happens to be one of the favorite drums Washington’s Iranophobic hawks like to beat.  And yet a range of credible reports suggest that the much-decried collusion between Iran and the Houthi rebels, who are the focus of the Saudi war in that country, is highly exaggerated.

Look, Iran is a significant, if often thwarted and embattled, regional power and a player, sometimes even a destabilizing one, in various regional conflagrations.  It supports proxies, funds partner states, and sometimes intervenes in the region, even sending in its own military units (think Syria).  Then again, so does Saudi Arabia (Yemen and, in funding terms, elsewhere), the United Arab Emirates (Yemen), Russia (Syria), and the United States (more or less everywhere).  So who’s destabilizing whom and why almost invariably turns out to be a matter of perspective.

The State Department and various other government agencies regularly label Iran the world’s leading “state sponsor of terrorism” -- and that couldn’t sound more menacing or impressively official and authoritative.  Yet to tag Iran as #1 on any terror list is misleading indeed.  The questions worth asking are: Which terrorists?  What constitutes terrorism?  Do those “terror” outfits truly threaten the U.S. homeland?

As a start, in 2016, the State Department’s annual survey of worldwide terrorism labeled ISIS -- not Iran, Hezbollah, or the Houthis -- as "the greatest [terror] threat globally." How do we square that “greatest sponsor” stamp with an Iran that has proven both thoroughly hostile to and deeply invested in the fight against ISIS and various al-Qaeda-linked groups in Iraq and Syria?

Iran does support Hezbollah in Lebanon and Hamas in the Palestinian territories.  However, lumping regionally focused nationalist organizations like Hezbollah with genuine global jihadist groups like ISIS and al-Qaeda (in its proliferating forms) is deceptive, often purposely so.  The Lebanon-based Hezbollah, for example, is largely fixated on Israel, but has sometimes even fought ISIS in Lebanon and Syria.  In other words, Hezbollah, though it had previously attacked U.S. troops in the region, isn’t sending its operatives to crash planes into American buildings.

To think of it another way, more foreign ISIS volunteers hail from Belgium or the Maldives Islands than from Iran. In fact, most of the top sources of ISIS’s foreign recruits (Tunisia, Saudi Arabia, Turkey, and Jordan) turn out to be “friendly” American “partners.”  From 1975 to 2015, Iranian-born terrorists inflicted zero deaths in attacks on U.S. soil.  In contrast, citizens of key U.S. allies -- Saudis, Egyptians, and Lebanese -- killed thousands on 9/11.  In fact, since then, 85% of domestic terrorists turned out to be American citizens or permanent residents.  Most were American-born.  Of the 13 U.S. citizens involved in such fatal terror attacks, none were Iranian-American.

As to the charge that Iran is by nature an aggressive power, there can be little question that the Islamic Republic aggressively pursues its regional interests.  That, however, by no means makes its moves automatically antagonistic to Washington’s interests in the region.  If anything, as a Pentagon assessment concluded in 2014, its military strategy is ultimately defensive in nature and based on a feeling of being threatened, which makes sense when you think about it.  After all, when it comes to American power -- from the 1953 CIA-British coup that overthrew Iran’s elected prime minister and installed the autocratic Shah to Washington’s support for Iraqi autocrat Saddam Hussein in his war of aggression against Tehran (1980-1988) to the present administration’s all-in support for the autocratic Saudis in an anti-Iranian partnership, they have legitimate reasons to feel threatened.

In addition, unlikely as it may seem to most Americans, on certain issues like a Taliban-free Afghanistan, the U.S. and Iran actually have had converging, if complex, interests. Additionally, though Iran once promoted Iraqi Shiite militias that attacked and killed U.S. troops (including my soldiers, Mike Balsley and Alex Fuller), today, both countries desire a relatively stable, ISIS-free Iraq. None of this is easy to swallow (least of all by me), but prudent strategy demands a dispassionate, rational assessment of inherently emotional issues.  Unfortunately, when it comes to Iran, that’s hardly an American predilection at the moment. 

The Company We Keep 

In 1957, the U.S. supplied a key regional leader with his first (“peaceful”) nuclear reactor, as well as the necessary scientific training for those who would run it and some weapons-grade uranium to power it. Then, in the 1970s, American experts began to fear that their partner might be seeking to develop nuclear weapons on his own.  A few years later, revolutionaries overthrew him and inherited that American-originated program. That leader was, of course, the man the Americans had installed as ruler of Iran in 1953, Reza Shah Pahlavi.

It always struck me as odd that Iran made the cut for the very exclusive membership in George W. Bush’s “axis of evil.”  After all, unlike those 15 Saudi hijackers and perhaps even the Saudi government, it had no connection to 9/11 and was “comprehensively helpful” in the initial takedown of the Afghan Taliban and the arrest of fleeing al-Qaeda fighters.

By contrast, consider just a few of Washington’s “partners” in the region:

* Saudi Arabia: this monarchy enforces a strict brand of conservative Wahhabi Islam not so terribly different from the basic theology of ISIS.  The Saudi government publicly executes an average of 73 people per year, including juveniles and the mentally ill.  Beheading is the favored technique. (Sound familiar?)  Nor are all the victims convicted murderers.  According to a 2015 Amnesty International report, “Non-lethal crimes including adultery, robbery, apostasy, drug-related offenses, rape, ‘witchcraft,’ and ‘sorcery’ are punishable by death.”  In addition to its citizens carrying out the 9/11 attacks, Saudi Arabia supported a branch of al-Qaeda (Jabhat al-Nusra) in the Syrian conflict.  Furthermore, its ongoing U.S.-backed air strikes against Yemen’s Houthi rebels have been killing numerous civilians and may have helped to cause and further intensify a disastrous famine. The U.S. response: a record-breaking $110 billion arms deal for the Saudis.

* Egypt: In the wake of a 2013 coup d’état led by General Abdel Fatah al-Sisi against an elected government, that country’s military gunned down hundreds of demonstrators.  Since then, its strongman has used “mass, arbitrary arrests,” tortured detainees, and conducted “extrajudicial executions” -- all in the interest of retaining power.  The U.S. response: $1.4 billion in (mostly military) foreign assistance in fiscal 2017.  To top it off, President Trump recently invited Sisi to the White House, lauded the dictator’s “fantastic job in a very difficult situation,” and is planning a future visit to Egypt.

* Turkey: this formal ally boasts NATO’s second largest military and hosts an important U.S. airbase.  Unfortunately, Turkey is increasingly unstable thanks to a recent coup attempt, its ongoing war with Kurdish separatists, and an escalating intervention in Syria’s civil war.  Worse yet, after relaunching an internal war against Kurdish rebels, its president, Recep Tayyip Erdogan, has taken the country into distinctly autocratic terrain in the wake of a narrow victory in a referendum that does away with the office of prime minister and further centralizes executive power in his hands.  Turkey’s deteriorating human rights record includes the pre-trial detention of more than 40,000 coup “suspects,” the summary dismissal of 90,000 civil servants, the shuttering of hundreds of offices of nongovernmental organizations and media outlets, and the imposition of a 24-hour curfew in the predominantly Kurdish southeastern part of the country. The U.S. response: $3.8 million in direct (military) assistance in fiscal 2017, and promises to continue arms sales which topped $2.3 billion last year.

This motley crew has one thing in common -- they’re no angels. 

“Rip It Up”

Iran hawks live on both sides of the political aisle.  In 2015, for example, Hillary Clinton told an audience at Dartmouth College that Iran represents “an existential threat to Israel.”  Though she expressed tacit support for Obama’s then-pending nuclear deal -- the Joint Comprehensive Plan of Action, or JCPOA -- she added that “even if we do get such a deal, we will still have major problems... [Iran is] the world’s chief sponsor of terrorism.”

When it comes to real rancor toward Iran, however, you have to look to the right.  Senator John McCain, for instance, immediately cried foul about the JCPOA, calling it a “bad deal” likely to “nuclearize” the Middle East.  More colloquially, as both a candidate and as president-elect, Donald Trump repeatedly vowed to “rip it up,” while former governor and presidential hopeful Mike Huckabee accused President Obama of “marching the Israelis to the door of the oven.”

Despite the bellicose rhetoric, intelligence and congressional testimony indicate that Iran is complying with the JCPOA.  Former Chairman of the Joint Chiefs General Martin Dempsey -- not exactly a dove -- believed that the deal reduced the risk of Iran weaponizing its nuclear power. All the appeals from the president, various pundits, neocons of every sort, and congressional hawks to withdraw from it also neglect an obvious reality: the JCPOA is a multilateral deal and none of our partners (Russia, China, Great Britain, France, and Germany) will support “tearing up” the agreement.  Imagine the optics of a future American unilateral abrogation of an agreement Iran is complying with: the onus will be on Washington alone; its allies will continue to abide by the deal and, with genuine justification, Iran’s leaders will be able to depict the Americans as destabilizing “cowboys.” 

Here’s the reality of the present situation: despite decades of sanctions and the military containment of Iran, the U.S. has not significantly affected its policies or stance in the region.  Few in Washington display the courage to ask the crucial question: Why continue?  Why not a creative new approach -- the gradual normalization of relations?

Though you wouldn’t know it, given the prominence of Iranophobes in Washington, the U.S. has little to lose.  Current policy is counterproductive in so many ways, while Washington’s never-ending bellicosity and threats to “rip up” the nuclear agreement only undercut Iran’s moderates and the eminently sensible President Hassan Rouhani, who recently won a smashing electoral victory against a hardline, fundamentalist opponent in which a stunning 73% of Iranian voters cast ballots. Why not make it more, not ever less, difficult for Iran’s conservatives to vilify the U.S.?

Forty Years of Failure

There’s an uncomfortable truth that Washington needs to face: U.S. policy toward Iran hasn’t achieved its goals despite almost four decades of effort since an American-installed autocrat was overthrown there in 1979.  Foreign policy hawks -- Democrats and Republicans alike -- will undoubtedly fight that reality tooth-and-nail, but as with the Cuban embargo, Iranian isolation has long outworn any imagined usefulness.  That ostracizing Iran remains fashionable reflects domestic political calculus or phobic thinking, not cogent strategy, and yet our new president just traveled to Saudi Arabia, a truly autocratic country, and in the wake of an Iranian election that was by all accounts resoundingly democratic, denounced that land as despotic and all but called for regime change

So here’s a question that, believe it or not, is okay to ask and is not actually tantamount to treason: What exactly does Iran want and fear?  It wants international legitimacy, security, and a reasonable degree of regional power (not world domination). It fears continued isolation, any coalition of hostile Sunni Arab nations led by Saudi Arabia (assisted by Israel), and U.S.-sponsored attempts at regime change. If you think that makes the Iranians sound paranoid, just check out the recent celebratory get-together in Saudi Arabia or remember how, just before the Bush administration’s 2003 invasion of Iraq, Newsweek quoted a senior British official summing up the situation in Washington this way: “Everyone wants to go to Baghdad. Real men want to go to Tehran.”

In sum, U.S. policy in the Middle East is confused, contradictory, counterproductive, and dangerous.  It could leave Washington involved in a war with Iran. (And given our recent wars in the region, imagine where that’s likely to land us.)

The U.S. doesn’t require more enemies. Its hands are already full enough without additional faux “existential” threats or, as John Quincy Adams warned so long ago, eternally going “abroad seeking monsters to destroy.”

Oddly enough, the Trump administration has a unique opportunity to normalize relations with Iran.  While President Obama’s modest overtures toward that country were greeted with scathing partisan scorn, President Trump might just be able to garner enough Republican support to do so much more, were he ever to try.  At the moment, he clearly possesses no such plans, and yet, as only Nixon could go to China, perhaps only Trump can go to Tehran!

My small bit of advice, however: don’t hold your breath...

Major Danny Sjursen, a TomDispatch regular, is a U.S. Army strategist and former history instructor at West Point. He served tours with reconnaissance units in Iraq and Afghanistan. He has written a memoir and critical analysis of the Iraq War, Ghost Riders of Baghdad: Soldiers, Civilians, and the Myth of the Surge. He lives with his wife and four sons near Fort Leavenworth, Kansas.

Monday, May 29, 2017

Trump voters and progressives agree on this

The Cross-Partisan Appeal of Single-Payer Healthcare

In early April, a public radio program in the Rust Belt city of Rochester, N.Y., spent an hour discussing healthcare—but not, as you might expect, the GOP’s attempt to repeal and replace Obamacare. It focused instead on the brightening prospects for a single-payer healthcare system. The guests included a Trump voter and small-business owner, Tim Schiefen, and the co-chair of the Rochester chapter of the Democratic Socialists of America (DSA), Karen Vitale. What was remarkable was how little they disagreed. 

Asked his opinion of single-payer, Schiefen responded that it was worth exploring. “The problem is putting the foxes in charge of the henhouse,” he said. “Why are we allowing these gross, overspending health insurance companies … to administer this stuff?” 

Increasingly, the single-payer solution is generating that sort of consensus across ideological and party affiliations. In early April, an Economist/ YouGov poll showed that 60 percent of respondents supported a “Medicare for all” system, including 43 percent of people who identified as conservative and 40 percent of Trump voters. 

The energy behind single payer is partly a result of the GOP’s success in pointing out the flaws in Obamacare, then failing to offer a workable alternative. Vitale believes that, in a paradoxical way, it’s also driven by Trump. 

“I think Trump broke open a lot of things,” says Vitale, who grew up in a rural small town an hour south of Rochester. She says that the Trump voters she knows trusted his populist pitch— and “now they’re activated, and they’re acting from a place of self-interest. You can’t put them back in the box.” When Trump breaks campaign promises, she predicts, “They’re going to notice really quickly. They noticed with Trumpcare.” 

That doesn’t mean they’re ready to abandon Trump. On the radio program, Schiefen said he appreciates Trump’s “moxie” and has no regrets. But he also said he would be willing to vote for Democrats with better ideas. “The whole system is built too much on us [versus] them,” he said. “Let’s put aside the differences. Let’s get to the root of the concern.” 

A healthy interest 

Vitale and other members of the Rochester DSA are part of a coalition pushing for single-payer reform in New York State. In early April, they traveled to Albany to lobby state legislators. They also regularly canvass the city, educating people about single payer and urging them to call their representatives. 

“It’s not difficult to talk about healthcare with people from across the spectrum,” Vitale says. “People want to pit rural Trump voters against the educated, progressive people in the cities, and that’s not where the tension is. The tension is with suburban Trump voters who are wealthy and doing very well in our current healthcare system, and have no interest in reform.” 

The power of single payer as an organizing tool seems to hold true across the nation. As with many DSA chapters, the East Bay DSA has seen a spike in membership since the election, and much of the new energy is being channeled into the push for single payer. The chapter sends hundreds of volunteers each month to canvass on behalf of the Healthy California Act, which would create a state single-payer system. 

“It’s strategic because it’s something that’s going to profoundly benefit the vast majority of people,” says Ari Marcantonio, East Bay DSA’s lead organizer for the campaign. “So this is an issue we can mobilize tens of millions around. But single mothers, people of color, poor people and immigrants will benefit the most. ” 

Among some conservatives, the shift in thinking on healthcare is being driven by the idea that, as Schiefen said, the insurance companies are profiting at the expense of people’s health. That critique allows them to pin the problems on Obamacare while embracing the idea of universal healthcare. 

Consider Christopher Ruddy, a Trump supporter and CEO of the influential conservative website Newsmax. In a recent editorial, he urged Trump to “reject the phony private health insurance market as the panacea” and lamented that Paul Ryan’s second plan “accepts key parts of the Obamacare law that benefit the insurance industry, but it ends the Medicaid expansion program that benefits the poor and keeps costs down.” 

Ruddy didn’t embrace a full single-payer system. But he did argue that Trump should honor his campaign pledge to provide universal healthcare. It could be achieved, he wrote, by expanding the Medicaid system “to become the country’s blanket insurer for the uninsured.”

When a dramatic expansion of the Medicaid program is a prominent conservative’s solution to our healthcare crisis, we’ve entered uncharted waters. 

A bigger boat 

As recently as last year, the push for a single-payer system seemed virtually dead among the Democratic establishment. Hillary Clinton ran on the promise of tweaking Obamacare. The liberal economist Paul Krugman wrote that Bernie Sanders’ “Medicare for all” proposal was “just not going to happen anytime soon.” 

Now, the goal seems a lot closer. In January, Rep. John Conyers (D-Mich.) reintroduced a bill—originally put forth in 2003—that would create a publicly financed universal healthcare system funded largely by a payroll tax, tax hikes on the rich and a financial transactions tax. Conyers’ bill, The Expanded and Improved Medicare for All Act, has widespread backing from unions, medical organizations and progressive groups, and had 104 co-sponsors as of late April. 

Bernie Sanders has promised to introduce a single-payer bill in the Senate, leading CNN to predict that “Democrats eyeing the 2020 presidential contest could soon face a ‘Medicare-for-all’ litmus test from the party’s progressive base.” At a rally in March, Sanders said, “Every major country on earth guarantees healthcare to all people … don’t tell me that in the United States of America, we cannot do that.” 

This abrupt turnabout is partly a result of the Republican failure to replace Obamacare. The GOP’s flailing has energized and focused the resistance to Trumpism while undermining the party’s legitimacy on the issue. The videos and headlines from raucous town halls have been particularly devastating. A Pew Research poll released in mid-April found a 19-point gap regarding which party is trustworthy on healthcare, with 54 percent saying that Democrats would do a better job. 

At the same time, progressive energy has expanded the horizon of possibilities. Groups devoted to pushing the Democratic Party in a progressive direction—like Justice Democrats, Brand New Congress and Progressive Change Campaign Committee (PCCC)—are making healthcare reform central to their work, and they’ve moved well beyond Obamacare. Brand New Congress, which recruits and supports progressive candidates for office, cites “making Medicare available to anyone who wants it” among its highest priorities. PCCC has collected more than 40,000 signatures on a petition that asserts, “All Democrats running for office in 2018 should publicly support and run on passing Medicare for All.” The goal is “to create a push for Democrats to go bold,” says Kaitlin Sweeney of PCCC. 

These federal reform initiatives are working in synergy with state-level proposals. In Minnesota, state Sen. John Marty introduced legislation in January to create a single-payer system with universal coverage. More than 250,000 Minnesotans are currently uninsured. 

“The Affordable Care Act was a half-baked solution,” says Marty, a member of the Democratic Farmer Labor Party. “I don’t want to minimize for a minute the difference it makes. It covered many millions more people. But … the system is dysfunctional, and it’s getting worse.” 

Drop by drop 

Marty compares the healthcare fight with the struggle for marriage equality, in which state laws created a domino effect. In 2008, he introduced a marriage equality bill in the Minnesota Senate and said it could pass in five years—which it did, in 2013. “This is doable stuff,” he says. “Times are changing and [single payer] could happen.” 

None of the state-level campaigns are a sure thing. The November election turned the Minnesota legislature considerably “redder,” meaning Marty’s bill has no chance in the near term. The Healthy California Act, introduced in February, appears to have broad support in the legislature, but Democratic Gov. Jerry Brown has been skeptical. In New York, single-payer legislation is stuck in the GOP-controlled Senate. 

But if and when one state adopts a single-payer system, it could quickly alter the national political landscape, with implications far beyond the fight for healthcare reform. For DSA, the fight for single payer is intended to be the first stage of a revolutionary program. 

“The single-payer campaign is really about training hundreds of young people who have never been involved in activism or politics to get brass tacks organizing skills, which are door-to-door outreach,” says Ari Marcantonio of East Bay DSA. “We’re using it to build a mass socialist organization, city by city, and the power and the infrastructure we need to win all kinds of things—like a living wage for all workers and housing as a human right.” 

Fundamentally, he says, the aim is to “challenge the very deeply ingrained notion that markets are our friend.”