Part of a series called Crossroads: Policy and Politics written by Michael Lighty, President of Healthy California Now

Since legislators in the US began promoting national health insurance in the 1930’s, it has been the clearly preferable policy and financial approach to achieve universal healthcare. Absent a predominant public single payer, there is no way to guarantee healthcare. Yet, we are still mired in a commercial insurance model, increasingly expensive and life-threatening. Many activists continue to assert the righteousness and policy advantages of single payer and that Democrats in particular should therefore enact that policy.

Clearly, that assertion by itself is insufficient.

What our demand for guaranteed healthcare requires for success is a political strategy to move legislators to adopt single payer based on their political self-interest – whether they “want to” or not. That in turn requires political leadership and a clear path including incurring political costs for failure to act.

We are at such a moment now – when the Governor who ran in support of single payer faces a recall attempt that if successful would be disastrous for us. So first, we must show the continued viability of the pro-single payer Governor, which means defeating the recall. Secondly, we need to show a clear path toward single payer that includes demonstrating support for California Medicare for All from the Biden administration and influencing the report of the Healthy California for All Commission toward a favorable position on single payer financing.

Finally, in the 2020 primary and general elections we need to support pro-single payer candidates over opponents – of whatever party, and that includes primary challenges where necessary.

These strategic elements depend on building institutional support among those groups that drive policymaking in the California legislature – labor unions, businesses, and community-based organizations.

Winning single payer in California means not only guaranteeing healthcare to all who live here, but likely propels the adoption of improved Medicare for All nationally. As former Vermont Governor Peter Shumlin said at the Healthy California for All Commission, if California were seriously moving to adopt single payer, Democrats in Congress would be compelled to enact it.

Let’s not mourn the failure of politicians to do the obvious, right thing in healthcare to save lives and money. Instead, let’s organize the political forces necessary to win.