Socialist Health Care Organizers Exit DSA

By Scott Tucker and Larry Gross
Published September 17, 2023
We are members of the Healthcare Justice Committee of the second largest chapter of the largest socialist group in the United States, namely the Los Angeles chapter of the Democratic Socialists of America (DSA-LA). We also work in a close coalition with members of Health Care for US (HC4US), and with independent socialists who are members of various community groups and social movements. We are committed to the public policy goal of a single-payer health care program, but we have found that our collective work cannot advance at present within DSA-LA. We are therefore resigning from membership in the entirety of DSA; the Los Angeles chapter and the national organization, and we are publishing this open letter to address the local and national membership of DSA, and the much larger number of progressives and socialists among the people of this country.
As is well known, the presidential campaigns of Bernie Sanders in 2016 and 2020 not only underlined the issue of Medicare for All and of single-payer health care, but also boosted the membership of DSA from roughly 6,000 members to just over 90,000 members. As a campaigner who filled stadiums with supporters, and who openly called for political revolution, Sanders deserves solid credit for renewing a national conversation about both democracy and socialism. Socialists crossed all lines of age, sex, race, and class, and were moving from protest to power.
Raising the ground floor of social democracy in health care cannot be optional for democratic socialists, no matter whether we work within the existing party system or outside it, and no matter whether we are members of DSA or not. Single-payer health care is a radical reform, in the sense that it does go to the roots of our present health care system, which has built in disparities that track along the lines of sex, race, and class. Indeed, every pandemic, including AIDS and Covid, reveals the “pre-existing conditions” of a class divided economy and culture, though in starker relief and detail when we study epidemiological charts and statistics.
To extract higher profits from a population of patients, the insurance companies insure themselves first and foremost.
A single-payer health care system is not a magical potion nor a social cure-all. It is, however, both a great moral and medical advance beyond a “free market” system that encourages perverse incentives among health insurance cartels. To extract higher profits from a population of patients, the insurance companies insure themselves first and foremost. They are like casinos that play the probabilities of their own gambling tables and machines, and stay in business at the general expense of most gamblers, though some will of course walk away with money. Likewise, insurance companies have greatly improved their older actuarial tables, and have much greater health data to cherry pick the healthier patients, and to lemon drop the sicker patients. Single payer requires a common “risk pool” of all patients: Everybody In, Nobody Out.
Although Medicare for All was the definitive issue raised by Sanders in his 2016 and 2020 campaigns, and among the most powerful magnets drawing new and younger members to DSA, the organization has retreated from a commitment to pursuing single-payer health programs in order to accommodate the interests of Democratic politicians both at the national and the state level. While President Biden has been honest in his opposition to single-payer, vowing to veto such a bill were it to arrive on his desk, California governor Newsom twice ran on a single payer pledge, proclaiming in 2017, “I’m tired of politicians saying they support single-payer but that it’s too soon, too expensive or someone else’s problem.” The California Nurses Association sponsored a bus that toured the state with a picture of Newsom’s face and these words: “Nurses Trust Newsom. He shares our values and fights for our patients.”
But their trust was misplaced. Newsom did not share their values nor fight for patients. In early 2022, Newsom introduced his budget while the state Assembly began to move a single payer bill called CalCare. When he was asked about it, Newsom got testy and replied, “I have not had the opportunity to review that plan, and no one has presented it to me.” Though Newsom said that single-payer was still “the ideal system,” he added: “The difference here is when you are in a position of responsibility, you’ve gotta apply, you’ve gotta manifest, the ideal. This is hard work. It’s one thing to say, it’s another to do. And with respect, there are many pathways to achieve that goal.”
We do not need leaders of DSA to play riffs on Newsom’s deadbeat excuses, or to explain why it is such hard work for Newsom to do what he says. As for “many pathways” to achieve the goal of single-payer, a long-time member of DSA named Michael Lighty has served California’s career politicians so well in changing the subject from an actual single-payer program to a legislative campaign of false advertising. Lighty worked from 1994 to 2018 for the California Nurses Association / National Nurses United, “where he coordinated campaigns for an HMO patients’ bill of rights,” according to his profile online as a Fellow of the Sanders Institute. Lighty served as Healthcare Constituency Director for the 2020 Sanders campaign. He also is a Medicare for All consultant with National Union of Healthcare Workers (NUHW), and is President of Healthy California Now (HCN), billed on the same Sanders Institute site as “the state single-payer coalition.” NUHW is the primary sponsor of HCN.
Except that HCN is not a single payer coalition. HCN’s signature effort this year was the introduction of SB770, which has now passed the legislature, and which we believe is intended to distract, delay and divert the campaign for CalCare, which is a true single-payer bill.