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The Left's Surprising Organizing Advantage


Last week, the Health Care for America Now coalition celebrated its first birthday. Formed, well, a year ago, with an initial infusion of $40 million and a coalition list that includes, SEIU, the Campaign for America's Future, and pretty much every other institution even vaguely on the left, HCAN has quickly become the dominant grassroots player on health-care reform. Which is really saying something.

Talk to veterans of the 1994 effort and they will invariably lament the total absence of a liberal ground game. The grassroots energy came primarily from conservative groups and trade organizations. The National Federation of Independent Business was, for instance, very effective at influencing legislators. So too was the Chamber of Commerce. There was no analogue on the left. Unions were exhausted and angry after the NAFTA battle. All-purpose progressive organizations like and Campaign for America's Future were largely non-existent. The conservatives dominated talk radio, but liberals did not have the online organizing infrastructure that they've utilized so successfully in recent years.

This year, the legislators flipping their positions under activist pressure are centrist Democrats who have been targeted by HCAN and its allies. The news stories about rallies and letter-writing campaigns and grassroots efforts tend to feature liberals organizing in support of the public option. And then, of course, there's the 800-pound gorilla that is Organizing for America, Obama's grassroots structure. The millions and millions of supporters on that list haven't really been activated yet, but there's every indication that they will be.

And on the other side? A former hospital corporation CEO who had to resign amid allegation of widespread fraud has formed Conservatives for Patients Rights. The insurer Wellpoint is beginning to campaign against the public option. Other, more credible, groups could eventually step into the void. But they'll have lost a lot of crucial preparation time. And there's no umbrella organization playing the coordinating role of HCAN.

There are a couple caveats to this, of course. The energy on the left is, for better or worse, substantially linked to the public plan. If something called a "public plan" isn't in the final legislation, it will be difficult to sustain their enthusiasm. And conservatives have an extremely potent and agile grassroots mechanism built around talk radio. Indeed, when that kicks into gear, you'll probably see the first real battle between the online left and the airwave right. But unlike in 1994, it will actually be a fight.

Photo credit: Tim Sloan/Getty Images.

By Ezra Klein  |  July 14, 2009; 7:13 AM ET
Categories:  Health Reform  
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The subsidies given out on the exchange will equal about 400-500 billion. The public plan will make that around $150 billin cheaper. If it is removed that means subsidies to help people buy insurance will be need to be made 25% less generous.

The public plan is directly linked to making health care affordable.

Posted by: JonWa | July 14, 2009 7:27 AM | Report abuse

That's right, JonWa.
A good public plan makes healthcare more affordable for individuals/employers AND government.

It probably becomes a bit less profitable for insurers but it's not like anybody's entitled to great wealth, right? They'll be just fine if they do a good job. In fact, they get the added bonus of not having to worry about a single payer system that might replace them if the whole system is allowed to collapse.

Posted by: jefft1225 | July 14, 2009 8:49 AM | Report abuse

What it all boils down to, and what's got the Left so up in arms about it, is that the Left understands that healthcare is not a benefit or priviledge, it is a right. And it is downright shameful that the United States of America is the ONLY truly industrialized country that does NOT take care of all of its citizens thru some sort of "universal"-type insurance, be it public, private, or a mix of the two.

I love arguing this point with some conservatives (including my own family), especially those under Medicare or covered under the VA plan, which are... drumroll, please... PUBLIC PLANS!!!!! Argument usually goes something like this: "So, if you dislike Public plans so much, why don't you drop your coverage"? Conversation usually ends there... ;-)

Posted by: JERiv | July 14, 2009 9:10 AM | Report abuse

Given that in the past you have mentioned (and partially convinced me) that the national insurance exchange and the rules around it are even more important than the existenmce of a public plan, can you give an update on where the various proposals stand regarding the rules for that exchange? Also, could you do a comparison of the various proposals regarding incentives to make care more integrated by trying to gather doctors and care providers into networks that share patient information? Thanks.

Posted by: mufti2 | July 14, 2009 10:49 AM | Report abuse

I keep hearing people say that Obama hasn't activated Organizing for America yet but it's just not true. I get about one email a week from it on health care. They organized house parties about a month ago. They've phoned me two or three times to volunteer. Last week or so they sent out an email linking to a tool for calling your reps on health care (including the public option). They just sent out a link to a letter to the editor tool on health care.

Some smart journalist ought to cover this story!

Posted by: chrismealy | July 14, 2009 1:00 PM | Report abuse

The rep-needling tool:

Posted by: chrismealy | July 14, 2009 1:00 PM | Report abuse

the reason that others on the right haven't stepped to the plate yet is that Obama has outrightly threatened them to deny them a "seat at the table" if they don't cowtow to his whims. To me that is a strategic mistake they are making because everyone knows Obama wants single payer. I just hope he realizes when hosptials close and you have to have ambulances driving 40-50 miles when they used to drive 10-20 that people's care will be affected.

At some point he actually has to address the cost curve that he spoke about so much before but all everyone seems to be talking about now is how to tax whoever they can.

The cost curve is spending less, getting healthier and putting programs in place that reward people for not being obese and having illnesses related to that.

Bending the cost curve is not adding more government programs.

To me they should write a law to either FORCE all insurers to be non profit or make every state adhere to a strict 85% medical loss ratio. At this point insurance carriers would see that as a welcome alternative to a public plan and it would save the taxpayers trillions in not having to go through a public plan and spending years to implement it while people get substandard care in the meantime.

Put in an 85% medical loss ratio effective 1/1/2010, get rid of pre-ex and actually regulate insurers.

that should do the trick and save trillions but that's not the democratic way of spend, spend spend.

Posted by: visionbrkr | July 14, 2009 1:08 PM | Report abuse

Public plan without the strong regulation of the private insurers is not going to do the trick. The margins of ALL insurers need to be regulated or squeezed. Visionbrkr has it about right.

Posted by: michaelterra | July 14, 2009 3:31 PM | Report abuse

Imagine if they had spent that money and time on actually providing healthcare services to people in need.

Posted by: fallsmeadjc | July 14, 2009 4:08 PM | Report abuse

The Constitution is supposed to protect us from mob rule.

The best way to build a majority in this country is to exploit stupidity and incite hysteria. Being good at that should not qualify someone to punish everyone they weren't able to manipulate.

Posted by: fallsmeadjc | July 14, 2009 4:13 PM | Report abuse


i agree but you see mine can be done WITHOUT a public option (and maybe if forced to with co-op plans) and just stronger government regulation of cost. ALso with correct oversight don't let insurers "fiddle" with the medical loss ratio. Give it strict definitions as to what is and what is not cost and then we can have true reform (including ending pre-ex)

oh and we don't need to spend a couple TRILLION dollars to do it.

The problem with the proposals is that there are processes in place to handle most of these things already, they're just not enforced.

Posted by: visionbrkr | July 14, 2009 5:06 PM | Report abuse


The healthcare reform bill released by the House Of Representatives is an excellent bill as I understand it. It is carefully written, and thoughtfully constructed, informed, prudent and wise.

This is the type of bill that all Americans can feel good about. And this is the type of bill that has the potential to dramatically improve the quality of healthcare for all Americans. Rich, middle class and poor a like. Democrats, Republicans, Independents, and all other party affiliations. This bill has the potential to dramatically improve the quality of life of every American.

The house healthcare bill should be viewed as the minimum GOLD STANDARD by which all other proposed healthcare legislation should be judged. All supporters of true high quality healthcare reform should now place all your support behind this healthcare reform bill released by the United States House Of Representatives, as the minimum Gold standard for healthcare reform in America.

You should all now support this bill with all your might, and all of your unrelenting tenacity. This healthcare bill is a VERY, VERY GOOD! bill for all of the American people. Fight tooth, and nail for every bit of this bill if you have too. Be aggressive, creative, and relentless for this bill.

AND FIGHT!! like your life and the lives of your loved ones depends on it. BECAUSE IT DOES!


God Bless You

Jack Smith — Working Class

Posted by: JackSmith1 | July 14, 2009 10:02 PM | Report abuse

This is not a good thing. This is nothing but the replication of federalized cancer cells within our society. It must be stopped.

Posted by: fallsmeadjc | July 14, 2009 10:42 PM | Report abuse

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