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Deval Patrick in Amherst


The Amherst town committee hosted Deval Patrick last night at the Jones Library. I've decided to support and volunteer for him (just so you know my biases). This is now the third time I've seen him in front of a crowd -- each one was different -- this was the first one that was public and attended by press.

His stump speech is starting to gel -- he is leading with education, economic development and healthcare. I think he has good ideas all around, but to tell the truth, I am not a policy wonk -- I prefer to pick someone I trust will approach the job in an engaged, intelligent, and open-minded way. I trust Deval Patrick to approach the Governorship this way.

That being said, and with the full acknowledgement that "I am ignorant" on the issues and specific policy choices with regards to healthcare -- I want to talk a little about Patrick's delivery of his thinking on this issue.

Anyone following the healthcare debate in Massachusetts knows that there are basically two leading proposals for getting to universal health-care, single-payer and (in a framing coup for progressives) incrementalism. MA Progressives are by and large lining up behind single-payer. Again, I am not a policy expert, but it's fair to say that single-payer is a transformative event, and as such is politically harder to do than a more incremental approach. This is true for some bad reasons (i.e. vested interests have the resources and influence to stop it) and for some not so bad reasons (i.e. many ordinary healthcare administrative jobs will be lost). Paul Krugman writes a little about this here and here he says:
Nonetheless, someone will eventually have to take on the health care special interests. Who might do that? I'll write about that in the next installment of this series
I think Krugman will suggest that the states will do this, and I think Deval Patrick should take this on now. Patrick insisted that he thinks single-payer is the answer, but acknowledged that he'd be willing to go with an incremental approach to getting there if it could happen fast (he isn't willing to let uninsureds wait). He does not believe that the incremental approach and single-payer approach are incompatible. I agree -- any kind of universal healthcare is a slippery-slope that leads to single-payer -- single-payer addresses the cost of universal healthcare -- once we have universal coverage, we will have to solve the cost problem.

However, this does not mean that we cannot go right to single-payer, and I think Deval Patrick needs to explain how we do that and ask us to help. The room in Amherst was decidely on the side of going to single-payer right now, and Patrick is willing to go there, so I think he needs to take a cue from FDR:
But they were all deeply conscious of the fact that there were national and international interests that transcended the partisan interests of the day. FDR was, of course, a consummate political leader. In one situation, a group came to him urging specific actions in support of a cause in which they deeply believed. He replied: I agree with you, I want to do it, now make me do it. He understood that a President does not rule by fiat and unilateral commands to a nation. He must build the political support that makes his decisions acceptable to our countrymen.
Deval Patick wants single-payer healthcare, but he cannot do it alone -- we must make him do it, but more importantly, he must ask us to make him to do it.