Thread by @joefirestonephd

1) This tweet storm is a lengthy reply to Birrion Sondahl’s “Medicare for All, Not for Some” a critique of efforts working for Universal Health Care programs at the State-level including S-P Programs. See: realprogressives.org/medicare-for-a…

2) Birrion compares a #NIMA strategy w/a State-by-State one. But, Red Berets/WW strategy is "fight on all fronts." (FOAF) It is a strategy pressuring 4 #NIMA, & also supporting State-level Single-Payer (S-P). So, his critique doesn't on its face apply to FOAF.

3) Birrion repeatedly says that only the most wealthy States can afford Single-P. Not true. Savings delivered by S-P can be viewed in terms of savings/person/yr w/upwards of 90% of ppl saving money under S-P, perhaps as much as $3,000. Savings/person critical 2 success!

4) A regional aggregation approach to State-based S-P programs can generate momentum toward #NIMA in successful States & pressure toward NIMA among the “have-nots”.

5) What about “a race-to-the bottom” (RTTB)? What about “a race-to-the-top” (RTTB)? In my view there will be a RTTP if State-level S-P gets started in WA because business, WA, & people will all save money compared to the present system. RTTB critics need specificity.

6) Federal financial passthrus & assistance, Network effects of the FOAF strategy, political pressures & even severe health & economic crises will all interact with State-level S-P programs & #MMT considerations 2 push in the #NIMA direction

7) FOAF better than head-banging against a tightly shut door & better than putting all eggs in 1 basket. Not subject 2 “only rich states” objections, since S-P programs will benefit from huge savings/person, majority federal financing, & ability of states to join in aggregates.

8) The Vermont case was not about the failure of an S-P program; it was about the failure of a Governor to try such a program due to consultant’s likely bad advice & a Governor’s willingness to take it.

9) Birrion asks questions about S-P proposal in WA. I answer them in the attached slides

10) Birrion raises an objection posed by Fadhel Kaboub about the RTTB. The RTTB doesn’t apply in this case because States can deliver can both save money & deliver greater benefits than the present system thru S-P programs.

11) FOAF does not ignore the class struggle by advocating for both #NIMA & State-level S-P programs, because the class struggle exists at the local, state, national, supra-national & international levels of analysis.

12) Birrion claims that State-level universal health care programs are necessarily a distraction &/a compromise. I say that in the context of the FOAF strategy they are neither, but a mid-level strategy to be used in the grand strategy & on-going struggle 4 #NIMA #M4A

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